Health freedom movement

The term health freedom movement is used to describe the loose coalition of consumers and alternative medicine providers around the world who are pushing for unhindered freedom of choice in healthcare. The movement is critical of the pharmaceutical industry and medical regulators, and uses the term "health freedom" as a catch phrase to convey its message.

Main message and objectives
Health freedom campaigners generally tend to believe that the practice of medicine has become constrained by monopoly interests and profit, to the detriment of health and freedom of choice. Although the concept of health freedom does not preclude the practice of conventional medicine (allopathic medicine) per se, campaigners generally tend to have strong preferences for orthomolecular/naturopathic/alternative medicine and an overall distrust of the pharmaceutical industry. In recent years, the movement has increasingly been expanding its focus to include opposition to water fluoridation and the use of pesticides, herbicides and food additives. Generally speaking, the health-freedom movement favors organic food and is opposed to genetically modified food. Some health freedom campaigners would like adults to be free to choose marijuana for personal or medical use without criminal penalty. The money currently spent on arresting people for possessing pot, they say, could be better used to go after more serious criminals or funding alternative health-care programs.

There is no formal structure to the health freedom movement, although cooperation and coordination among some of the various organizations and individuals involved in it does occur. One of the movement's central claims is that there exists a large body of scientific evidence about the positive health effects of vitamins and other dietary supplements, and that this is either ignored or actively suppressed by the conventional medical establishment. However, no such evidence (based on double-blind, large sample, independently repeatable trials) has ever been produced. Some of the movement's spokespeople, such as the Alliance for Natural Health, take a more moderate stance on this issue, however, saying that negative media publicity about nutrients such as vitamin E are a result of misinterpretations over the science. These campaigners also criticise the latest research indicating that vitamin C supplements do not protect against the common cold as having a number of fundamental flaws.

One of the health freedom movement's key objectives is for people to have unrestricted access to vitamins and other food supplements. There is a strong belief in the movement that many chronic diseases can be largely prevented or even cured using micronutrients and that the optimal level for ingestion of these is significantly above the RDA levels. The belief that high levels of antioxidants and vitamins confer increased longevity is shared with the Life-extension movement, with which the health freedom movement has close links.

The belief that supplements and vitamins can demonstrably improve health or longevitiy is not backed by evidence-based medicine, nor is it widely accepted in the orthodox medical community, as there is felt to be insufficient evidence to support such claims. Indeed, large doses of some vitamins can lead to vitamin poisoning (hypervitaminosis).

The limiting factors influencing the degree to which health freedom exists include consumer protection legislation, lobbying of politicians and legislators by corporations in competing industries (such as pharmaceutical companies) as well as by associated or allied trade organizations, media bias, and resistance by the mainstream medical establishment.

Political roots of the health freedom movement
The health freedom movement does not easily fall into traditional political categories. The loose coalition of health freedom activists come from a variety of backgrounds. For example, the demands for a radical deregulation of the medical profession and health care sector could arguably be construed as right-wing libertarian. The criticism of big companies in the pharmaceutical industry, on the other hand, could be viewed as a left wing position. Outside the movement there are politicians, governments and opinion leaders who would probably not identify themselves with the health freedom movement but who sometimes support the same causes.

The British activist Martin Walker is politically left-wing, whilst the Republican congressman and 2008 U.S. presidential candidate Ron Paul, who has pledged to preserve health freedom, is a free market libertarian. A leading supporter of the movement, Paul introduced the Health Freedom Protection Act in the U.S. Congress in 2005. Other examples of people with polar opposite political views whose healthcare ideology at times appears to bear some comparison to that of the health freedom movement are Prince Charles, who has defended alternative therapies in an address to the World Health Assembly, and Cherie Blair (the anti-royalist wife of British Prime Minister Tony Blair) who is believed to have influenced her husband's reported opposition to the EU Food Supplements Directive. The British right wing Conservative Party (UK) has supported the Save Our Supplements campaign as part of its campaign against the EU Food Supplements Directive. The Swedish conservative Moderate Party is also opposed to the EU imposed vitamin restrictions. Many of the Green Parties in Europe are opposed to the EU Food Supplements Directive and are also in favor of alternative medicine. Prominent celebrity supporters of the movement include the musician Sir Paul McCartney, who has gone on record as saying that people "have a right to buy legitimate health food supplements" and that "this right is now clearly under threat", and the pop star/actress Billie Piper, who joined a march in London in 2003 to protest at planned EU legislation to ban high dosage vitamin supplements.

The term Health freedom movement has probably been used in the United States since the early 1990s. Around 2003 to 2005 a campaign organization founded by the British author Lynne McTaggart called the Health Freedom Movement existed in the United Kingdom.

Interest groups and stakeholders
Both consumers and providers have material interest to gain from the health freedom agenda.


 * Consumers

Consumers who advocate the concept of health freedom seek unhindered freedom to use whatever health products or therapies they wish. These consumers believe they will benefit from new therapies that are cheaper (and which they see as safer) than conventional medicine. They also seek increased insurance coverage of their treatment choices and/or increased provision of such therapies by the State.


 * Providers

Health freedom providers include large and powerful producers and myriad practitioners. They primarily identify themselves with alternative medicine, as opposed to mainstream medicine, and see themselves as its competitors. These providers seek unregulated access to consumers and seek increased insurance coverage of their products and services. They also form a loose alliance in their efforts to lobby politicians, influence legislation, and influence consumers, and use professional lobbying, organized media campaigns, and mass marketing methods to achieve their goals. The Council for Responsible Nutrition is a lobby organization for the provider industry in the US.

Legislation

 * United States

The enactment into law of the Dietary Supplement Health and Education Act (DSHEA) in the United States (US) in 1994 is an example of a piece of pro-health-freedom legislation. DSHEA defines supplements as foods, and puts the onus on the United States Food and Drug Administration (FDA) to prove that a supplement poses significant or unreasonable risk of harm rather than on the manufacturer to prove the supplement’s safety. The act was passed by Congress after extensive lobbying by the manufacturers of dietary supplements, and received strong support from non-medically-oriented politicians such as Senator Tom Harkin and Senator Orrin Hatch, whose state of Utah is a hub for herbal manufacturers. The act allows natural supplements to be marketed without any proof of their purity, safety or efficacy. Producers of these supplements are largely exempt from regulation by the Food and Drug Administration, which can take action against them only if they make medical claims about their products or if consumers of the products become seriously ill.

Following concerns about numerous raids, censorship issues, pharmaceutical conflicts of interest, product bans, and more proposed FDA restrictions, what became the DSHEA in 1994 was the subject of the largest grassroots letter writing campaign to Congress. However, the current level of popular support for the deregulation of the supplement industry can at times seem unclear. A large survey by the AARP, for example, found that 77% of respondents (including both users and non-users of supplements) believed that the federal government should review the safety of dietary supplements and approve them before they can be marketed to consumers.

Similar confusion about the implications of DSHEA was noted in an October 2002 nationwide Harris poll. Here, 59% of respondents believed that supplements had to be approved by a government agency before they could be marketed; 68% believed that supplements had to list potential side effects on their labels; and 55% believed that supplement labels could not make claims of safety without scientific evidence. All of these beliefs are incorrect as a result of provisions of the DSHEA.

Nevertheless, in recognition of the support for DSHEA, President Bill Clinton, on signing it into law, stated that "After several years of intense efforts, manufacturers, experts in nutrition, and legislators, acting in a conscientious alliance with consumers at the grassroots level, have moved successfully to bring common sense to the treatment of dietary supplements under regulation and law." He also noted that the passage of DSHEA "speaks to the diligence with which an unofficial army of nutritionally conscious people worked democratically to change the laws in an area deeply important to them" and that "In an era of greater consciousness among people about the impact of what they eat on how they live, indeed, how long they live, it is appropriate that we have finally reformed the way Government treats consumers and these supplements in a way that encourages good health."

Another example of the passing of pro-health freedom legislation occurred in March 2007, when Governor Timothy M. Kaine signed a bill into law in the U.S. State of Virginia allowing teenagers 14 or older and their parents the right to refuse medical treatments for ailments such as cancer, and to seek alternative treatments so long as they have considered all other medical options. Kaine described the bill as being "significant for health freedom in Virginia."

In addition, some U.S. states have proven willing to allow nonlicensed practitioners to diagnose and treat patients, and forms of nonlicensed practice have been approved in California, Rhode Island, Idaho, Louisiana and Oklahoma. As a result, between 2000 and 2006, 15 percent of the U.S. population gained some access to nonlicensed practitioners.


 * Europe

So far as supplements are concerned, the legislative trend in Europe in recent years has been towards increased regulation. As such, health freedom movement writers and campaigners in Europe fear that European Union (EU) laws such as the Food Supplements Directive, the Traditional Herbal Medicinal Products Directive, and the Human Medicinal Products (Pharmaceuticals) Directive, will ultimately reduce access to food supplements and herbal medicines without evidence of comprehensive safety testing or historical practice. European health food producers, retailers and consumers have been vocal in protesting against this legislation, with the health freedom movement inviting supporters to "Stop Brussels from killing natural medicine". On the day that Members of the European Parliament voted for a clampdown on vitamin sales, the parliament's computer system crashed under the strain of thousands of speed-dial emails, wildly claiming that the new directive would ban 300 popular supplements and drive British health stores out of business. In Strasbourg, meanwhile, Euro-MPs were accosted by activists handing out a propaganda video accusing five European commissioners of corruptly colluding with big pharmaceutical firms in an attempt to destroy the alternative network of homoeopathic and natural medicines. No evidence to support this accusation has been produced.

In 2004, the Alliance for Natural Health (ANH) and two British trade associations had a legal challenge to the Food Supplements Directive referred to the European Court of Justice by the High Court in London. Although the European Court of Justice's Advocate General subsequently said that the EU's plan to tighten rules on the sale of vitamins and food supplements should be scrapped, he was eventually overruled by the European Court, which decided that the measures in question were necessary and appropriate for the purpose of protecting public health. ANH, however, interpreted the ban as applying only to synthetically produced supplements - and not to vitamins and minerals normally found in or consumed as part of the diet. Nevertheless, the European judges did acknowledge the Advocate General's concerns, stating that there must be clear procedures to allow substances to be added to the permitted list based on scientific evidence. They also said that any refusal to add a product to the list must be open to challenge in the courts. However, some media observers believe that, as a result of this legislation, a black market will inevitably emerge, and that controls over ingredients and quality will vanish.


 * Oceania

In New Zealand, health freedom campaigners have been concerned that many supplements would be removed from the shelves under the Therapeutic Products and Medicines Bill that was introduced to the NZ Parliament in 2006 by Food Safety Minister Annette King. If passed, the Bill would have created a joint agency with Australia to regulate therapeutic products. In July 2007, however, King announced that the Bill would be postponed until there was more support in the New Zealand parliament for the scheme. She subsequently passed responsibility for the issue to New Zealand Health Minister Pete Hodgson, who said that "the status quo of an unregulated market for medical devices and complementary medicines cannot remain". It is understood that officials are now planning to look at using ministerial powers to create domestic regulations to apply to such products sold in New Zealand.

The influence of the pharmaceutical industry on health freedom
Naturally occurring forms of nutrients and herbs cannot be patented. Because of this, health freedom-orientated writers and campaigners tend to see restrictive legislation on supplements as being designed to protect the interests of the pharmacuetical industry, the profitability of which depends upon the sale of patented synthetic drugs. If herbal medicines and supplements are removed from sale, they argue, patients will have no alternative but to use conventional pharmaceutical medicines. Matthias Rath goes even further than this, however, and believes that the pharmaceutical industry has a vested interest in the continuation and expansion of diseases, rather than their cure, in that without the current widespread existence of diseases the industry would cease to exist in its current form.

In addition to criticising the pharmaceutical industry, the health freedom movement is also critical of the actions of individual pharmaceutical companies. As reported in the British Medical Journal, for example, health freedom organisations have condemned Merck & Co.’s marketing methods, claiming the company hopes to use profits from Gardasil to fund the litigation costs it has had to pay over rofecoxib (Vioxx). Health freedom-orientated campaigners in the UK, meanwhile, have publicly criticised Boots, Britain's largest chemist, for "watering down" its vitamin and mineral supplements to ensure that its products complied with the European Union's Food Supplements Directive.

The influence of Codex on health freedom
A key focus of the health-freedom movement in recent years has been the activities of the Codex Alimentarius Commission, which it perceives to be acting in the interests of the pharmaceutical industry. Sponsored by the World Health Organization (WHO) and the Food and Agriculture Organization (FAO) of the United Nations, the Codex Alimentarius Commission develops standards and guidelines for foods, including food supplements.

Whilst the adoption by countries of the various standards and guidelines developed by Codex is theoretically optional, the creation of the World Trade Organization (WTO) on 1 January 1995 essentially changed their international status, in that they are now increasingly used as the benchmark in the adjudication of international trade disputes. As such, the potential threat of becoming involved in, and losing, such a dispute now effectively makes the adoption of Codex guidelines and standards mandatory, in that it leaves countries little or no option but to harmonize to Codex standards for goods that they wish to export without unreasonable trade barriers. (The Codex has no application to internal trade unless the national Government wishes it, though in practice all major producers aim for an international market).

The Guidelines for Vitamin and Mineral Food Supplements, for example, were adopted by the Codex Alimentarius Commission as a new global standard at its meeting in Rome in July 2005. The National Health Federation, by virtue of its official observer status at Codex, was the only delegation present at the meeting to oppose the guidelines' adoption. Drafted using the EU Food Supplements as a blueprint, health-freedom orientated researchers argue that the eventual effect of these Guidelines will be to remove large numbers of the most effective forms of nutrients from the global market, set restrictive upper limits on the dosages of all permitted nutrients, and prevent the sale of all supplements for curative, preventative or therapeutic purposes without a doctor’s prescription. As a result, there is a general belief in the health-freedom movement that Codex is seeking to ensure that the sale of curative, preventative, and therapeutic health products remains the exclusive province of the pharmaceutical industry. Other Codex texts, such as those affecting health claims, organic foods, genetically modified foods, labeling, and advertising are similarly opposed by health-freedom organizations, who argue that the Commission puts trade interests before human health. For its part, the Commission asserts that products listed on the Codex have been accepted by the signatories as proven to be safe and thus there is no case for any member state of the WTO to deny importation on safety grounds. However, member states may refuse entry to products that have not achieved a listing on the Codex.

The influence of regional trade harmonization on health freedom
A number of health-freedom organizations and their political supporters believe that the increasing tendency for countries to form large, so-called free trade areas and trade blocs threatens their freedom of choice in healthcare, on the grounds that they believe these further increase the pressure upon countries to harmonize their food and supplement laws to the standards and guidelines set by Codex. Texas Republican Rep. Ron Paul, for example, has said that the Central American Free Trade Agreement "increases the possibility that Codex regulations will be imposed on the American public." This assertion is despite the fact that the Codex only applies to the right to refuse imports: nations are at liberty to make local decisions on products entirely within their own territories.

Nevertheless, because of this belief, there has been a certain degree of convergence between the health-freedom movement and the anti-globalization movement in recent years in that some health-freedom organizations and campaigners now openly oppose regional free trade agreements and trade-governing bodies such as the World Trade Organization, and include such opposition as a part of their campaigning activities.

Campaigners, organizations, and newsfeeds
The core of the health freedom movement consists of a loose coalition of activists, campaigners, bloggers, and newsfeeds. Some of these are mentioned in the section below.


 * USA and the Americas

The American Association for Health Freedom (AAHF) was founded in 1992 and is affiliated with the European organization, Alliance for Natural Health. AAHF describes themselves as the politically active voice at the federal and state level for the right of the consumer to choose and the practitioner to practice.

The American Holistic Health Association (AHHA) was founded in 1989. It describes its mission as being to promote holistic principles where mind, body, and spirit are working together and individuals actively participate in their own health and healthcare. AHHA sees its role as educational and, as a result, it does not run campaigns by itself.

International Advocates for Health Freedom was founded in 1996 to catalyze awareness of the Codex international threat to health freedom and the tangential harmonization actions.

The Institute for Health Freedom (IHF) was founded in 1996 as a Washington based think-tank with a leaning towards free market liberalism. The focus of IHF is more directed towards conventional medicine than the other health freedom organizations. Some of the issues IHF are working with are: patient rights and increased choice in Medicare/Medicaid

The Life Extension Foundation was founded in 1980. The original goal of the LEF was to find methods to extend the human life-span. Over time, LEF has developed an extensive business selling discounted supplements to their paying members. During this process, it has been involved in a number of legal battles with the FDA. Today, LEF is vocal in the health freedom movement and has initiated a number of campaigns over the years. It has an extensive campaign editorial in each issue of its monthly member magazine, Life Extension Magazine.

The National Health Freedom Coalition was founded in 2002 and has organized an annual Health Freedom Conference since 2004.

The National Health Federation was established in 1955 and has observer status as a Non-governmental organization (NGO) at the official Codex Alimentarius meetings.

The Nutritional Health Alliance (NHA) was founded in 1992 as a campaign and lobby organization to persuade Congress to enact the DHSEA. The NHA was recently revived to lobby against what they perceive as new threats towards the DHSEA.


 * Europe

The Alliance for Natural Health (ANH) is a UK based pan-European campaign organization that was founded in 2003 to launch a legal challenge against the EU Food Supplements Directive.

The Dr. Rath Health Foundation is founded by the German doctor, Matthias Rath. The foundation is financed by the profits from a supplement manufacturer owned by Dr Rath.

The Campaign for Truth in Medicine is a consumer advocacy group based in the United Kingdom.


 * Rest of the World

The Alliance for Health Freedom Australia (AHFA) is an Australian non-profit campaign organization.


 * Individual campaigners

An integral part of the health freedom movement is comprised of a number of individual campaigners, newsfeeds, and opinion makers.

Some of the more notable ones are: the US based Gary Null, Dr Joseph Mercola, the British Martin Walker, Eve Hillary, and the newsfeeds News Target based in the US, and the UK based Zeus Information Service

Examples of US based talk radio stations are HealthRadioNetwork.com, The Deborah Ray Show, and Joyce Riley's talk radio show The Power Hour.

Health freedom films
The film medium has been used to convey the message of the health freedom movement to a broader audience. The most notable are mentioned below. The two documentaries We Become Silent and Prescription For Disaster are produced by core activists in the movement while the other films convey a message that is similar to the positions held by the movement but produced by people that don’t identify themselves with the health freedom movement.

Documentary

 * We Become Silent A film by Kevin P. Miller
 * Prescription For Disaster A film by Gary Null, winner of: Best Documentary Feature, at the Red Bank International Film Festival 2006
 * Money Talks: Profits before Patient Safety from 2006. A documentary made by the same team that made the feature fim Side Effects.

Feature films

 * Side Effects (film) from 2005, directed by Kathleen Slattery-Moschkau. A satire about a woman making a career in the US pharmaceutial industry.

For further reading

 * A Bibliographic History of the Health Freedom Movement by Martin J Walker.
 * A Meeting of Two by Scott Tips.
 * Shangri-La on the Rhine: The Codex Committee Meets Again in Bonn by Scott Tips.
 * Passing the Event Horizon - International Charter lacks legal standing and is drawing us into a black hole by Scott Tips.
 * Who Says Whatever Happens at Codex Does Not Affect US Law and Why Do They Say It? by Suzanne Harris.
 * The Growing Threats to DSHEA by Paul Anthony Taylor.
 * Codex Guidelines for Vitamin and Mineral Food Supplements: The Bigger Picture.
 * The ’Framing’ of Food Supplements in the EU by Bert Schwitters.
 * Free Speech and Dietary Supplements: A health freedom speech by Rep. Ron Paul.
 * Vitamin Safety by Andrew Saul
 * Dietary Supplement Health and Education Act of 1994
 * European Union Food Supplements Directive, 2002.
 * Codex Guidelines for Vitamin and Mineral Food Supplements, 2005.
 * Who's confused about complementary medicine by Robert Verkerk.
 * "Health Freedom", from Quackwatch.