Making pseudoscience of homeopathy immune from criticism does not serve public weal

A physician friend alerted me the other day about a strange new official proclamation from the Government of India (GoI). With a long history of uncritical friendliness (as well as State-sponsorship) towards various alternative medicine modalities, GoI —specifically, the ministry in charge of altmed, the Ministry of AYUSH (Ayurveda, Yoga, Unani, Siddha & Homeopathy) in this case— announced that a “high level committee” has been set up to “deal with issues” related to “false propaganda against homeopathy”.


AYUSH Ministry Communication

Screengrab from AYUSH Ministry official notification. Source: Press Information Bureau (PIB); link as above

The AYUSH Ministry in India is particularly concerned about the global decline in the fortunes of homeopathy; one of the likely causes for this reaction may be the fact that in India, homeopathy is accorded all the privileges of a proper medical discipline, including State-run homeopathy training institutes — which churn out an army of homeopathy graduates allowed to practise their craft on unsuspecting people (who are led to believe that homeopathy is a medical modality just like any other). It’s not, though.

Providing healthcare to a country of a billion people is always a concern justifiably fraught with trepidation, so when homeopathy steps up to fill a crucial grap, the government ignores that the emperor, in fact, has no clothes, i.e. it disregards the mounting evidence for lack of efficacy of homeopathy as a therapeutic regimen. In fact, the AYUSH Ministry took to severely criticizing the most recent of such evidence, the study by Australia’s top medical research organisation, the National Health and Medical Research Council (NHMRC), which found that homeopathy was not more effective compared to placebo.

On August 8, a tweet from the Information & Broadcasting Ministry of the GoI reposted the same information as the AYUSH Ministry about the “high level committee”. Which means the Government is giving this matter of homeopathy not only administrative consideration, but also an official voice. The term “high level committee” has traditionally been used to attach grave significance, often with an intimidatory aspect to it, to matters under consideration.

Interestingly, neither ministries actually defined what is meant by “false propaganda against homeopathy” and why this matter merited an official government proclamation.

As readers of this blog likely know, I have been, for a long time, an ardent critic of all manners of pseudoscience, including homeopathy, and I have written quite a bit about it. Sadly, this sudden concern for homeopathy seems to have overtaken other interests of the AYUSH Ministry, some of which could be legitimate subjects of scientific studies with potential benefits. I had several questions for the Ministry of Information & Broadcasting (MIB), which I tweeted out to them (without expecting, of course, any response). The following is what I wrote, in long form here:

  1. Instead of defending the indefensible pseudoscience of homeopathy, can’t you focus efforts on ethnobotany studies via Ayurveda?
  2. We’ve such rich natural resources of medicinal herbs & plants of tremendous potential; why not push efforts there?

Despite the current political tension between India and China, there is one relevant aspect we could learn from China — its commitment to extensive and detailed scientific research with its natural resources. China invested heavily in what it refers to as Traditional Chinese Medicine, or ‘TCM’; persistent pharmacognosy/ethnobotany studies in this discipline led to medicinal products, and a Nobel Prize to boot. I have earlier written about about how the painstaking efforts of one scientist, Tu Youyou, working under Chinese government patronage, made this prestigious Nobel possible for her in 2015.

India, the country of my birth, certainly does not lack qualified scientists. So can it not do the same with the natural resources that we already have in abundance? I asked the MIB.

There is actually an interesting conundrum for homeopathy aficionados in India and Southeast Asia. There are many —and this perception is encouraged— who like to differentiate between homeopathy & ‘Western medicine’ (commonly referred to by a term most popular in India, ‘allopathy’); the fact that homeopathy is ‘Western’ in origin, too, is often ignored and not communicated to patients because it doesn’t fit with a particular narrative about this modality of therapy.

Homeopathy, especially classical homeopathy of Hahnemannian origin, is the product of prescientific vitalistic thinking, with a presumed mode of action that is biologically and physicochemically implausible. Clinical studies after clinical studies have naturally failed to show an effect of homeopathy significant beyond the placebo effect (most recently the linked NHMRC study), and in fact, there is some evidence (I had discussed it) that the beneficial placebo effect may be accentuated by a positive patient-physician interaction rather than any medicinal properties of the homeopathic nostrum.

A fact with assorted homeopaths across the world like to deny most vigorously is that the lack of evidence of clinical efficacy combined w/its implausibility of action has already prompted many nations to abandon homeopathy, the NHS UK being one of the latest examples. The observations that were corroborated by NHMRC Australia in 2015 were hardly unique. (In this regard, do read this analysis of the NHMRC report from one of homeopathy’s most famous and vocal critics, a man who was once a legitimate professor of alternative medicine, Dr. Edzard Ernst.)

In this backdrop, my question to MIB and the Government of India assumes a critical significance: Must our nation cling to the outmoded and delusional pretend-medicine of homeopathy, and not focus on the wealth of natural resources we already have? I would like to see my birth-country become a standard bearer for science, especially good science proudly done in India with its natural resources. In that respect, it’s important to remember that critiques are a crucial aspect of conducting science research. I urge the Government of India to eschew terms like “propaganda” when dealing with legitimate concerns and critiques of homeopathy. Classical homeopathy is not medicine; it’s unable to prevent/treat/offer symptomatic relief from a physical/psychological disorder. Shielding it from criticism does not help vulnerable patients, and the government must not be involved in pushing it.


A version of this post in Tweet form was published on the Kanvz platform earlier.

7 Comments

  1. India is frequently held up as a shining example of a country where homeopathy is valued, widely used, highly successful and an integral and vital part of their healthcare system.

    However, it might not be as prevalent as homeopaths might like us to believe. As you point out, homeopathy is generally grouped with other alternative therapies: Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH). The National Sample Survey Office of the Indian Government, in its survey on Social Consumption: Health, conducted between January to June 2014 and covering all of India, including urban and rural sectors (n=333,104), stated:

    3.2.2 Clearly a higher inclination towards allopathy treatment was prevalent (around 90% in both the sectors). Only 5 to 7 percent usage of ‘other’ including AYUSH (Ayurveda, Yoga or Naturopathy Unani, Siddha and homoeopathy) has been reported both in rural and urban area.[1]

    Since homeopathy is not identified separately but included under the banner of AYUSH, it is not known how many use it — all that can be stated is that less than 7% (and likely a lot less) use homeopathy. While this indicates that a number as high as 87 million could be using homeopathy, that still means that 1.164 billion do not.

    __________
    1 NSSO – Key Indicators of Social Consumption in India Health. The Hindu Centre for Politics and Public Policy. 2015.http://www.thehinducentre.com/resources/article7378862.ece

    • admin

      August 11, 2017 at 1:49 am

      Thank you for pointing that out, Alan. However, please bear in mind that Governmental Statistics often may not always capture the whole magnitude of the issue. I’ve to look up the actual report to find out if they stratified their data based on the urban rural divide; likely not. In the semi-urban, rural and remote areas (which translate areas with poor people and areas of lower literacy), homeopaths and homeopathy retain a substantial amount of influence – especially since homeopathic “medication”, doled out in doses (rather than in bottles; with zero quality control, of course), is often cheaper than having to travel to a pharmacy and buying medicines which are undoubtedly costly.

      Government Statistics would also not capture a segment of people like my parents, who would by choice or compulsion visit proper doctors and take the prescribed medications, but would at the same time self-medicate with various homeopathic nostra, and retain a firm belief in the latter’s “medicinal” value.

      It’s complicated, for sure. But the reasons behind the perception of homeopathy’s “efficacy” remain the same in India as in the world over.

      • Fascinating. I take it there’s no other data available? It would be interesting to find out the split between the different components of AYUSH, particularly since they are so diverse. Or are they seen as one homogeneous ‘system’?

      • Looking at the NSSO link, Homeopathy is part of AYUSH and AYUSH is part of “other”.

        “Other” makes up 5-7% of the respondents. Given the number of respondents I would expect this to be a fair representation of the population. Due to the nature of the NSSO I would be surprised if it wasn’t.

        Anyway, Homeopathy still comes in as a fraction (part of AYUSH) of a fraction (part of “other) of, at best, 7% of the population. Messing with polling criteria isn’t going to have much of an impact on such a tiny fraction.

        You state: “In the semi-urban, rural and remote areas (which translate areas with poor people and areas of lower literacy), homeopaths and homeopathy retain a substantial amount of influence…”

        So your argument here is that homeopathy is popular amongst the poor and undereducated? That’s not a good look.

        Also, popularity is irrelevant. The best quality research we have today shows, conclusively, that it doesn’t work and this is being acted on by multiple governments around the world. Australia, the UK, Spain, multiple government departments in the US… All have removed, or are in the process of removing, subsidies and recognition of homeopathy because of the weight of evidence against it.

        Science is a hard thing to argue against.

        • admin

          October 27, 2017 at 3:55 pm

          Science is a hard thing to argue against.
          Gold/Unifex, I am not sure what your point is. Did you happen to actually read what I wrote in the blog-post – before you responded? Perhaps I may even trouble you to read through the links to my previous posts on the pseudoscience of homeopathy?

        • admin

          October 27, 2017 at 3:57 pm

          For some strange reason, I got a notification of your annotation before I saw your actual comment. Whatever the reason, my apologies for the delay in response. However, I did respond to your annotated comment on the 12th of September, and assumed you were satisfied given that there was no counter-response. If you still have questions, comments, etc., please feel free to write here. Work pressure has kept me from investing time in the blog for a little while, but I promise to keep checking for comments.

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