An Interview with International Leader Peter Smith, M.D.

By Eric L. Foxman, Pharm. (Ret.), AAHP Secretary  

In this issue, we introduce Peter Smith, M.D., whose multi-national experiences provide a broad perspective on important steps that could make differences to all homeopathic manufacturers in numerous countries.

As background, Dr. Smith has an MB, ChB (University of Cape Town); an MFHom (UK); and a Diploma in Homeopathy (CEDH). He has been a member of the Chiropractors, Homeopaths and Allied Health Service Professions Council of South Africa, as well as a working member of the Medicines Control Council of South Africa (Complementary Medicines Committee). Dr. Smith is currently a Board Member of the HPCUS, and active on the European Committee on Homeopathy (Provings Sub-Committee).

AAHP: How did your interest in homeopathic medicine arise? 

Smith: Upon completion of my postgraduate training at Groote Schuur Hospital in Cape Town, I was a “dyed-in-the-wool” skeptic of homeopathy, acupuncture, and all other complementary “dark arts.” Shortly after starting out in Family Practice, however, I was fortunate to encounter several patients who were successfully drawing on both complementary and, where appropriate, the allopathic medical systems. By listening and observing I learnt so much and this curiosity led, over the next few years, to training and qualifications in both homeopathy and Traditional Chinese Medicine (TCM). Then followed two decades of really satisfying practice in which I applied these modalities. 

AAHP: Out of that medical background, what prompted your work connection with homeopathic manufacturers? 

Smith: In the 1990s, I was involved in the founding of the South African Medical Homeopathy Association and later the South African Complementary Medical Association. SACMA convened the first South African National Congress for Complementary Medicine (held on Robben Island) in 1998. This led to my election to the Chiropractors, Homeopaths and Allied Health Service Professions Council of South Africa and a subsequent appointment to the Medicines Control Council of South Africa (the forerunner of the present day South African Health Products Regulatory Authority (SAHPRA)). In these roles I had a lot of interaction with the manufacturing sector and became familiar with the various challenges facing the industry and in later years I consulted to a number of homeopathic manufacturers. 

AAHP: In that capacity, what lessons can you share from those experiences? 

Smith: In the South African context, there were significant challenges in persuading the regulatory bodies that allopathy was not the only paradigm through which health and healing should be viewed and practiced. Over the years this has improved and is now reflected in the structures and powers invested in the Allied Health Professions Council of South Africa and SAHPRA’s Complementary Medicines Committee (CMC)

Some of the lessons learnt include: 

• These hard-fought rights of manufacturers need to be safeguarded and regularly revisited. 
• Interdisciplinary discussions and lobbying of the authorities are never-ending processes. 
• Ensure that the right people are elected to these key regulatory bodies and that they are in turn held accountable to their base (the manufacturers). 

AAHP: Since you left South Africa, what have you been doing in relation to the homeopathic pharmaceutical industry? 

Smith: My wife and I moved to Germany in 2008 where I took up a position in the Regulatory Department of Heel, transferring a few years later to the Department of Medicine and Research. When I retired from Heel in 2018. we moved to Ireland. While at Heel I learnt a number of things, including: 

• Although there was only one set of E.U. medicine regulations, there were a significant number of ways in which these were interpreted and applied, depending on which country you were dealing with. In the U.S., on the other hand, there is no such spectrum of interpretations and industry must focus only on what the U.S. authorities require. 
• Several national authorities are challenged in assessing homeopathic medicine topics, including applications for registration as well as technical queries. This is largely due to lack of training and experience in homeopathic manufacturing. 
• There is a gradual but progressive escalation in requirements from the authorities — be it from manufacturing topics such as validation, to the need for high-quality data to support a particular medicinal claim. 

AAHP: Any final words regarding what you see as necessary steps to take the homeopathic industry into the future on a sure foundation? 

Smith: In my opinion there are a number of key steps that should be considered, and attitudes to be developed and maintained, such as: 

• It is of vital importance to have a strong culture of the networking outside the homeopathic community, as well as lobbying the various regulatory bodies. 
• Develop and maintain the ability to look critically at ourselves from an allopathic point of view. This is most useful in helping industry with its strategic thinking and planning. 
• Strive for the establishment of an expert complementary medicines body that is part of FDA. For example, the CMC of South Africa’s SAHPRA and the specific commissions (e.g., Commission D (homeopathic medicinal products), Commission E (herbal medicinal products) support the work of Germany’s BfArM by providing expertise in the manufacture of various modalities (e.g., homeopathic, ayurvedic, and phototherapeutic such as Western, Traditional Chinese). This an aspiration, and an important point. 

Dr. Smith can be reached by email at peterrae.smith1@gmail.com.