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Back in 2005 the government rejected these complementary (CAM) therapies, arguing they failed to meet the legal requirement of scientific evidence of the three criteria of efficacy, cost-effectiveness and suitability. These three criteria to accept a therapy in the list for reimbursement, are required by the law.
The reversal in policy follows a nationwide vote in 2009 in which two-thirds of Swiss backed expanding the Swiss Federal constitution by an article stipulating that the Federal government and cantons shall ensure that, within the scope of their jurisdiction, complementary medicine is taken into consideration.
As far as the cost-effectiveness of these therapies are concerned, data published in an article in the Swiss Medical Journal* show that even though consultations with doctors who have an additional qualification in homeopathy or other complementary therapies are significantly longer than those in conventional medicine - and leading to a higher patient satisfaction - the total costs per patient per year are not higher and the costs per doctor per year are even 29% lower than in conventional medicine.
The economic benefit of these therapies may have been sufficiently demonstrated, but the health authorities are not yet convinced of the efficacy of the complementary therapies. A federal commission in December 2010 even recommended to strike them permanently from the list because of a 'lack of scientific evidence'. Nevertheless the government has given the medical CAM associations some respite. The associations will have to present conclusive evidence for the efficacy of the complementary therapies by 2017, thus leaving them some time to fill in the gaps for those therapies that so far have not, or only partially, managed to fully meet this requirement.
The evidence is then to go before a recognised international institute for an independent scientific assessment. That institute could be the National Center for Complementary and Alternative Medicine in the USA or the National Institute of Clinical Excellence in the UK.
The government’s decision also includes provisions to boost research and training in the field, which would not be counter-productive, even if there is a negative result for the therapies after the trial period.
* the article in the Swiss Medical Journal - Schweizerische Ärztezeitung is available here, in German only.
Montagnier, who is also founder and president of the World Foundation for AIDS Research and Prevention, makes the following strong statement for homeopathy and homeopathic doses: "I can't say that homeopathy is right in everything. What I can say now is that the high dilutions are right. High dilutions of something are not nothing. They are water structures which mimic the original molecules."
In a study that was published in 2009, Montagnier demonstrated that some bacterial DNA sequences are able to induce electromagnetic waves, even at high aqueous dilutions up to 10^-18. This study was an important contribution to the growing evidence base in fundamental research with direct relevance to homeopathy.
Montagnier will take on the leadership of a new research institute at Jiaotong University in Shanghai and plans to study the phenomenon of electromagnetic waves produced by DNA in water. His research team will study both the theoretical basis and the possible applications in medicine.
In the interview Montagnier says that he cannot pursue this research in France because he does not have much funding there. Because of French retirement laws, he is no longer allowed to work at a public institute. But there is another reason as well. When he applied for funding from other sources, he was turned down. Montagnier argued that there is a kind of fear around this topic in Europe.
In this context he refers to Dr Jacques Benveniste, a French physician/scientist who conducted research on homeopathic doses. Montagnier regards him as a "modern Galileo." "Benveniste was rejected by everybody, because he was too far ahead. He lost everything, his lab, his money. … I think he was mostly right, but the problem was that his results weren't 100% reproducible." "I am told that some people have reproduced Benveniste's results, but they are afraid to publish it because of the intellectual terror from people who don't understand it."
Is Montagnier worried that his colleagues will think he has drifted into pseudoscience? He replies adamantly: "No, because it's not pseudoscience. It's not quackery. These are real phenomena which deserve further study."
The whole interview is available at the website of Science magazine.
The aim of CAM-quest is not to rate clinical studies, but rather to demonstrate that a huge body of clinical research in the field of CAM does exist. The database includes research studies in nine therapy categories – acupuncture, anthroposophy, ayurveda, bioenergetics, homeopathy, manual medicine, mind-body medicine, phytomedicine and TCM – and searches can be made by disease, therapy and study design.
The CAM-quest ’quick search’ function provides a fast and easy way to find clinical research which assesses alternative treatments for many common diseases. However, there is also the option of an ‘expert search’ which allows you to carry out a comprehensive search in CAM clinical research literature, including access to a large number of German homeopathic case reports.
The website presenting the CAM-quest database is currently available in English, French, Dutch and German, but will eventually be translated into all of the European languages.
The database is accessible at www.cam-quest.org
The Homeopathy Research Institute promotes research in the field of homeopathy by:
- Facilitating research projects within international academic institutions
- Providing a peer review process for research proposals submitted to their Scientific Advisory Committee.
They aim to facilitate research which explores different aspects of homeopathy, such as the effectiveness of homeopathy in daily practice, effectiveness in treating key pathologies and the physical properties of homeopathic preparations. They also aim to inform health professionals and the general public about research in homeopathy through the provision of:
- An online homeopathy research database
- A free quarterly newsletter covering various homeopathy research topics.
The HRI has established a research database, which comprises randomised controlled trials (RCTs) of homeopathy that have been published in peer-reviewed journals up to 2009. Other such RCTs will be added in due course, and the database will be updated on an ongoing basis to remain a current resource.
The website and the database are accessible at http://www.homeoinst.org
The 'Veterinary Clinical Research Database in Homeopathy', or 'VetCR-database' for short, having approximately 200 entries of randomised clinical trials, non-randomised clinical trials, observational studies, drug provings, case reports and case series, enables researchers and veterinarians, sceptics and supporters to get a quick overview of the status of veterinary clinical research in homeopathy and alleviates the preparation of systematical reviews or may stimulate reproductions or even new studies. It is free of charge and open to all interested veterinarians and researchers.
Most studies were published in English and German. Data were extracted on the bibliographical data, clinical field, design of study, type of homeopathic treatment, type of control and blinding, species, intervention, number of animals, outcome, application of high potencies and prophylactic applications. By far the most studies involved gynaecological conditions in cattle, including infertility and MMA syndrome (mastitis-metritis-agalactia). More than 50% of the studies are randomised clinical trials.
Most of these studies were motivated by and interesting for economic considerations (cost reduction, production increase). The general aims are, on the one hand, the improvement of meat and milk quality, the reduction of postpartum infertility and of the calving-to-conception-interval, the increase of the number of offspring and its survivability and the diminution of diseases, especially mastitis at drying-off, and on the other hand, the reduction of use of chemical therapeutics (especially antibiotics), to lower the chemical load of meat and milk and to reduce treatment costs.
Many promising results suggest that homeopathically supported health concepts in organic and conventional meat production and dairy herds are suitable to decrease chemical therapeutics input. However, there are also studies showing no positive effect after homeopathic treatment. Therefore, further research and reproductions, accompanied by systematic reviews and meta-analyses, are necessary.
The database is probably far from being complete. Readers are therefore encouraged to notify the Karl and Veronica Carstens Foundation of missing studies.
The database can be entered here.
Clausen J, Albrecht H (2010) Database on veterinary clinical research in homeopathy. Homeopathy, 99:189-191 [PubMed]