A fair go for homeopathy

By Dr Penny Caldicott, President of the Australasian Integrative Medicine Association.

A 2015 Australian report on homeopathy wasn't particularly good news for at least 200 million consumers worldwide who use homeopathic remedies. Or for the new wave of integrative medicine physicians who combine the best of conventional medicine with evidence-based complementary therapies.

The homeopathy review, by the Australian Government's National Health and Medical Research Council (NHMRC) stated "There are no health conditions for which there is reliable evidence that homeopathy is effective". It produced global media headlines.

Like many physicians around the world Dr Sophie Scheffer at Centre Epidaure in Belgium uses homeopathic medicine. Recently she told me how local oncologists there are now recognising the value of homeopathic remedies to support patients undergoing chemotherapy.

Yet we have a report on the table, from our Government's health research authority, that says none of this works. To understand why, we have to probe more into the scientific method used in the report, which is exactly what the Australian Homeopathic Association did, assisted by the Homeopathy Research Institute (HRI) in the UK. Their in-depth analysis of the NHMRC report reveals that the science used in compiling the report was, well, less than scientific. They found that the NHMRC actually did the review twice, but rejected the first report and it was never published.

In addition, the Chair of the NHMRC committee that conducted the review, initially failed to declare that he was a member of the lobby group 'Friends of Science in Medicine', known to be opposed to homeopathy. Why would someone with such an extraordinary conflict of interest be appointed as Chair? In fact, there was not one homeopathy expert on the committee, a violation of NHMRC's own guidelines. A bit like having a review of a cardiology practice, without having a cardiologist on the Committee- unthinkable!

In its review of evidence, the Committee introduced an arbitrary rule that for all trials to be 'reliable' they had to have at least 150 participants and reach an unusually high threshold for quality. (NHMRC itself routinely conducts studies with less than 150 participants). These unusual and arbitrary rules meant exclusion of many trials and the results of the remaining 171 of the 176 trials were completely disregarded as being 'unreliable' leaving only 5 trials NHMRC considered to be 'reliable' and which they assessed as negative.

The 60 page analysis of the NHMRC report identified numerous scientific failures including, use of an inappropriate scientific method, failure to use standardised, accepted methods, failure to obtain sufficiently accurate data to perform a meaningful review, failure to conduct an effective preliminary and public consultation and evidence of bias and misreporting. As Rachel Roberts, Chief Executive of HRI says "NHMRC's review is just bad science. Decision-makers and the scientific community rely on these kinds of reports and need to trust their accuracy".

It is precisely that trust that is now in question.

Compare the NHMRC approach with that taken by the Swiss Government in their extensive and wide ranging review of homeopathy conducted by Gudrun Bornhöft and Peter F. Matthiessen, from both the University of Witten/ Herdecke in Germany and PanMedion Foundation in Zurich. Having comprehensively reviewed all the major evidence for homeopathy they concluded that homeopathic high potency remedies produce 'regulative and specific changes in cells or living organisms" and reviews of human research found "at least a trend in favour of homeopathy". The evidence was especially strong in the case of upper respiratory tract infections and allergic reactions.

Homeopathy is an adjunct to conventional medicine and when appropriate, is an inexpensive and exceptionally well tolerated, safe treatment option.

HRI, among many others, point to numerous studies that support homeopathic treatments. The World Health Organisation (WHO) recognises homeopathy and many western countries including the UK and France have homeopathy in their health services. In it's 2009 report, WHO emphasises the need for quality – especially in determining the authenticity of the source materials and the reproductability of the manufacturing processes. They also note that plants can be subject to contamination from microbes, insects, pesticides, fumigants and heavy metals, which is why the purity and integrity of plant development and medicinal formulation is so important.

As the Swiss prepare to take further steps forward with an evidence-based approach to homeopathy, Australia takes a step back in my view and its homeopathy report is now the subject of a formal complaint to the Ombudsman.

We have a value in Australia called the "Fair Go" – in a 2006 survey more than 90% of people said it was the value they held as most important. As you would expect, it speaks to being fair and even -handed.

It would seem in our country and perhaps in others, that homeopathy is still waiting for a fair go.

Dr Caldicott is Founder of Invitation to Health, an integrative medicine practice north of Sydney, Australia