By Eric Brand

I recently had the pleasure of giving a lecture on granules in Paris that was organized by the well-known French author Philippe Sionneau. I was very impressed with the environment and the audience, and it was an honor to work with Philippe on his native soil. Many teachers and herbal experts attended the lecture, and we enjoyed some fantastic contributions from Philippe and Chris Dhaenens over the course of the lecture.

In many ways, observing the state of herbal medicine in France was one of the most fascinating aspects of the trip. I was born in France and my family always had a strong connection to France, but I’d never been there with an eye towards assessing the Chinese herbal situation before. Given the upcoming changes in European herbal regulations, I was quite keen to see what the situation looked like on the ground.

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Below are a few of my (highly subjective) observations about the herbal situation in France, with a bit of overlap from the surrounding areas in Western Europe. These observations are not in any way an authoritative assessment, simply the field notes of a TCM tourist. If any readers have more insight on the situation or corrections, please write in a comment so that we can all benefit from your knowledge and experience.

In general, many practitioners are not aware of the new herbal regulations in Europe, and there is a lot of uncertainty about the effects of the changes. In Western Europe, the majority of herbal prescriptions are routed through herbal companies rather than individual practitioners. However, while the companies are often well-informed about the upcoming regulatory changes, the individual practitioners that write the prescriptions often do not understand the complexities of the new laws. Everyone is hoping for the best but only a small number of practitioners are actively working to change the situation.

In an effort to rectify this and create a unified voice, Chris Dhaenens and others have created a group called Benefyt, which is actively involved in crafting solutions to the regulatory challenges. To donate to their cause or simply to learn more about it, click on this link. These people are working hard to preserve herbal access in Europe.

The hope is that the changes to the EU law can be modified so that they do not discriminate against traditional herbal systems such as TCM and Ayurveda, and many practitioners are holding out hope that the Chinese and Indian governments will intervene with economic pressure to turn the herbal issue into a free trade dispute. Alternatively, it is possible that the case could be won in court as a human rights issue (assuming that one can make the case that access to traditional forms of therapy is a basic human liberty in a multicultural society). Another possible long-term solution would entail the creation of harmonized professional standards in the Chinese medicine field in Europe. Basically this latter approach would aim to create a qualified group of people that are authorized to prescribe herbs, assuming that they meet the educational requirements and other aspects of licensure. While it would be a long-term solution, such a change would be slow to implement and would require increased consistency of training at European schools of Chinese medicine. Essentially the problem, no matter which way we look at it, is a problem of unity and cohesive representation.

Many European nations (France included) do not allow acupuncture to be legally practiced by non-MDs. Consequently, it is difficult to organize a strong unified voice for the profession. People practice underground and pay taxes on their acupuncture income, but technically the practice of acupuncture remains illegal for non-MDs and the risk of running an herbal pharmacy out of the office is an even greater risk than performing acupuncture illegally. Thus, very few practitioners stock their own herbal pharmacies in France, and nearly all prescriptions are filled by outside pharmacies/herbal companies that are located outside of France (for example, in Andorra, Switzerland, Holland, and Belgium). Paris has very few Chinese herbal pharmacies, and the one Chinatown-style shop that I visited had never even heard of the upcoming regulatory shift.

Sourcing herbs from another country poses an interesting solution to the herbal regulations. For example, Andorra is not an EU country, so they will likely continue to have access to herbs. However, will they be able to continue to freely ship these herbs to France? Will the shipments to non-EU countries continue to make it through customs, given that the final destination market is in large EU countries like France rather than tiny non-EU countries like Andorra? Will herbs become like acupuncture is in France now, illegal but widely accepted and largely tolerated? These are the questions that are difficult to answer. No one knows if the laws will simply be flouted or if the customs departments will take a hard line and prohibit their entry.

In a bit of positive news, I learned that some suppliers have successfully moved a few herbal formulas through the regulatory system (at great expense). The formulas I heard had 8 ingredients or more, which I previously thought was an insurmountable obstacle from the regulatory perspective. Perhaps there is hope, but for now there are more questions than answers.

One fascinating thing about Chinese herbs in France: Most practitioners have never seen the whole herbs (decocting pieces) themselves. They know what to prescribe for a case, but the paucity of Chinese herbal pharmacies within France and the lack of formal training in herb ID makes for an interesting situation- few people can perform a visual identification of the herbs themselves. (Of course, even though we are required to learn herb identification in U.S. schools, we still have lots of confusion in the market…)