Regulation of Complementary and Alternative Medicine in the EU

Overview by Michael McIntyre MA, MRCHM, FNIMH, DU, Visiting Professor Middlesex University, UK

(Excerpt from the overview, which can be downloaded in pdf, see below)

This document contains 4 sections:

  • Section 1. What is CAM? - definition and usage
  • Section 2. CAM regulation by the European Union
  • Section 3. Regulation of CAM practitioners and CAM practises
  • Section 4. Regulation of CAM medicinal products, herbs, remedies and food supplements

From Section 1:

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There have been several attempts to define the heterogeneous practices generally considered as CAM.

The CAMbrella Project (2013)[2], charged by the European Commission to survey the use of CAM in Europe, proposed the following definition: “CAM, as utilised by European citizens, represents a variety of different medical systems and therapies based on the knowledge, skills and practices derived from theories, philosophies and experiences used to maintain and improve health, as well as to prevent, diagnose, relieve or treat physical and mental illnesses. CAM therapies are mainly used outside conventional health care, but in many countries some therapies are being adopted or

The British Medical Association (BMA) adopted a working definition in 1993 of CAM as “those forms of treatment which are not widely used by the orthodox health-care professions, and the skills of which are not taught as part of the undergraduate curriculum of orthodox and paramedical health-care courses.”[1]

WHO has a somewhat different description of CAM declaring that “The terms "complementary medicine" or "alternative medicine" are used interchangeably with traditional medicine in some countries. They refer to a broad set of health care practices that are not part of that country's own tradition and are not integrated into the dominant health care system.” For this reason WHO prefers to use the abbreviation T&CM (Traditional and Complementary Medicine)[2] describing traditional medicine as “the sum total of the knowledge, skills, and practice based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness.”[3]

Complementary and/or alternative
The BMA made a distinction between complementary and alternative forms of CAM:“Complementary therapies are those which can work alongside and in conjunction with orthodox medical treatment. Within this category there is clearly a wide diversity of types of practice, which would include self-help therapies… such as yoga; re-educational  therapies such as the Alexander Technique; relatively non-invasive therapies such as healing and massage; and all interventive therapies such as acupuncture, osteopathy, and chiropractic….In this role the therapies are an additional and complementary form of treatment. ...By contrast, ‘alternative therapies ‘could be seen as those which are given in place of orthodox treatment… - there are some therapies which, by their very nature, aim to replace orthodox medicine. Examples of such therapies might include herbal medicines, which are often given in place of orthodox medication…”[4]

Integrated and integrative 
More recently there has been a move in the European sphere to replace the term CAM with the epithet “Integrated Medicine”[5] while in the USA the term “Integrative Medicine” is generally used[6] signalling a similar shift in emphasis since both descriptors highlight the trend that in some countries aspects of CAM therapies are now being adopted or

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You can download the entire document as pdf here, with references.