August 21, 2009
Sense About Science
The WHO has responded to a call from young medics and said that it DOES NOT recommend the use of homeopathy for treating HIV, TB, malaria, influenza and infant diarrhoea1. In an open letter to the WHO in June this year, the group of early career medics and researchers from the UK and Africa asked the body to make clear that homeopathy cannot prevent or treat these serious diseases in the face of its growing promotion by manufacturers and practitioners2. The Director General's office has confirmed that the responses from WHO departments (below) "clearly express the WHO's position". Today the Voice of Young Science network,3 who coordinated the letter, has written to the health ministers of all countries to publicise the WHO's position, asking them to combat the promotion of homeopathy for these dangerous diseases.
Dr Mario Raviglione, Director, Stop TB Department, WHO: "Our evidence-based WHO TB treatment/management guidelines, as well as the International Standards of Tuberculosis Care (ISTC) do not recommend use of homeopathy."
Dr Mukund Uplekar, TB Strategy and Health Systems, WHO: "WHO's evidence-based guidelines on treatment of tuberculosis…have no place for homeopathic medicines."
Dr Teguest Guerma, Director Ad Interim, HIV/AIDS Department, WHO: "The WHO Dept. of HIV/AIDS invests considerable human and financial resources […]to ensure access to evidence-based medical information and to clinically proven, efficacious, and safe treatment for HIV… Let me end by congratulating the young clinicians and researchers of Sense About Science for their efforts to ensure evidence-based approaches to treating and caring for people living with HIV."
Dr Sergio Spinaci, Associate Director, Global Malaria Programme, WHO: "Thanks for the amazing documentation and for whistle blowing on this issue… The Global Malaria programme recommends that malaria is treated following the WHO Guidelines for the Treatment of Malaria".
Joe Martines, on behalf of Dr Elizabeth Mason, Director, Department of Child and Adolescent Health and Development, WHO: "We have found no evidence to date that homeopathy would bring any benefit to the treatment of diarrhoea in children…Homeopathy does not focus on the treatment and prevention of dehydration – in total contradiction with the scientific basis and our recommendations for the management of diarrhoea."
Dr Robert Hagan, Postdoctoral Researcher, Biomolecular Scientist, University of St Andrews: "We need Governments around the world to recognise the dangers of promoting homeopathy for life threatening illnesses. We hope that by raising awareness of the WHO's position on homeopathy we will be supporting those people who are taking a stand against these potentially disastrous practices."
Juliet Stevens, Medical Student, University of Oxford (on placement at Somerset State Hospital, Cape Town, South Africa): "Despite awareness in Britain of the medical burden in South Africa, little can prepare you for seeing this first hand. On the Paediatric wards infants are diagnosed with stage 3 HIV/AIDS on a daily basis, and TB meningitis is rife. The minimal cost of state healthcare is prohibitive for some, and denial regarding HIV diagnoses is still common, making the population here a vulnerable target for unproven therapies."
Tom Wells, PhD student, Department of Chemistry, Imperial College London: "Treatments, developed through rigorous, clinical testing are powerful tools with which to save lives. To undermine their application by promoting alternatives, without evidence of efficacy, is irresponsible and dangerous. All people suffering with TB, malaria, influenza and the ravages of HIV deserve proven treatments, not false hope."
Dr Daniella Muallem, Postdoctoral researcher, Department of Neuroscience, Physiology and Pharmacology, UCL: "When medicines exist which have been proven to be highly effective at treating life threatening diseases such as HIV and malaria I believe it is highly unethical to advocate treatments for which there is no good evidence as an alternative for poor people."
Evelyn Harvey, Biochemist and Medical Writer: "The aggressive stance some homeopathic practitioners take towards life-saving drugs for HIV, TB, malaria and other diseases that ravage the developing world is irresponsible, patronising and unnecessary. We should not deny people in developing countries access to the full facts and to high-quality scientific evidence."
Duncan Casey, PhD student, Department of Chemistry, Imperial College London: "This isn't the difference between two schools of medicine; this is like comparing a 747 to a magic carpet. The magic carpet is a lovely idea – but at the end of the day, which would you rather trust with your life?"
Dr Peter Flegg MD, FRCP, DTM&H, Consultant Physician, Department of Infectious Diseases, Victoria Hospital: "As a physician who has had first hand experience of the devastating effects of these life-threatening infections in Africa, I am frankly appalled that anyone would consider treating them with totally irrational, ineffective and unproven therapies. These infections all have effective conventional treatments available, and to use homeopathy for them is highly unethical and morally repugnant."
Professor Raymond Tallis, Emeritus Professor of Geriatric Medicine, University of Manchester: "The catastrophic consequences of promoting irrational and ineffective treatments for serious illnesses have been demonstrated in South Africa, where Thabo Mbeki's policies have led to an estimated 365,000 unnecessary premature deaths. The prospect of replicating this reckless behaviour elsewhere in developing countries by advocating homoeopathic treatments for AIDs and other potentially lethal conditions is appalling. I hope that the timely intervention by the Voice of Young Science Network will help to pre-empt a public health disaster. It illustrates the importance of young scientists, torchbearers for a better future, taking a stand and speaking out."
Dr Alastair Miller MA FRCP DTM&H, Consultant Physician, Tropical & Infectious Disease Unit, Royal Liverpool University Hospital: "We frequently see patients in our unit from developing countries who have been advised to take inappropriate and unproven therapies for their HIV and not to take the very well established and effective anti viral agents. This leads to tragic and inevitable breakdown of the immune system and very adverse outcomes for our patients"
Dr NJ Beeching, Senior Lecturer and Clinical Lead in Infectious Diseases, Tropical and Infectious Disease Unit, Royal Liverpool University Hospital: "Infections such as malaria, HIV and tuberculosis all have a high mortality rate but can usually be controlled or cured by a variety of proven treatments, for which there is ample experience and scientific trial data. There is no objective evidence that homeopathy has any effect on these infections, and I think it is irresponsible for a health care worker to promote the use of homeopathy in place of proven treatment for any life-threatening illness. New treatments, whether conventional or homeopathic, should not replace current therapy unless they have been shown to be at least as effective in carefully monitored clinical trials."
Dr David Misselbrook MSc MA FRCGP, Dean, Royal Society of Medicine: "I offer my personal support to the stand taken by Sense about Science and the Voice of Young Science in their letter to the WHO expressing their concern about the use of homeopathy to treat serious disease in the developing world.
Homeopathy is valued by patients in wealthy countries as a complementary therapy that may help them to feel better during periods of illness. However there is no good quality scientific evidence that homeopathy is effective against serious diseases such as TB, malaria or AIDS. It seems quite wrong to encourage Western complementary therapies in the developing world when they stand in such acute need of the basics that we take for granted such as clean water, sanitation and access to proven medical treatments for serious disease."
Professor Tom Welton FRSC, Professor in Sustainable Chemistry, Head of the Department of Chemistry, Member of advisory panel for the Pan African Chemistry Network: "It is with shock that I read that homeopathy is being proposed as an alternative to scientifically proven treatments for life-threatening diseases such as malaria and HIV/AIDS. Homeopathy proposes that diseases can be cured by tinctures that contain no active ingredient. There is, of course, no systematic evidence that shows that these work. To propose that a therapy for which there is no evidence for its efficacy as a substitute for treatments that have been shown to work is reckless and frankly wicked. If this is not prevented, lives will be lost.
I remember the days before the introduction of antiviral therapies for the treatment of HIV/AIDS, when the only hope that my sick friends had to cling to was treatments such as homeopathy. They died in appalling numbers. The advent of effective anti-viral drugs has turned this situation around completely and I have not lost another friend since. It is imperative that these drugs are made available to all who can benefit from their use, not that they are replaced with so-called treatments that don't work."
Professor Nicholas White OBR FRS, Tropical Medicine, University of Oxford; Chair, Wellcome Trust SE Asian Units and of the WHO Antimalarial Treatment Guidelines Committee:"We still rely heavily on natural products for the treatment of malaria (Cinchona alkaloids, artemisinin derivatives), but we use quality assured products at doses shown conclusively to be effective. Malaria is a potentially lethal infection. Treating with inadequate doses or ineffective products diverts the patient from receiving effective medicines and may result in their death."
Dr Ron Behrens, Director, Hospital for Tropical Diseases: "I would strongly support this letter. There is an important role for anti-malarial compounds extracted from local plants for the treatment of malaria, which are being, and have been identified through careful research in a number of developing countries. However their clinical use should follow the same rigorous scientific evaluation and testing as all drugs for humans."
Professor JM Ryan, Emeritus Professor of Conflict Recovery, St George's Hospital University of London: "Those who practice conventional medicine live in a world constrained by the need to consider best evidence when recommending therapies and this is absolutely the correct approach."