Memorandum submitted by Sense About Science HO36

 

 

 

1. Background

Sense About Science is a UK registered charity that works to equip people to make sense of science and evidence. We work with over 4,000 scientists, from Nobel prize winners to our Voice of Young Science network of postdoctoral researchers, to help civic groups including community organisations, media and commentators to weigh up claims about evidence.

 

2.1 Public perception of homeopathy

We monitor public discussions, together with our own log of requests for help and concerns raised by scientists, to identify frequently occurring misconceptions or misleading information. In 2006 we reviewed discussion about homeopathy and made two observations:

a) That it was believed to contain an active ingredient, and was often confused with herbal medicine (and, related to this, that people were often unaware of the mystical belief in water memory and in 'like cures like' on which it is based).

b) That because it was supplied on the National Health Service, it was assumed that it 'must be effective' and 'there must be something in it'.

 

2.2 We also noted regular reports of homeopathic remedies being marketed for serious diseases, notably at that time anti-malarial prophylaxis. We assessed this to be in part a consequence of the assumptions a) and b) above.

 

2.3 We noted, through discussions held with clinicians and researchers, that there was an atmosphere of resigned frustration about the possibility of addressing the misconception that homeopathic products contain active ingredients and the misconception that there was reliable evidence of efficacy beyond the placebo effect. In particular they found it hard to argue against something that was supplied through the NHS and that appeared to be officially endorsed. We also noted their frustration about the acclaimed 'holistic' approach of homeopathy despite its inability to diagnose disease and the potentially dangerous consequences of that. Furthermore, if the use of some unproven and unlikely remedies is officially flattered and endorsed, then this affects our ability to reason through debates about the suitability or provision of any other remedy. In other words, one cannot demand that people accept the evidence regarding the provision of drugs for Alzheimer's yet overlook it regarding the provision of homeopathy.

 

2.4 Scientists' resignation to public misconceptions is anathema to Sense About Science's mission of equipping the public to make sense of science and evidence. It disenfranchises the public by removing scientific reasoning to senior common rooms and private clubs.

 

3. Challenging perceptions

We supported and encouraged medical scientists to make themselves plain in public discussions about homeopathy in the following ways:

 

3.1 In May 2006, a group of medical specialists, led by cancer surgeon Professor Mike Baum, writing to the medical directors and directors of public health at NHS trusts to draw attention to the provision of homeopathy and the lack of evidence in support of its efficacy. In particular they raised concern about: overt promotion of homeopathy for general use in the NHS, including on the NHS Direct website; a government-funded patient guide, prepared by the Foundation for Integrated Health; and the Smallwood report commissioned by the Prince of Wales to make a case for increasing NHS provision of homeopathy. They pointed out that over a dozen systemic reviews had failed to provide convincing evidence of effectiveness. This letter was followed one year later with a letter led by Professor Gus Born, enclosing a copy of an evidence review by a London NHS trust.

 

3.2 From this time, a group of clinical researchers and journalists gathering information on the extent of provision of homeopathy by NHS trusts, a summary of which has been supplied to you separately.

 

3.3 In July 2006, working with experts in malaria and tropical diseases to warn the public that homeopathic medicines offer no protection against malaria or other serious tropical diseases. This followed a short investigation by Sense About Science, which showed that the first ten homeopathic clinics and pharmacies selected from an internet search and consulted were willing to break public health protocols by providing unproven homeopathic pills to protect against malaria and other tropical diseases such as typhoid, dengue fever and yellow fever. In widely report comments, the malaria experts called on the Government to ensure that the safety of the travelling public was not put at risk by such prescriptions. Subsequent action was brought by the Royal Pharmaceutical Society of Great Britain (the pharmacy registration body at that time) against two of the pharmacies investigated. This is ongoing.

 

3.4 In September 2006 producing a short public leaflet, Sense About Homeopathy, describing homeopathy in a scientific context and exploring why some people think it works (http://www.senseaboutscience.org.uk/pdf/SenseAboutHomeopathy.pdf).

 

3.5 In autumn 2006, challenging the Medicines for Human Use (National Rules for Homeopathic Products) Regulations 2006. The new regulations permitted homeopathic products to make medical claims but exempted them from providing scientific evidence that they are effective. This was the first time in its history that the regulation of medicines moved away from science and from clear, meaningful information for the public. What is more, it happened without parliamentary time or public debate. In October 2009, Sense About Science summarised for parliament hundreds of responses protesting the introduction of the regulations, including many from scientific and medical bodies. These were instrumental in pressing for the debate that was held in the House of Lords on 26th October 2006. The serious concerns of the scientific and medical community were raised by Lord Taverne (Chairman of Sense About Science), Lord Rees of Ludlow (President of the Royal Society), Lord Turnberg, Lord Jenkin of Roding, Lord McColl of Dulwich and Baroness O'Neill of Bengarve. A summary of our objection at that time was:

 

"The regulations

The mission of the UK's licensing body, the Medicine and Healthcare products Regulatory Agency (MHRA), is to ensure "that medicines and medical devices work, and are acceptably safe". However, with the introduction of the new rules for homeopathy, it now accepts homeopathic provings as evidence of efficacy. A 'proving' is the method homeopaths use to determine the symptoms a substance causes (with a view to treating diseases with similar symptoms). Provings are not carried out on the finished product and are nothing to do with efficacy.

 

The regulations also mean that, for the first time in more than 30 years, homeopathic products will be able to make medical claims such as "For the relief of...". Such claims, however worded, imply efficacy where none has been proven.

 

The MHRA did not have to change the regulations in this way. It was not required to do so by EC Directive 2001/83. The MHRA set out four options to government, including doing nothing. It chose to eliminate the old, stricter licences in order to facilitate the "expansion of the homeopathic industry" through new products.

 

The MHRA has designed the regulations to respond to pressure from the homeopathic industry, which wants to expand (see impact assessment right)."

 

 

3.6 In June 2009 working with Voice of Young Science to urge the World Health Organisation to respond to the promotion of homeopathy in developing countries for infant diarrhoea, influenza, HIV, tuberculosis and TB. A note from Julia Wilson of VoYS is appended.

 

 

 

Submission to Evidence Check: The evidence base on homeopathic products and services

1. SUMMARY

A group of young researchers have received comments from directors of WHO disease programmes stating that they do not recommend homeopathy for the treatment of HIV, influenza, TB, Malaria and Infant diarrhoea. These comments have been sent to all health minsters in the world and provide a guideline for governments and health care workers dealing with these issues.

2. BACKGROUND

Voice of Young Science (VoYS) is a network of over 600 early career researchers set up by Sense About Science. Sense About Science is a charity that equips people to make sense of science and evidence. VoYS became aware of a conference[1] promoting the use of homeopathy in developing countries and discovered that homeopaths are setting up clinics in these countries and claiming to treat HIV, malaria, TB, influenza and infant diarrhoea. Medics working with the most rural and impoverished people of the world already struggle to deliver the medical help that is needed. The promotion of homeopathy for serious diseases puts lives at risk. On 1st June 2009 25 early career researchers and medics from the UK and Africa sent an open letter to the World Health Organisation (WHO) calling on the body to condemn the promotion of homeopathy for treating life threatening diseases. Their letter available at http://www.senseaboutscience.org.uk/index.php/site/project/331/ had the support of leading international experts in malaria, HIV and other serious diseases.

3. RESPONSE

VoYS received supportive comments from the Stop TB Department, the TB Strategy and Health Systems, the HIV/AIDS Department, the Global Malaria Programme and the Department of Child and Adolescent Health and Development stating that they do not recommend homeopathy for serious diseases. These comments are available at http://www.senseaboutscience.org.uk/index.php/site/project/392/. The Director General's office confirmed that these 'clearly express the WHO position'.

4. IMPACT

VoYS released the WHO response on 21st August 2009. It was sent to the health ministers of all countries to highlight the WHO's position on homeopathy and to call on governments to combat its promotion for serious diseases. The WHO response was covered widely in UK and international media including African, Indian and South American news. VoYS were contacted by a number of researchers and medics in Africa and India, organisations such as the Centre for Inquiry in Nigeria and several South African journalists, concerned about the promotion of homeopathy in their countries and pleased to have this support.

 

 

November 2009



[1] Homeopathy for Developing Countries, An International Conference in Amersfoort, the Netherlands, 6-7 June 2009. The programme can be found here: www.homeopathycommunity.com/upload/HomeopathySeminar.pdf