The World Health Organization (WHO) recognises that nearly 80% of the world’s population is dependent on traditional medicine for primary health care. Herbal medicine constitutes a large part of what is practiced as traditional medicine around the world.
WHO has published guidelines for the assessment of herbal medicines in an attempt to help the ministries of health of all governments develop regulations that ensure medicines are labeled properly, and that consumers and practitioners are given proper directions for their use. Many doctors are revisiting herbal remedies in response to consumer interest.
The use of alternative medicines in the United States, particularly herbal products, increased dramatically during the last decade. In 2001 alone, Americans spent US$4.2 billion on herbs and other botanical remedies (Judith P. Kelly et al, 2005). Although this issue now receives considerable attention in the medical and lay press, few details about the frequency and nature of use of herbal and other natural products (herein referred to as dietary supplements) have been published.
In addition, herbal alternatives are increasingly being used to control soaring healthcare costs. Although we may think that our pharmaceutically-based medical practices are the norm for the world, this is not true. In fact, 80% of the world’s population relies on herbal remedies because they cannot afford Western drugs.
Even in many wealthy nations, herbal remedies are being re-integrated into mainstream medicine. Traditionally, botanists define an herb as any plant that dies down to the ground each winter.
According to Malaysian Standard MS 1860:2005 , herbal medicine include herbs, herbal materials, herbal preparations and finished herbal products that contain active ingredients, parts of plants, or other plant materials, or acombination thereof. Herbal products consist of herbal preparations made by one or more herbs, in any dosage forms.
A concentrated form of the herbal preparation obtained by processing the crude herb with an appropriate solvent, by maceration, fractionation, infusion, supercritical fluid extraction, or any other means of extraction is known as herbal extract according to the Malaysian Standard as stated earlier.
A survey on the awareness of herbal medicine among consumers was conducted in Kuala Lumpur, Selangor, and some parts of Ipoh. Based on the survey, out of 110 respondents who have tried herbal medicine, seven of them said that they have experienced side effects such as dry skin, acne, hair loss and stomach pain. About 37% of them who had side effects said that it could be due to the active ingredients in the product, followed by insufficient information on the product, and the user’s negligence. The respondents were asked on the importance of labeling in herbal product and why consumers do not read the labels on the product.
About 37 % of the respondents said that the label wording was too small and crowded and 3% of them said that they bought imported products which have their description in a foreign language that they do not understand. Consumers said that the most important aspect that needs to be modified in the labeling of herbal product is to have easy-to-understand description (32%), bigger font size (27%), detailed usage instructions (14%) and indication of side effects (13&).
Other important aspects highlighted were an advisory when using herbal products (12%) and an ccurate indication of the ingredients in the bottle or package 11%). When it comes to awareness, many of the consumers are still not aware on what are the mandatory requirements when it comes to the labeling of herbal medicines/ products and where can they make a complaint or enquiry.
For respondents who did not try herbal medicine, 33% of them said they do not think herbal medicine is effective , 28% said that they are afraid of the side effects and the rest said they prefer only products recommended by their doctors. About 54% of the respondents are interested in getting more information about herbal products and herbal medicine while 32% are not interested at all and the rest of the respondents are not sure.
Overall, the consumers were interested in herbal products related to supplement (36%), followed by cosmetics (29%), medication (12%) and food (11%) and the rest did not choose anything.
The Malaysian Association of Standards Users (Standards Users) is aware that more and more consumers are interested in herbal and natural products. This could be due to a new evolution of products that are available in the market and at a cheaper rate. Some products are also highly marketed by pharmaceutical companies. However, Standards Users wish to highlight a few issues pertaining to herbal medicine and herbal products.
Labeling is very important in consumer goods and services. Medicine and health related products are highly regulated in Malaysia by the Ministry of Health. But, some over- the -counter products are available to consumers and they can purchase them without prior consent from doctors or pharmacists. This is something worrying.
Some of the herbal medicine, as mentioned earlier, contains active ingredients which can cause serious side effects to consumers when used. It is important that consumers go through an authorised personnel, in this case a doctor or pharmacist, to purchasing them. This way, the consumer can be advised accordingly and based on his/ her condition. Even if the product does not need to be a controlled item, proper labeling should be in place.
From the survey, it showed that consumers at times not able to read the labels due to the small font and improper printing. And in case if the product is imported, it has to have a mandatory labeling in Bahasa Malaysia or English. But some of the consumers have said that there are products that have labels in foreign languages. This shows that there is either a lack of control mechanism on the entry of such goods into the country or there is a weak monitoring system in the market by regulators to prevent such products from being marketed to consumers in Malaysia.
Based on the above, once again Standards Users would like to urge the enforcement unit regulators and policymakers to pay close attention to the issues mentioned about herbal medicine and herbal products. There should be mandatory safety standards on labeling and improvement in labeling aspects.
If there is strong regulation on this matter, it will surely help the consumer to consume safer herbal products and medicine and standards can also help industries that are keen on herbal products to have better guidelines to ensure quality, safety and efficacy when catering to consumers.
The writer is attached to the Malaysian Association of Standards Users.