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Natural Health Products: Research Priority Setting Conference - Health Canada Health Protection Branch - November 6-8, 1999

November 6-8, 1999

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Natural Health Products: Research Priority Setting Conference - Health Canada Health Protection Branch - November 6-8, 1999 (Portable Document Format - 223 Kilobytes)(PDF Version - 223 K)

Contact: Policy Bureau Enquiries

Table of Contents

Executive Summary

The goal of the conference was to provide Health Canada with a broad perspective on the critical needs in Natural Health Products (NHPs) research over the next 3-5 years and to recommend a strategy for Health Canada to support a sustainable NHP research endeavor across Canada. Participants at the conference were invited specifically to provide input from a variety of stakeholders groups including government, industry, scientists, the community and both traditional and complementary practitioners.

The conference took the form of preliminary information sessions provided by invited speakers chosen to represent the perspectives of the various stakeholders. Two recognized experts from outside of Canada were invited to speak to the manner in which NHP research is being pursued in other countries. After the information sessions the participants broke up into small groups and discussed, with the aid of facilitators, four questions which related to the critical research challenges and the manner in which funding research in this area should be approached by government. After the small group sessions a final consensus discussion was held.

To briefly summarize the findings of the conference it was clear, both from the reports from the small groups and from the larger discussion, that the role of Health Canada should be to provide seed money to facilitate the formation of a research network that would engage in relevant research in NHPs across the country. Such a research network should lead to the formation of a "Virtual Institute" within the framework of the Canadian Institutes of Health Research (CIHR) program which will come into place April 1, 2000.

Further to this, three major research areas emerged as critical. One was the creation of a credible database of existing knowledge in this area that has been subject to expert analysis. Another was research in the area of risk/benefit analysis. This area would include safety and efficacy studies at both pre-clinical and clinical levels. The third critical area was research into standardization of NHPs.

Based on the conference discussions three recommendations could be made:

  1. That Health Canada immediately work with active researchers in the field to develop a strategy for achieving a CIHR Institute for NHP research.
  2. That the research supported by Health Canada be of a seed nature, that it give priority to cross-cutting research across disciplines, that it be delivered within a framework of a NHP research network and, finally, that the research supported be relevant to industry and health care practitioners.
  3. That initial research supported relate to the creation of a credible database and to research into the safety, efficacy and standardization of existing NHPs.

Introduction

The use of Natural Health Products (NHPs) in Canada has expanded exponentially over the last decade. The result of this rapid expansion is that the market for NHPs has outpaced both research in this area and the regulatory framework of Health Canada. To deal with this situation the Office of Natural Health Products (ONHP) was created by the Minister of Health, Allan Rock. Within the next few months the regulatory framework for NHP regulation will be devised by ONHP. However, there is currently insufficient pre-clinical and clinical research to provide support for this framework. This was recognized by Minister Rock in his decision to award seed funding targeted specifically to NHP research. The purpose of this conference was to identify immediate and long term NHP research needs to aid government in making appropriate decisions regarding this, and future, NHP specific research funding. Since it is unlikely that Health Canada will have the resources to fully fund the required research, a reasonable strategy to work with researchers to develop sustainable, multidisciplinary, externally funded, relevant research in this area across Canada is required.

This report reflects the deliberations of over 65 individuals with diverse expertise and experience. Individuals were chosen from government, the scientific community, industry and community organizations based on their interest and experience in the arena of natural health products. The contributing group varied from a NHPs specialist at a small local health food store, to a government scientist working on NHP/drug interactions, to the president of a multimillion dollar NHP corporation. The meeting was jointly organized by Sharon Chard of Health Canada and a local organizing team at Dalhousie University consisting of Drs. Tim Lee, Tannis Jurgens and Frank Chandler.

The format of the meeting was designed to enable all stakeholders an equal opportunity to contribute their ideas and opinions, based on a significant knowledge base. Thus the meeting began with plenary talks from experts in the various sectors, followed by in-depth discussions of specific questions in workshop groups and then a facilitated consensus meeting of all of the participants.

To reiterate, the goal of the conference was to identify the short term and long term research concerns in the area of NHPs. A goal of equal importance was to suggest a reasonable strategy for Health Canada to address these goals. As described below, the participants were asked to address what the overall role of government should be in supporting research in this area and also to suggest specific short term goals that government should consider.

The four questions to be specifically addressed at this meeting were:

  1. What are the critical scientific challenges to be addressed in the area of natural health products?
  2. What should the role of the various sectors be in fostering research in this area?
  3. How should limited government funding be distributed to facilitate these research endeavors?
  4. Rank, in order of priority, the five key research areas to be addressed over the next 3-5 years. How should Health Canada facilitate the development of sustainable research in these areas over the next year?

It was expected that some of the groups would not be able to rank the priorities, and that some may come up with more than 5, but that common themes would run through the groups with respect to what is most important in the short and long term.

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Format of the Meeting

To ensure that all sectors were provided with a reasonable perspective, the first morning of the conference consisted of a series of information talks given by members of the various stakeholder sectors. Speakers were selected specifically to provide the unique perspectives of government, industry, university researchers and the community. International research input was provided by Dr. Alice Clark, Director of the National Center for Natural Products Research in Mississippi, who led off the talks with an exceptional review of her Center and the manner in which government, academia and industry are working synergistically to tackle research in NHPs in the United States. An international government funding perspective was provided by Beth Clay from the US government (Appendix I - Presentations).

Following the talks the participants broke up into eight workshop groups, each with a facilitator provided by Health Canada. The composition of the groups was carefully selected by the organizing team to balance the input from the various sectors in each of the groups and take into consideration the relative strengths of the individuals in the groups. The facilitators were given specific instructions to draw out opinions from group members who were less forthcoming than others. In each of these groups one individual was assigned to be a scribe and take down the essential points under discussion and to record the answers to the various questions.

The next morning all of the scribes presented the results of their groups deliberations to plenary. A facilitator provided by Health Canada recorded salient points based on the information provided and attempted to identify recurring themes. During the break that followed, the facilitator, with the help of Dr. Lee, constructed summary sheets based on the recurring themes. Following the short break the participants reassembled to try to arrive at a consensus based on these summary sheets of recurring themes.

For the sake of completeness, a transcription of all of the scribes summary overheads (in places filled out by the scribes notes) has been included (Appendices A-E). Every effort was made to cross check the scribes reports against the written notes of the scribes in the group settings for fidelity.

Part 1: Specific Challenges in NHP Research

In this section the participants were asked to address the most important challenges facing NHP research. Specific research concerns are reflected in the summary list that follows but more general concerns regarding barriers to NHP research in Canada were raised at this meeting. A number of recurrent themes occurred in all of the groups and they reflect the fact that there is a perceived negative bias towards NHP research in the scientific and medical community. This results in a "catch 22" situation where data to support NHP claims of efficacy are not forthcoming because of lack of funds for research. However, research funds cannot be obtained in the current competitive grant environment unless data are available to give credibility to the NHP area as a whole. Credibility in the minds of scientists and clinicians remains a major barrier to NHP research. This
situation limits the ability of NHP research to attract new researchers and to attract cross-over research from investigators in other fields. This is of critical importance to Health Canada since a research infrastructure of committed, trained researchers across the country is a prerequisite to active research in any area.

At the present time there are few NHP researchers with peer reviewed funding and this problem must be rectified before a vibrant, sustainable NHP research endeavor can be mounted in Canada. Health Canada's challenge will be to support this endeavor in its early stages without disregarding the importance of peer review.

A second barrier to NHP research that emerged from discussions within the groups and in the general discussion was the problem of intellectual property and proprietary rights including those of the First Nations. Since most NHPs are not patentable, there is reluctance on the part of industry to commit large amounts of funds to research in this area. This is in contrast to the pharmaceutical industry where proprietary protection is available for discoveries and thus large amounts of funds are expended both "in house" and in academic settings.

A third barrier to NHP research, especially in the clinical setting, is the fact that NHPs are used in a more heterogeneous fashion than prescription drugs. A variety of health care providers and situations are involved in the use of NHPs and there is a large component of self-treatment evident in this area. This presents a specific barrier to traditional clinical trials. This is especially evident in settings where NHPs are used as only one part of multiple therapy regimens such as in First Nations healing practices.

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The following is a summary list* of the Scientific Challenges developed from the scribes reports:

  1. Lack of sufficient infrastructure and seed research funding for successful funding approaches to conventional funding agencies.
  2. Lack of access to research information with sufficiently credible analysis to be of use in the research setting.
  3. Lack of product standardization and standardization of source material.
  4. Lack of information about active ingredients.
  5. Lack of information about NHP/drug and NHP/NHP interactions.
  6. Lack of standard methodologies for bio-assay of activities of NHPs.
  7. Lack of support for clinical trials.
  8. Lack of research relevant to clinical practice.
  9. Lack of support for research into new NHPs.
  10. Lack of guidelines for intellectual property and freedom to operate.
  11. Lack of information regarding safety and efficacy.
  12. Lack of appropriate information on risk/benefit assessment.
  13. Lack of quality control standards.
  14. Inability to standardize to active ingredients and lack of alternate surrogate markers for standardization.
  15. Lack of knowledge about the relationship between the context of NHP delivery to efficacy.
  16. Lack of an integrative approach to NHP research which would include government, universities, industry and practitioners.
  17. Lack of epidemiological information about NHP activities in populations and specific ethnic groups.
  18. Negative bias on behalf of the scientific community with respect to the efficacy of NHPs and the importance of NHP research.
  19. Lack of acceptance of NHP efficacy and safety by mainstream physicians.
  20. Lack of incentives for industry based NHP research given the current situation regarding proprietary rights.

* The complete list, a composite of the reports of all 8 groups, can be found in Appendix A.

Part 2: Roles of the Various Sectors

In this section the participants were asked to outline what the roles of the various sectors were in the advancement of research in NHPs. Although the sectors were not specifically identified for the groups, the information talks referred a number of times to government, industry and academia. During final instructions to the participants before breaking out into groups, Dr. Lee specifically reminded participants to include in this context the role of the health care provider. As expected, these four sectors were the ones concentrated on by the groups. However, one sector emerged which, in hindsight, was an important oversight in the earlier discussions and that was the consumer.

There was remarkable consensus on the roles the various sectors should play in the advancement of NHP research. In general, the groups all agreed that the role of government is to provide seed money for the development of NHP research initiatives and to foster the development of NHP collaborative research interactions. It was also agreed that the government could help foster the NHP research agenda by providing incentives to the various sectors to stimulate interest in this area.

It was generally held that industry should be funding research both directly and indirectly. There was support for the suggestion that, because of the lingering issues regarding proprietary rights to NHPs, direct research support should be "in house" and that research support in academia should be indirect, such as the provision of funds for research trainee programs and/or Professorships in NHP research.

It was generally agreed that the core of any national research program is in the university setting. This is well demonstrated by the research activities supported by the pharmaceutical industry. Thus the role of academia was primarily to engage in relevant, arms-length research. Further, since any credible multidisciplinary national research initiative would have to be university based it is incumbent on the university based researchers to facilitate the development of such an initiative. A second, but no less important role of academia is to actively engage in the education of the next generation of researchers and research-oriented health care providers.

The health care provider was seen to have a role in both education and active research. The education relates both to educating the public about the importance of NHP research but also acting as a source of information regarding relevant areas of research for the other sectors. In active research the health care provider could be involved in the contributing to both clinical trial research and information gathering and analysis research.

The final sector considered was the consumer. It was generally held that the consumer had an important role in stimulating NHP research. That role included providing strong support to the area of NHP research by expressing their opinions in a variety of forums. The consumer will be an effective foil to the bias held by the scientific and traditional medical community regarding NHPs. In the short term this could be best expressed by lobbying private foundations, which represent individuals where NHP use is high, to earmark special funds for NHP research. Example foundations would be those related to arthritis and cancer. The other major contribution that consumers can make is by effectively keeping the ongoing research on a relevant track by identifying needs, monitoring research endeavors and becoming actively engaged in clinical trial research.

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The following is a summary list* of the Roles of the Various Sectors
developed from the scribes reports:

Government:

  1. Develop the infrastructure for a coordinated effort to obtain long term sustainable funding for NHP research from existing and novel sources.
  2. Enable the creation of a credible database and implementation of appropriate information management in an international context.
  3. Provide incentives for the various stakeholders (including academia, practitioners and industry) to become engaged in NHP research.
  4. Facilitate the co-operation of Federal and Provincial agencies for the support of research in the area of NHPs.
  5. Provide sufficient seed funding for the development of multidisciplinary research teams across Canada. This would require sustained "A based" funding.

Industry:

  1. Contribute to the knowledge base by performing research in house and communicating, where possible, the important findings to the research community.
  2. Help build research capacity in the academic setting by supporting personnel programs.
  3. Instigate collaborative interactions with the other research sectors for relevant research.
  4. Collaborate with national Associations to provide credibility in the area of NHPs in the eyes of consumers.

Academia:

  1. Perform arms-length research in an academic setting.
  2. Facilitate the development of multidisciplinary research teams and collaborative interactions with government and industry.
  3. Provide new directions for research in NHPs.
  4. Educate the next generation of researchers and research oriented practitioners.
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Practitioner:

  1. Help identify priority needs for research.
  2. Participate in research endeavors with academia and industry.
  3. Enable the future practical application of current research.
  4. Engage in consumer education regarding current NHP research.
  5. Engage in practitioner-oriented research endeavors such as the publication of case reports and the collection of data for appropriate documentation of NHP activity.

Consumer:

  1. Help identify research priorities and gaps in knowledge.
  2. Lobby various organizations to establish a reasonable funding level for NHP research. In particular, lobby private foundations to establish funding for NHP research as a priority.
  3. Act as a watchdog to ensure research accountability.
  4. Co-operate with health care providers to report the effects of NHPs.
  5. Where possible, participate in ongoing clinical NHP research.

* The complete list, a composite of the reports of all 8 groups, can be found in Appendix B.

Part 3: How Should Limited Government Funding be Spent?

There was general agreement that Health Canada, and other levels of government (such as Agriculture Canada) could best contribute to NHP research by facilitating an infrastructure that would lead to the development of sustainable centers of NHP research across Canada. Government can take a lead role on working with academia and industry to develop a plan to take advantage of existing resources and to leverage those resources to facilitate the development of cross cutting multidisciplinary groups. Advantage should be taken of the substantial human resources already available in Health Canada and Agriculture Canada. An example would be the government scientists who are already engaged in research in this area. Government could enhance the research of such scientists and facilitate their successful integration into the larger Canadian research community by making NHP research a priority within government.

The following is a summary list* of How Limited Government Funding
Should be Spent developed from the scribes reports:

  1. Facilitate an infrastructure that will result in long term sustainable research in the area of NHPs.
  2. Provide incentives to enhance research in academia and industry.
  3. Make NHP research a priority issue within government.

* The complete list, a composite of the reports of all 8 groups, can be found in Appendix C.

Part 4: The Priorities

This section deals with the research priorities in the long and short term. The discussion regarding priorities was, as expected, the most animated. It is thus important to give significant weight to the fruits of the workshop groups since in this forum balanced input from a variety of stakeholders in an open and relaxed forum was obtained. The results of these workshop group discussions are best seen in the listing of the answers to question 4 by the scribes of the eight groups (Appendix D).

On examination of these scribes reports it is clear that some areas that were given significant emphasis in the scribes reports, such as drug/NHP interactions, do not appear to have the same emphasis in the plenary summary list. There are also some areas, such as the development of new methodologies, which have more emphasis than one would expect from the scribes reports of the group discussions. This may reflect a true change in emphasis brought about during the larger discussion or it may reflect an apparent change in emphasis. One of the drawbacks of the larger discussion format is that it is difficult for everyone to input during the allocated time.

The initial section of this part of the report relates the framing discussion that was engaged in by the facilitator at the beginning of the large format discussion. It was thought that some framing principles should be clarified to ensure that the discussion remained on focus and that everyone had an understanding of the situation in which we are operating.

The following framing principles were discussed:

  1. There must be a distinction between support of NHP research and research in the broader area of Complementary and Alternative Medicine (CAM). The priority for this conference was to provide information on research needs in NHP research. However, it should be recognized that NHP usage often overlaps with CAM practice.
  2. It should be recognized that the NHP specific, Health Canada research funds are best seen as "seed" money for the creation of a sustainable NHP research endeavor funded by more conventional means (such as private Foundations and national granting agencies). Therefore, it is important to consider the context in which all funds are released with the idea that these funds should fit into the larger context of sustainable research endeavors in Canada.
  3. Some infrastructure must be build to facilitate the best distribution of funds to credible researchers involved in relevant projects likely to lead to sustainable NHP research.
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The following is a summary list of the Five Priorities as developed during the large format discussion:

  1. * Database: Create a credible and complete database which will allow assessment of knowledge to date. This database would not simply be a listing of available data but an analysis of the data to sift the "wheat from the chaff". Analysis by credible researchers will be critical to the usefulness of this database. Databases which do not include this analysis are already in existence and should not be replicated.
  2. * Risk/Benefit research: This area would include basic, pre-clinical animal studies, clinical studies and long term followup research. It would include research in safety, efficacy and mechanism of action of NHPs. Safety issues would include such areas as toxicity and drug /NHP interactions. Efficacy would include in vitro research, animal research and clinical research.
  3. * QC and standardization: This area would include research which would aid in the development of quality control methodologies and the development of standards. The latter area would overlap, in some respects, with the efficacy research in that standardization to active ingredients or some surrogate marker of activity would be preferable.
  4. Health Economics: This research would encompass both traditional health economics and research into consumer usage. This will enable government and the research community to more closely track trends in NHP usage and its overall contribution to the health care system in Canada. This will be important for both the study of drug/NHP interactions and will allow convincing arguments to be made regarding the economic, social and health care importance of NHPs to Canadians.
  5. Development of new assessment methodologies: This area of research would address the issue of the context in which NHPs are often used. This context does not easily accommodate placebo controlled double blinded clinical trials. Other investigative modalities will have to be used to provide credible data to support efficacy. Some of these already exist but others may have to be developed.

* These three priorities come up repeatedly in the scribes reports of the discussions of the various groups (see Appendix D).

Part 5. How Should Health Canada Proceed

This section deals with what the immediate priorities are for Health Canada to achieve an advancement of NHP research in Canada. The major recurrent theme was that of Health Canada being a facilitator and engaging immediately in an effort to foster research collaborations across the country with the goal of setting up sustainable research centers. The creation of a single National Institute (such as the one in Mississippi) was mentioned but by far the most support was for the formation of a "Virtual Institute" of NHP research through a successful application to the Canadian Institutes of Health Research (CIHR) which will become active in April 2000. Clearly infrastructure support and seed money would be required to bring such an initiative to fruition. Given that the CIHR program will be an ongoing program with Virtual Institutes set up over the next few years, Health Canada, and other government agencies, have the opportunity to support the creation of an NHP Research Network across the country that would lead to a successful CIHR application in NHPs.

The second issue that received significant support was the generation of a credible database to support NHP research and practice. Many databases currently exist but they do not provide expert analysis of the collected data. This could be constructed as a government initiative, a government contract or as one pillar of a CIHR Institute in NHPs. What is important about the database is that ongoing funds must be available to support it since the area of NHP research is rapidly changing and a credible database must be updated regularly. Thus, the database must be linked to some sustainable funding source.

The following is a summary* list of the Immediate Priorities for Health Canada as developed from the scribes reports:

  1. Enable the creation of a credible database that reflects a thorough analysis of available literature by researchers expert in the particular field.
  2. Foster the creation of an interdisciplinary research endeavor across Canada such as a CIHR in Natural Health Products Research. This could be accomplished by sponsoring network-ing conferences for active NHP researchers.
  3. Develop, in consultation with active NHP researchers, a strategic plan to accomplish #2 above.

* The complete list, a composite of the reports of all 8 groups, can be found in Appendix E.

Summary

The conference went extremely well and was able to achieve its mandate. The quality of the expert information talks was excellent and many of the participants commented on the advantage of having these preparatory talks. The participants also appreciated the facilitated workshop groups since it gave many people the opportunity to contribute their opinions in a small group, non-threatening, situation. The final, open session was somewhat controversial at the point of discussion of research priorities. It is therefore important to closely examine the results of the small group meetings with respect to the research priorities (as reported in Appendix D) and give them equal weight as the fruits of the larger discussion about the five priorities.

There was unanimous agreement that there is a need for relevant, multidisciplinary research in a variety of fields and research settings across Canada. It was clear, however, that current NHP research in Canada is limited by the availability of funding by peer reviewed agencies. This very lack of research presents a credibility problem that is difficult to overcome in the current competitive funding environment. Thus, it was generally agreed that the Health Canada mandate should be to provide seed funding for research so that more traditional, and newer, funding sources could be successfully approached by NHP researchers.

Recommendations

Based on the outcomes of the discussions, the following recommendations could be developed:

  1. Health Canada should immediately work with active researchers in the field and support a strategy for achieving a CIHR Institute for Natural Health Products Research. A CIHR in NHP research is a viable option since there is already acceptance of NHP research in some quarters. Moreover, NHPs lend themselves most easily to rigorous scientific examination. In addition, there are a number, albeit low, of credible scientists in Canada already working in NHP research and a significant interest on the part of industry and government to advance research in this area. A focussed, credible, research based CIHR application for NHP research could be successful within the next 3-5 years.
  2. That the research support by Health Canada be of a seed nature, that it give priority to cross-cutting research across disciplines, that it be delivered within a framework of a NHP research network and, finally, that the research supported be relevant to industry and clinical practice. Any research network will need to include representatives from government, industry, academia and clinical practice. Cross-cutting research across disciplines and among stakeholder groups would be a priority.
  3. That initial research supported relate to the creation of a credible database and to research into the safety, efficacy and standardization of existing NHPs. There is particular concern about the lack of information which has undergone credible analysis, the lack of standards in the marketplace, the lack of current ability to standardize to efficacy or surrogate markers and the growing evidence of potentially serious interactions of common NHPs with prescription and non-prescription drugs.

Appendix A - Breakout Group Answers to Question 1 from the Scribes Reports

What are the critical scientific challenges to be addressed in the area of natural health products?

Group 1.

  1. Infrastructure development
    • access to critically appraised relevant research info
    • communication of information in databases
    • human resources capacity (support existing initiatives at Universities)
  2. Development of methodology for identity and quality testing of sources of NHP
    • QC driven protocols for plant authentication and product standardization
    • methods validation
  3. Development of methodology for bio-assay of NHPs
    • standardized and validated protocols
  4. Lack of adequate support for clinical trials
  5. Foster research relevant to clinical practice
  6. R+D for new NHP discovery
  7. Development of partnerships
    • academics, practitioners, industry
  8. Lack of guidelines for intellectual property and freedom to operate
  9. Understanding role of practice in pattern of use of NHP
    • who is taking what in which manner
    • behavioral patterns and implications
    • research into the development of practice guidelines

Group 2.

  1. Define and develop Canadian quality standards
  2. Risk assessment and benefit ratio
  3. Integrative approach
  4. Level of information
  5. Delivery systems research
  6. Environmental risk assessment
  7. Intellectual property
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Group 3.

  1. Lack of expertise and resources
  2. Standards of evidence related to specific disease states
  3. Ethnoepidemiology and issues of clinical relevance
  4. Need for standardized extracts allowing for reproducible products, aiding clinical evaluation, pharmacokinetics and determining mechanism of action
  5. Address users needs6. Address areas specifically pertaining to safety and efficacy

Group 4.

  1. Global database not established
    • avoid research duplication
    • should include efficacy, safety, GMP
  2. Active ingredients not identified
    • marker compounds
    • standardized extract vs. whole organism
  3. Hard to establish efficacy
  4. Test methods vary
  5. Cultural considerations in a broad sense
  6. Drug/product interactions not known
  7. NHPs are not proprietary
  8. Information on NHPs is in its infancy in Canada
  9. Profiles on safety/toxicity not established fully
  10. Limited scientific research capacity
  11. Bias exists - limitation by scientific assumption
  12. Need to focus on current products as well as new products

Group 5.

  1. Canadian - global context; resources; consumers; cultures; regulation
  2. Multidisciplinary nature
  3. Communication
  4. Study of efficacy, safety, quality - innovation
  5. Research incentives - academic, government, industry
  6. Current information - obtain, assess; systematic approach
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Group 6.

  1. Identify gaps/problems perceived by consumers in quality and usage of NHPs
  2. Define what products are NHPs (herbals, vitamin C, etc.)
  3. Establish/agree on criteria for determining quality, efficacy and safety of NHPs
  4. Address quality of NHPs
    • identify actives
    • methodology development to authenticate NHP
    • method must be applicable to industry
  5. Work toward complete monographs on NHPs
  6. Clinical trials need to be more inclusive of different populations
  7. To facilitate collaborations
  8. Develop library of "actives" in NHPs (i.e. National Reference Collection)

Group 7.

  1. Product - consistency, complexity, availability, sheer numbers
  2. Methods - validate new approaches; third category; funding decisions
  3. Capacity - interdisciplinary; access to expertise
  4. Regulatory - jurisdictional barriers

  5. Resistance - bias; lack of knowledge
  6. Incentives - non-proprietary; liability; lack of funding
  7. Dissemination - product to practice

Group 8.

  1. Funding
  2. Need to characterize/standardize material
  3. Decision on focus - what research; what products
  4. Choosing appropriate methodology
  5. Capacity of expertise
  6. Ownership of intellectual property
  7. NHPs in larger utilization context
  8. Engaging the mainstream health system

Appendix B - Breakout Group Answers to Question 2 from the Scribes Reports

What should the role of the various sectors be in fostering research in this area?

Group 1.

Government:

  1. Leading role
  2. Initial $
  3. Interactive with industry

Industry:

  1. Self-directed research of direct benefits
  2. Build up research capacity (e.g. personnel programs) which brings credibility to industry and long term benefits

Academia:

  1. Provide infrastructure support for personnel
  2. Coordination role

Private:

  1. Fund ongoing research with specific objectives relevant to various foundations and directly applicable to patients
  2. Call for increased research funding for NHP

Group 2.

Government:

  1. Actively foster an integrative approach by funding conferences
  2. Foster the development of a CIHR in NHPs or similar body
  3. Build infrastructure
  4. Facilitate the creation of a credible database

Industry:

  1. Funding academic study and research
  2. Inter-lab methods evaluation
  3. Sharing information
  4. Foster research in the agridevelopment of botanicals, environmental risk assessment and bio-piracy

Academia:

  1. Independent evaluation of efficacy and mechanism of action
  2. Increase emphasis on ethno-botanical education
  3. Develop the science behind the evaluation of products (e.g. authenticity and toxicology)
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Practitioners:

  1. Identify research priorities
  2. Participate in research
  3. Develop practice based research networks
  4. Publish case studies
  5. Interact with academia and industry
  6. Develop standardized record keeping to validate and support database

Consumer:

  1. Identify research priorities
  2. Become active participants in the research process at all levels
  3. Fund-raising and raising public support

Group 3.

  1. Need to work together more important than individual roles
  2. True interdisciplinary approach
    • academic/industry
    • academia/practitioner
    • academia/government

Group 4.

Government:

  1. Funding
  2. Coordination
    • act as repository
    • sponsor international forums
    • avoid duplication
  3. Education
  4. Assessment of health outcomes
  5. Provide incentives
    • tax
    • physician incentives to consider CAMs
    • reimbursement
    • regulatory incentives

Industry:

  1. Manufacturers
    • educate retailers, professionals, consumers
    • R&D new products
    • ensure quality
  2. Retailers
    • education of consumers
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Academia:

  1. New models for research
  2. Provide appropriate pool of expertise
  3. Provide objectivity ("arms length")
  4. Provide linkages between government, industry, consumers
  5. Run trials

Consumer:

  1. Lobbying government
  2. Demanding research, scientific data, outcomes
  3. Proactive participation in their own health care
  4. Watchdog role

Practitioners:

  1. Need to have awareness of research
  2. Respect diversity ("open mind")
  3. Participate in research
  4. Education of patients

Non Governmental Organizations:

  1. Funding
  2. Advocacy

Group 5.

Government:

  1. Safety and efficacy standards
  2. Provide $$ dedicated funding
  3. Provide suitable review mechanisms
  4. Create incentives (e.g. matching programs)
  5. Invest in training (academia and industry)

Industry:

  1. Identify needs
  2. Market information
  3. Research partnerships (including $)

Academia:

  1. Training
  2. Research
  3. Removing barriers to practitioner participation
  4. Program development for research in CAM Institute

Public:

  1. Lobby for safety, efficacy, recognition, availability, quality, research needs
  2. Public includes - consumer organizations; advocacy groups; media

Practitioners:

  1. Identify needs
  2. Patient recruitment
  3. Time for research
  4. Participation on research teams
  5. Lobby for professional development
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Group 6.

Government:

  1. Administration:
    • provide funds
    • provide forums to identify priorities of stakeholders
    • remove "Schedule A"
    • remove barriers to allow NHP research to be conducted
    • NHPs addressed should not just be "fad" NHPs
    • harmonize stakeholders
  2. Research:
    • demonstrate value of NHP research to public
    • educate public
    • facilitate collaborations
    • get input from stakeholders as to needs

Industry:

  1. Corporate:
    • funding
    • in-kind partnerships
    • corporate commitment
  2. Research:
    • interact with academic researchers
    • utilize basic research developed by academic researchers
    • communicate needs to academic researchers

Academia:

  1. Idea source
  2. Education of the next generation
  3. Capacity building (i.e. develop expertise)

Consumers & Community:

  1. Give feedback, complaints to other sectors
  2. Identify gaps in education and research
  3. Give feedback on applicability and relevance of NHP research

Funding Agencies:

  1. Provide and build good peer review capacity
  2. Provide incentives to foster interdisciplinary teams in NHP
  3. Recognize that NHP research needs to be conducted
  4. Address programmatic priorities
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Group 7.

Manufacturers:

  1. Identify gaps and set priorities
  2. Fund and conduct research (and share results)
  3. Provide product
  4. Lend expertise
  5. Be open and transparent

Researchers:

  1. Work collaboratively (across disciplines, countries)
  2. Listen to stakeholders
  3. Set priorities
  4. Synthesize, conduct and communicate research
  5. Develop innovative methodology
  6. Train

Practitioners:

  1. Steer priorities
  2. Ensure and evaluate safety and effectiveness
  3. Convey consumer feedback

Consumers:

  1. Lobby and define agenda
  2. Describe needs
  3. Report benefits and adverse events
  4. Participate
  5. Monitor research production

Group 8.

Government:

  1. Source of adequate funding
  2. Source of expertise
  3. Foster an environment/context for NHP research
    • create incentives
    • research collaboration criteria
    • identify the type of science to take place
    • set rules/parameters and incentives
  4. Information provider (e.g. Canadian Health Network)
  5. Federal and Provincial have some unique and some shared responsibilities
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Industry:

  1. Collaborate on existing compounds
  2. Industry more than distributors and retailers
  3. International collaboration
  4. Global context

Other Stakeholders with Roles:

  1. Consumers
  2. Research Institutions
  3. Media
  4. Educational Institutions
  5. National Voluntary Associations
  6. National Professional Associations
  7. International Organizations
  8. Practitioners

Appendix C - Breakout Group Answers to Question 3 from the Scribes Reports

How should limited government funding be distributed to facilitate these research endeavors?

Group 1.

No report

Group 2.

  1. Leverage more funding through government, foundations and industry
  2. Add NHP arm to other research (CIHR)
  3. International collaboration on research database
  4. Education
  5. Infrastructure and capacity building
  6. Focusing where there is most need
  7. Facilitate a Virtual Institute in CIHR for NHPs

Group 3.

  1. Identify long and short term priorities
  2. Need for a common focus through which stakeholders could be brought together to investigate the big picture
  3. Focus can act as resource for facilitating funding
  4. Importance of leverage funding
  5. "Clean up" existing information as relates to safety, efficacy, dosage
  6. Direct funding for training of post-docs, fellowships, education
  7. Partnerships between industry and academia

Group 4.

No report

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Group 5.

  1. Be effective as seed $$ for leverage
  2. Proposal to CIHR to create a virtual "Cdn Inst for NHP Research"
  3. Summarize current knowledge
    • identify and fill in gaps; deal with conflicting results
  4. Create industry incentives - intellectual property; matching programs
    • respond to industry priorities
  5. Consumer survey
    • identify and fill in gaps (e.g. consumer experience)
  6. Create mechanisms for long term investment

Group 6.

  1. Focus on costly health issues where substantial savings can be realized
  2. Develop infrastructure rather than research projects
  3. Spend on projects with broad applicability to advance the field (initially)
  4. Spend on planning
    • identify research needs
    • build in flexibility

Group 7.

  1. Develop a framework and 5 year plan with measurable outcomes
  2. National coordination and funding of priorities by knowledgeable people
  3. Compile inventory and nurture network
  4. Invest in facilities and students
  5. Consider consumer needs

Group 8.

  1. Transform the $3 million into $30 million annual budget
  2. Cost effectiveness studies
  3. Establish funding criteria, including matching funds
  4. Examine international best practices

Appendix D - Breakout Group Answers to Question 4a from the Scribes Reports

Rank, in order of priority, the five key research areas to be addressed over the next 3-5 years.

Group 1.

  1. Infrastructure development
  2. Methodology development for QC
  3. Methodology development for bio-assays
  4. Clinical Trials
  5. New NHP discoveries

Group 2.

  1. Develop Canadian quality standards
  2. Risk assessment and benefit ratio
  3. Integrative approach
  4. Delivery systems approach
  5. Environmental risk assessment

Group 3.

  1. Evidence based research in clinical (animal human) settings including methods of administration to determine efficacy
  2. Health Service research investigating usage methods prescribing habits and issues related to trends in self medication
  3. Identifying pharmacological and chemical profile to aid consistency of product in addition to determining pharmacologically active agents
  4. Determine safety (drug/NHP, NHP/NHP) and inherent product toxicity
  5. Develop evidence based models to evaluate traditional healing therapies
  6. Process development for specific NHPs
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Group 4.

  1. Assemble comprehensive database on NHPs - government to coordinate and disseminate information
  2. Identify active ingredients with reference to prospective claims and safety
    1. establish identity
    2. establish safety/toxicity
    3. drug/NHP interactions
    4. establish appropriate GMPs

Group 5.

  1. Consumer survey
    1. top products
    2. who's using for what
    3. consumer experience
  2. Summarize current scientific knowledge on safety, efficacy and quality
    1. identify gaps
  3. Fill in gaps
  4. Identify actives; analytical methods; appropriate biomarkers; chemical fingerprinting
  5. Interactions (drug/NHP, NHP/NHP, NHP/other)
  6. Communication - effectively and to the public

Group 6.

  1. Develop methods for authentication of NHPs (re. assessment of quality)
    1. ID active ingredients
    2. develop library of reference tools
  2. Establish criteria for quality and efficacy, as NHPs are different from Pharmas
  3. Evaluate NHP interactions (with drugs, foods, cosmetics)
  4. ID problems in quality (consumer perception)
  5. ID gaps in NHP usage
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Group 7.

  1. Methodology for measuring content (what, how much)
  2. Risk/Benefit communication
  3. Identification of knowledge base and gaps in that base
  4. Consumer utilization information
  5. Interactions of NHPs with other agents
  6. Information regarding practitioner background, education and qualifications

Group 8.

  1. Develop research priorities
  2. Methodology development
  3. Quality, efficacy and safety
  4. Impact analysis
  5. Cost effectiveness
  6. New product development

Appendix E - Breakout Group Answers to Question 4b from the Scribes Reports

How should Health Canada facilitate the development of sustainable research in these areas over the next year?

Group 1.

  1. Establish "Virtual Institutes" across the country and coordinate collaborative efforts
  2. Foster interdisciplinary research that is relevant to clinical practice

Group 2.

  1. Coordinate infrastructure
  2. Financial support for junior faculty
  3. Funding interdisciplinary conferences
  4. Develop CIHR for NHP/CAM
  5. Encourage NHP/CAM as arms of other research

Group 3.

  1. Training of people capacity building
  2. Making interdisciplinary research a priority
  3. Funding centers of excellence to facilitate expertise
  4. Plan for funding-leveraging
  5. HC should create agency to facilitate leveraging
  6. Facilitate networking - e.g. conferences
  7. Consider "A" base status

Group 4.

  1. Assemble comprehensive database on NHPs
  2. Set up the ONHP as soon as possible
  3. Provide incentives, research, regulation and enforcement

Group 5.

  1. Commitment by separate arm of NHP to "champion" research
  2. Mechanisms for research training
  3. "Champion" proposal to CIHR to create "virtual" NHP Institute

Group 6.

  1. Ensure communication between stakeholders

Group 7.

No Report

Group 8.

  1. Establish ONHP office, fully staff and resource ASAP
  2. In shorter term, explore ongoing established research funding mechanisms to get the research underway (e.g. CIHR, NHRDP)
  3. Set up a National Center for CAM research using collaborative multidisciplinary partnerships
  4. Build on successful models in other jurisdictions to seek additional funding for sustainable future research

Appendix F - Breakout Groups

  1. Lunenburg room
    1. Michael Vertolli
    2. Liz Gold
    3. Ken Kierstead
    4. Aubrey Dan
    5. Carol Silcoff
    6. Branka Barl
    7. Anne Flanagan
    8. Donna Shields-Poe
  2. Northumberland room
    1. Lois Hare
    2. Bill Bowie
    3. Alicia Wojewnik-Smith
    4. Mike O'Connell
    5. Beth Clay
    6. Patangi Rangachari
    7. Wayne Gulliver
    8. Ann Eastman
  3. Fundy room
    1. Michael Smith
    2. Jackie Shan
    3. John Harrison
    4. Scott Jordan
    5. Heather Boon
    6. Julie Carrier
    7. Richard Barton
  4. Bedford room
    1. William LaValley
    2. Phyllis Bentley
    3. Gerry Harrington
    4. Robert Peterson
    5. Jeffrey Wright
    6. Ron Carr
    7. Elsie Casaway
    8. Nancy Baines
    Top of Page
  5. Hospitality 250
    1. Claire Bombardier
    2. Donna Herringer
    3. Willy Kalt
    4. Edmund Lui
    5. Barb Findlay
    6. Marilyn Schneider
    7. Peter Chan
    8. James Dunn
  6. Hospitality 257
    1. Allison McCutcheon
    2. Rosalie Wynne
    3. Berndt Licht
    4. Ann Fraser
    5. Alice Clark
    6. Julie Conquer
    7. Shawna MacKinnon
    8. Norman Viner
  7. Hospitality 258
    1. Mary Wu
    2. Ellen Mary Mills
    3. Meri Hanlin
    4. Brian Foster
    5. Nora Lee
    6. Allan Best
    7. Jeffrey Slivocka
    8. Anne Wilkie
  8. Hospitality 254
    1. Kate Shields
    2. Joseph Tai
    3. Nancy Smithers
    4. Joan Simpson
    5. Colin Briggs
    6. Robert Orr
    7. Michael Winther

Appendix G - Participants List

  • Baines, Nancy
    Boehringer Ingelheim Canada Ltd.
    5180 South Service Road
    Burlington, Ontario L7L 5H4
    Ph: 905-631-4550
    Fax: 905-639-5293
    E-mail: Nbaines@quest.ca
  • Barl, Branka
    University of Saskatchewan
    Dept. of Horticulture Science
    1 Campus Drive
    Saskatoon, SK S7N 5A8
    Ph: 306-966-5868
    Fax: 306-966-5015
    E-mail: Branka.barl@usask.ca
  • Barton, Richard
    University of British Columbia
    Department of Biochemistry
    2146 Health Sciences Mall
    Vancouver, BC V6T 1Z3
    Ph: 604-822-6215
    Fax: 604-822-5227
    E-mail: Barton@unixg.ubc.ca
  • Bentley, Phyllis
    One Voice: The Canadian Seniors Network
    695 Young Street
    Penticton, BC V2A 5T3
    Ph: 250-493-5118
    Fax: 250-493-0099
    E-mail: Phbentley@vip.net
  • Best, Allan
    Centre for Clinical Epidemiology and Evaluation
    Vancouver Hospital and Health Sciences Centre
    VGH Research Pavillion, Rm. 711
    828 West 10th Ave.
    Vancouver, BC V5Z 1L8
    Ph: 604-875-4111, ext. 6177
    Fax: 604-875-5179
    E-mail: Abest@vanhosp.bc.ca
  • Bombardier, Claire
    Institute for Work and Health
    250 Bloor Street E.
    Suite 702
    Toronto, ON M4W 1E6
    Ph: 416-927-2027, ext. 2132
    Fax: 416-927-4167
    E-mail: Claire.bombardier@utoronto.ca
  • Boon, Heather
    The Michener Institute for Applied Health Sciences
    222 St. Patrick Street
    Toronto, ON M5T 1V4
    Ph: 416-596-3101, ext. 3210
    Fax: 416-596-3168
    E-mail: Hboon@staff.michener.on.ca
  • Bowie, Bill
    Preventative Medicine/Infectious Disease
    University of British Columbia
    Vancouver, British Columbia
    Ph: 604-875-4147
    Fax: 604-875-4013
  • Briggs, Colin
    University of Manitoba
    Faculty of Pharmacy
    Winnipeg, MB R3T 2N2
    Ph: 204-474-8794
    Fax: 204-474-7617
    E-mail: Briggs@ms.umanitoba.ca
  • Carr, Ronald I.
    Dalhousie University
    Dept. of Microbiology & Immunology, and Medicine
    Tupper Medical Building
    859 University Ave.
    Halifax, NS B3H 4H7
    Ph: 902-494-7017
    Fax: 902-494-5125
    E-mail: Ronald.carr@dal.ca
  • Carrier, Julie
    University of Saskatchewan
    Dept. of Agriculture & Bioresource Engineering
    57 Campus Drive
    Saskatoon, SK S7N 5A9
    Ph: 306-966-5317
    Fax: 306-966-5334
    E-mail: Carrier@engr.usask.ca
  • Casaway, Elsie
    Assembly of First Nations
    1 Nicholas Street, Suite 1002
    Ottawa, ON K1N 7B7
    Ph: 613-241-6789
    Fax: 613-241-5808
    E-mail: Ecasaway@afn.ca
  • Chan, Peter
    Natural Health Products Division
    Health Canada
    Ottawa, ON
    Ph: 613-941-3073
    Fax: 613-954-6511
    E-mail: Peter_chan@hc-sc.gc.ca
  • Chandler, Frank
    Chandler Herbal Consulting
    8 Robin Street
    Halifax, N.S. B3M 1W2
    Ph: 902-443-0662
    Fax: 902-443-4878
    E-mail: Frank.chandler@ns.sympatico.ca
  • Clark, Alice
    University of Mississippi School of Pharmacy
    National Center for Natural Products
    Research
    University, MS 38677
    Ph: 662-915-1005
    Fax: 662-915-1006
    E-mail: Lbray@olemiss.edu
    Top of Page
  • Clay, Beth
    Government Reform Committee US House of Representatives
    2157 Rayburn House Office Building
    Washington, DC 20515
    Ph: 202-225-5074
    Fax: 202-226-1274
    E-mail: Beth.clay@mail.house.gov
  • Conquer, Julie
    University of Guelph
    Human Nutraceutical Research Unit
    Guelph, Ontario
    Ph: 519-824-4120, ext. 3749
    Fax: 519-763-5902
    E-mail: Jconquer@uoguelph.ca
  • Dan, Aubrey
    Wampole Canada Inc.
    465 Milner Avenue, Unit 1
    Scarborough, Ontario M1B 2K4
    Ph: 416-754-0086, ext. 2200
    Fax: 416-754-2845
    E-mail: Aubreyd@wampole.ca
  • Dunn, James
    Aboriginal Nurses Association of Canada
    192 Bank Street
    Ottawa, ON K2P 1W8
    Ph: 613-776-4326
    Fax: 613-776-0833
    E-mail: Dunnojib@aol.com
  • Eastman, Ann
    BC Research Inc.
    Natural Health Products Division
    3650 Wesbrook Mall
    Vancouver, BC V6S 2L2
    Ph: 604-224-4331, ext. 714
    Fax: 604-224-6629
    E-mail: Aeastman@bcresearch.com
  • Ferguson, Don
    Director General, Atlantic Region
    Health Canada
    1557 Hollis Street, Suite 701
    Halifax, N.S. B3J 3V4
    Ph: 902-426-4097
    Fax: 902-426-6659
    E-mail: Don_Ferguson@hc-sc.gc.ca
  • Findlay, Barb
    Clinical Research & Professional Practice
    Tzu Chi Institute for Complementary and Alternative Medicine
    767 12th Avenue
    Vancouver, BC V5Z 1M9
    Ph: 604-875-4769
    Fax: 604-875-4776
    E-mail: Bfindlay@tzu-chi.bc.ca
  • Flanagan, Anne
    University of Alberta
    Edmonton, Alberta
    Ph: 780-430-7478
    Fax: 780-437-1168
    E-mail: Aflanaga@gpu.srv.ualberta.ca
  • Foster, Brian
    Office of Science
    Health Canada
    Ottawa, ON
    Ph: 613-957-3506
    Fax: 613-957-5035
    E-mail: Brian_foster@hc-sc.gc.ca
  • Gold, Elisabeth
    Family Physician
    Medical Arts Building
    Suite 111, 5880 Spring Garden Rd.
    Halifax, Nova Scotia B3H 1Y1
    Ph: 902-429-5338
    Fax: 902-423-0737
    E-mail: Elisabeth.gold@dal.ca
  • Gulliver, Wayne
    Memorial University
    Suite 202, Virginia Plaza
    200 Newfoundland Drive
    St. John's, Nfld A1A 3R5
    Ph: 709-753-5522
    Fax: 709-753-5478
    E-mail: Wgulliver@newlab-cro.com
  • Hare, Lois
    139 Union Street
    Burwick, NS B0P 1E0
    Ph: 902-538-8733
    Fax: 902-538-8733
    E-mail: Alders@istar.ca
  • Harrington, Gerry
    Non-Prescription Drug Manufacturers of Canada
    1111 Prince of Wales Drive, Suite 406
    Ottawa, ON K2C 3T2
    Ph: 613-723-0777
    Fax: 613-723-0779
    E-mail: Gerry.harrington@ndmac.ca
  • Harrison, John
    Office of Natural Health Products
    Health Canada
    Ottawa, ON
    Ph: 613-952-2558
    Fax: 613-946-1615
    E-mail: John_harrison@hc-sc.gc.ca
  • Herringer, Donna
    Canadian Health Food Association
    1196 Habgood Street
    Vancouver, BC V4B 4W9
    Ph: 604-535-1021
    Fax: 604-541-6172
    E-mail: Donnah@infinet.net
  • Jordan, Scott
    Chemical Health Hazard Assessment Div.
    Health Canada
    Ottawa, ON
    Ph: 613-946-1487
    Fax: 613-957-1688
    E-mail: Scott_jordan@hc-sc.gc.ca
  • Jurgens, Tannis
    College of Pharmacy
    Dalhousie University
    Halifax, Nova Scotia B3H 4H7
    Ph: 902-494-3796
    Fax: 902-494-1396
    E-mail: Tannis.Jurgens@dal.ca
  • Kalt, Wilhelmina
    Agriculture & Agri-Food Canada
    Atlantic Food & Horticulture Research Centre
    Kentville, NS
    Ph: 902-679-5757
    Fax: 902-679-2311
    E-mail: Kaltw@em.agr.ca
  • Acta-Med Inc.
    541 Charlotte Street
    Fredericton, NB E3B 1M1
    Ph: 506-455-4110
    Fax: 506-455-4675
    E-mail: Ken@actamed.net
    Top of Page
  • LaValley, William
    Canadian Complementary Medical Ass.
    227 Central Street
    Box 2020
    Chester, NS B0J 1J0
    Ph: 902-275-4555
    Fax: 902-275-4555
  • Lee, Nora
    Nutrition & Evaluation Division
    Health Canada
    Ottawa, ON
    Ph: 613-957-0352
    Fax: 613-941-6636
    E-mail: Nora_lee@hc-sc.gc.ca
  • Lee, Timothy
    Dept. of Microbiology & Immunology
    Dalhousie University
    Halifax, Nova Scotia B3H 4H7
    Ph: 902-494-3882
    Fax: 902-494-5125
    E-mail: Tim.lee@dal.ca
  • Licht, Bernd
    Purity Life Health Products Ltd.
    6 Commerce Crescent
    Acton, ON L7J 2X3
    Ph: 519-853-3511, ext. 229
    Fax: 519-853-4660
    E-mail: Blicht@puritylife.on.ca
  • Lui, Edmund
    University of Western Ontario
    Dept. of Pharmacology & Toxicology
    Medical Sciences Building
    London, ON N6A 5C1
    Ph: 519-661-3312
    Fax: 519-661-4051
    E-mail: Elui@julian.uwo.ca
  • MacKinnon, Shawna
    Agriculture and Agri-Food Canada
    Atlantic Food and Horticulture Research Centre
    Kentville, NS
    Ph: 902-679-5755
    Fax: 902-679-2311
    E-mail: MackinnonS@em.agr.ca
  • McCutcheon, Allison
    Canadian Herb Society
    5251 Oak Street
    Vancouver, BC V6M 4H1
    Ph: 604-222-3488
    Fax: 604-222-9613
  • Mills, Ellen Mary
    Canadian Association of Chain Drug Stores
    301-45 Sheppard Ave., East
    Toronto, ON M2N 5W9
    Ph: 416-226-9100, ext. 27
    Fax: 416-226-9185
    E-mail: Emm.cacds@sympatico.ca
  • O'Connell, Michael
    Ashbury Biologicals, Inc.
    4700 Keele Street, Farquharson Bldg.
    Toronto, ON M3J 1P3
    Ph: 416-736-5585
    Fax: 416-736-5846
    E-mail: Chemist@dalton.com
  • Orr, Robert
    Ocean Nutrition Canada Ltd.
    757 Bedford Highway
    Bedford, NS B4A 3Z2
    Ph: 902-457-2399
    Fax: 902-457-2357
    E-mail: Rorr@ocean-nutrition.com
  • Peterson, Robert
    Therapeutic Products Program
    Health Canada
    Ottawa, ON
    Ph: 613-957-6466
    Fax: 613-952-7756
    E-mail: Robert_peterson@hc-sc.gc.ca
  • Rangachari, Patangi
    McMaster University
    Dept. of Medicine
    Health Sciences Centre, Rm. 3n5c
    Hamilton, Ontario
    Ph: 905-521-2100
    E-mail: Chari@mcmaster.ca
  • Schneider, Marilyn
    Canadian Breast Cancer Research Initiative
    10 Alcorn Avenue, Suite 200
    Toronto, ON M4V 3B1
    Ph: 416-961-7223, ext. 309
    Fax: 416-961-4189
    E-mail: Marilyns@cancer.ca
  • Shan, Jackie
    CV Technologies Inc.
    Suite 308, Campus Tower
    Edmonton, Alberta T6G 1K8
    Ph: 780-432-0022, ext. 257
    Fax: 780-432-7772
    E-mail: Jackie.shan@ualberta.ca
  • Shields, Kate
    Anesthesiology
    QEII Health Sciences Centre
    Halifax, Nova Scotia
    Ph: 902-473-4326
    Fax: 902-420-6626
  • Shields-Poe, Donna
    Medical Research Council of Canada
    Holland Cross, Tower B
    5th Floor, 1600 Scott Street
    Postal Locator 3105A
    Ottawa, Ontario K1A 0W9
    Ph: 613-957-6123
    Fax: 613-954-1800
    E-mail: Dshields-poe@mrc.gc.ca
  • Silcoff, Carol
    Information, Analysis, & Connectivity Branch
    Health Canada
    Ottawa, ON
    Ph: 613-954-8650
    Fax: 613-954-0813
    E-mail: Carol_silcoff@hc-sc.gc.ca
  • Simpson, Joan
    Health Promotion & Programs Branch
    Health Canada
    Ottawa, ON
    Ph: 613-954-8646
    Fax: 613-952-3427
    E-mail: Joan_simpson@hc-sc.gc.ca
    Top of Page
  • Slivocka, Jeffery
    Membertou Wellness Home
    350 Sparks Street, Suite 607
    Ottawa, Ontario K1R 7S8
    Ph: 613-563-4804
    Fax: 613-563-3878
    E-mail: Jslivocka@hendinlaw.com
  • Smith, Michael
    Canadian College of Naturopathic Medicine
    Toronto, Ontario
    Ph: 416-498-1255, ext. 249
    Fax: 416-498-3204
    E-mail: Msmith@ccnm.edu
  • Smithers, Nancy
    Naturally Nova Scotia
    2769 Lawrencetown Road
    Dartmouth, NS B2Z 1L3
    Ph: 902-434-7206
    Fax: 902-435-3698
  • Tai, Joseph
    University of British Columbia
    Rm. 218 Research Centre
    950 West 28th Avenue
    Vancouver, British Columbia V5Z 4H4
    Ph: 604-875-2457
    Fax: 604-875-2496
    E-mail: Jtai@interchange.ubc.ca
  • Vertolli, Michael
    Canadian Coalition for Health Freedom
    Central Canadian Herbal Practitioners Assoc
    10971 Jane Street
    Maple, ON L6A 1S1
    Ph: 905-303-8723
    Fax: 905-303-8724
  • Viner, Norman
    Office of Natural Health Products
    Health Canada
    Ottawa, ON
    Ph: 613-946-1780
    Fax: 613-946-1615
    E-mail: Norman_viner@hc-sc.gc.ca
  • Wilkie, Anne
    The Canadian Association of Health
    Products, Complementary and Alternative Medicine
    550 Alden Road, suite 205
    Markham, Ontario
    Ph: 905-479-6939, ext. 225
    Fax: 905-479-1516
    E-mail: Awilkie@chfa.ca
  • Wojewnik-Smith, Alicia
    Vita Health Company
    150 Beghin Avenue
    Winnipeg, MB R2J 3W2
    Ph: 204-661-8386, ext. 216
    Fax: 204-663-8386
    E-mail: Awojewni@leiner.com
  • Wright, Jeffrey
    Ocean Nutrition Canada Ltd.
    757 Bedford Highway
    Bedford, NS B4A 3Z2
    Ph: 902-457-2399
    Fax: 902-457-2357
    E-mail: Jwright@ocean-nutrition.com
  • Wu, Mary X.
    Toronto School of Traditional Chinese Medicine
    2010 Eglington Avenue W.
    Toronto, ON M6E 2K3
    Ph: 416-782-9682
    Fax: 416-782-9681
  • Wynne, Rosalie
    National Consumers Association of Canada
    Saskatchewan Branch
    Bay A5B, 116-103 ST. East
    Saskatoon, Saskatchewan S7N 1Y7
    Ph: 306-242-4909
    Fax: 306-373-5810
    E-mail: Cacsask@sk.sympatico.ca

Appendix H - Agenda:November 6-8, 1999 Westin Nova Scotian Hotel Halifax, Nova Scotia

  • Saturday, November 6, 1999
    • 3:00pm - 9:00pm
      Registration Harbour Suites Foyer
    • 7:00pm - 9:00pm
      Reception - Get Acquainted Harbour Suites
  • Sunday, November 7, 1999
    • 8:00am - 9:00am
      Breakfast Commonwealth B
    • 9:00am - 9:30am
      Opening - Dr. Tim Lee Harbour Suites
      National & International Perspective on NHP Research
      Moderator: Dr. Tim Lee
    • 9:30am - 10:30am
      NHP Research Harbour Suites
      International Perspective
      Dr. Alice Clark
    • 10:30am - 11:00am
      Health Break Harbour Suites Foyer
    • 11:00am - 12:00pm
      Presentations on research priorities Harbour Suites

      Invited speakers:
      • Dr. Claire Bombardier - Institute for Work and Health
      • Dr. Michael Smith - Canadian College of Naturopathic Medicine
      • Mr. Gerry Harrington - NDMAC
      • Dr. Jeffrey Wright - Ocean Nutrition Canada Ltd.
    • 12:00pm - 1:00pm
      Lunch (buffet) Commonwealth B
  • Sunday, November 7, 1999 - Afternoon Continued
    • 1:00pm - 1:30pm
      Presentations on research priorities Harbour Suites

      Invited speakers:
      • Dr. Brian Foster - Office of Science - Health Canada
      • Dr. Tannis Jurgens - College of Pharmacy - Dalhousie University
    • 1:30pm - 2:00pm
      Overview of Research Harbour Suites
      Funding for NHP Research in USA
      Ms. Beth Clay
    • 2:00pm - 3:15pm
      Workshop Groups TBA
    • 3:15pm - 3:45pm
      Coffee Break In workshop rooms
    • 3:45pm - 5:30pm
      Workshop Groups continued
    • 6:00pm
      Dinner Atlantic Ballroom
    • 7:00pm - 7:30pm
      Speaker
      Dr. Frank Chandler
  • Monday, November 8, 1999
    • 7:00am - 8:00 am
      Breakfast Commonwealth B
    • 8:00am - 8:30am
      Health Canada Harbour Suites
      Keynote- Dr. Bob Peterson
    • 8:30am - 11:00am
      Presentation of workshop results Townhall format Harbour Suites
    • 11:00am - 11:20am
      Health Break Harbour Suites Foyer
    • 11:20am - 1:00pm
      Discussion and Consensus on Priorities Townhall format Harbour Suites
    • 1:00pm - 2:00pm
      Lunch (buffet) Harbour Suites
    • 2:00pm - 2:30pm
      Summation of Priorities Harbour Suites
  • Closing Remarks
Date Modified: 2011-08-09

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