From farm to pharmacy we are under siege
- what are we going to do about it?

The Health Minister, Manto Tshabalala-Msimang, has already introduced the controversial pricing regulations for the pharmaceutical industry. Now she is taking dead aim at natural and complimentary medicines. If she gets her way natural medicines, vitamin supplements, energy drinks, breakfast cereals and even infant formulas will have to be registered as a pharmaceutical.

South African’s are already ten years behind Australia in our journey to embrace “organics”, and more than twenty years behind the USA and Europe. The natural and organic industry passed IT as the fastest growing market segment worldwide and we still do not have clarity from our government defining a clear organic market strategy.

Both of these issues really upset me. Not just the way the government is acting, but the passive diplomacy and non-action from the industry associations and business leaders who are affected. The first media reaction that we hear from pharmacists and other business leaders affected is that they are going to close up shop and immigrate to America or Australia. Please tell me that we South Africans are not this pathetic.

In 1979 I moved to Washington DC and worked as a trade promoter and lobbyist for the Italian, the Soviet Union, Hungarian, and Finish governments. Selling the Russians (then Soviets) to Ronald Reagan’s America was a challenge. What I learned from my 23 years in the USA was that there is no room for a timid or nice guy approach to contentious issues.

The American tobacco industry is facing a US$ 280 billion lawsuit from the US government. McDonalds, Coke and Pepsi are facing multi-billion dollar class action “fat-suits”, and Microsoft has been battling the US government in its anti-trust case for years – no one is packing up and moving to Australia. Guilty or innocent they stand their ground and fight tenaciously.

Let’s look at our local issues: first, the new pricing regulations for the pharmaceutical industry. The premise that drugs need to be affordable to all is a good one. Pick up any financial report from any major drug company and look at the profits they have made last year – it’s obscene, and they have been making those profits year after year. So why is the Minister of Heath picking on the weakest link – the pharmacist? Why not go after the drug producers?

If the dispensing fee of 16% capped at R16 for over the counter medicines and 26% capped at R26 for schedule 1 to 6 on prescription medicines is really going to close pharmacies then why aren’t they fighting this bad legislation with class action lawsuits? To go to court is very American, but it works. How long could the Ministry of Health fight 10 to 20 class action lawsuits? Look at the cost, and more importantly, look at the fact that fighting just one lawsuit is draining, time consuming and ties up your top management. I believe a concerted legal effort by the entire industry would result in a compromise that would suit all.

Regardless of the final results from this “mass-action”, the writing is on the wall: the days of traditional pharmacies are soon to be over. New business models will have to be found. In the US there are almost no stand-alone pharmacies left. Most drugs are dispensed through supermarket chains. All major food retailers have a dispensing pharmacy at the back or side of each store. These are convenient and must have a great cost advantage. Should our pharmacists be looking at this model? Won’t this bring the high cost of dispensing drugs into line?

The stand-alone pharmacy has the opportunity to make the transition to wellness centres. Advising, assisting and educating their customers on diet, supplements, natural and complimentary solutions so we will avoid getting ill in the first place.

That brings us to the natural medicine debate. Making a natural medicine or a vitamin supplement a pharmaceutical is moving the wrong direction. That will add a huge cost and make simple remedies unaffordable. Worse than that, it would put a large percentage of the industry out of business. Again America has already been through this debate. The Food & Drug Administration (FDA) had the same issues with the natural medicine industry that our own Minister of Health has.

Why? Some producers of natural remedies claim that their combination of grape seed and whatever cures everything, and you can lose weight, your hair will grow back, and your sexual powers will be enhanced. There is no clinical testing, no trials and we don’t even know what is actually in each pill – just what the producer tells us. That misleading information is equally wrong. The industry claims that only 3% of the industry falls into this category. That is hard to believe. The number of wild claimants is much higher than publicised.

The Americans reached a sensible compromise. If a producer wants to make a medical claim then those products must be regulated as a pharmaceutical. All other natural and complimentary medicines need to carry a disclaimer on the packaging and the container, which is similar to the cigarette - nicotine warnings. The standard wording that must appear on all non-pharmaceutically regulated products that has been agreed upon by the FDA for US companies reads: “These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.”

The FDA did not close down the natural medicine industry. It just regulated it. Ironically the sales of natural and complimentary medicines have increased – even with the FDA warning. It forced producers to communicate with their customers through exhibitions, conferences, specialised media and wellness directories. Vitamin C does not have to be a pharmaceutical to sell. Most people know the benefits.

So why here in South Africa did the natural and complimentary medicine producers not lobby effectively with the Minister of Health? There are international models to follow – why was it not proposed as a solution? The pharmacies and natural medicine producers were sure that nothing would happen. They had their tea and coffee in Pretoria, everyone smiled at each other, certain that they would not be affected. The powers that be said they had the ear of the Medicine Control Council – but they obviously did not. Now the industry is in crisis.

We ordinary South Africans deserve a lot better than this. Natural and complimentary medicines, remedies and supplements have been around for centuries. Are we going to sit and just accept that we might lose this key wellness component? Is the natural medicine industry going to put up a fight or are they all off to Australia.

Having moved countries myself there is one golden rule to follow. If you are not successful at home you will not be successful everywhere else you go. If you are a winner here – the world is your oyster. The problem is that I’m not seeing too many winners right now. So to all you industry leaders who are feeling gloomy about your future - stay at home and fight.

Finally, let me get one last thing off my chest. I am the organiser of the Natural & Organic Products Exhibition, which was launched very successfully this past June in the Sandton Convention Centre. Next year we will be in the Cape Town Intl Convention Centre 14 –16 October 2005.

Why is there no nationally recognised standard for organic producers? Why can’t the Department of Agriculture get its act together? We have 6 different certifying bodies. Some retailers have instituted their own, and in some cases even higher standards. There is so much confusion in the industry.

The other day Aubrey Parsons was on Noleen’s SABC 3 afternoon television show. He was saying that GMO’s were safer for us than organically produced crops. He went on to say the battery-fed chickens were also a lot safer for us than free-range chickens.

GMO wheat, soya, maize and other crops do have their place in today’s world. It allows crops to be grown in dry, hot climates. It also allows those same crops to be grown in regions with cooler climates that have a shorter growing season. Feeding people is important and I support that.

What no one tells you is that once a farmer turns to GMO production – he has to buy the seed every year and all the toxic chemicals / fertilizers that are required for the crop to grow. But then if a farmer is already addicted to toxic fertilizers – why not go the whole way and embrace GMO’s as well.

I personally will continue to eat my non-chemical organically produced veggies.

The free range chicken issue. Battery-fed chickens don’t get mud on their feet – because they don’t walk at all. They can hardly move. They are fed growth hormones and anti-virals everyday. Worse than that - the dead and diseased chickens are ground up with the feet and heads and other non-edible parts and mixed into feed for these battery-reared chickens. When did we decide it was okay for chickens to eat chickens? Where did Asian bird flu and mad cow disease come from? I’m sorry Mr Parsons, you can be defensive about South Africa’s food supply and you can avoid free-range chickens, organically grown fruit, vegetables and meat, it just leaves more for us – the true believers.

When I left South Africa in 1979 we were out of step with the entire world. Why are we doing this again? Then it was apartheid, now it’s regulations concerning natural health and organics. When will we learn?

This lone voice will not sit tight. What is happening to our pharmacists and natural and organic producers is not right. I did not come back to the third world to see it slide backwards. I want to see “mass action” – from farm to pharmacy. Let’s all join together, rid ourselves of the “small white self-serving rich elite” label and fight this.

Natural and complimentary medicines and eating chemically free foods is good for every South African. Even the Minister of Health agrees with this. Let’s get a group together that represents the entire spectrum – from farm to pharmacy and meet with both the Health and Agricultural Ministries – a two day workshop where we all look to explore positive options, really listen and understand each point of view and in the spirit of compromise, craft solutions that mirror those already achieved in the first world.

David Wolstenholme is the organiser and exhibition Director for the Natural & Organic Products Exhibition that will be held in Cape Town’s International Convention Centre from the 14 – 16 October 2005.