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Acquaintance with information on the scientific underpinning of CAM is greatly lagging behind its increasing use by European citizens. To plug the information gap the European Information Centre for Complementary and Alternative Medicine (EICCAM) has been founded with the aim of providing and disseminating understandable, objective and high-quality information on the safety, effectiveness and efficiency of Complementary and Alternative Medicine (CAM). The outcome of research on complementary medicine is usually only presented in scientific journals and to fellow scientists, using scientific terminology. Consequently there is a communication gap. As long as this exists, it will be a barrier to CAM’s greater use.
EICCAM central purpose is to collect and update scientific information on CAM on a regular basis, converting the scientific information into a summarised and understandable format for the educated non-expert public. This information is independent, comprehensive, understandable and quality assured in order to contribute to informed decision-making by politicians, legislators and other stakeholders. The centre also networks with the scientific community, with CAM stakeholders, and is intending to organise or participate in scientific events on CAM.
EICCAM has been set up as a Public Utility Foundation under Belgian Law, with a Management Board and a Scientific Board. Both boards jointly decide on actions and activities while the Scientific Board selects the information input and output and, most importantly, ensures its quality and independence. The current scientific committee includes reputable scientists working at European universities and includes expertise in the CAM field. To date, they have published several ‘EICCAM Research Facts’ on studies in the field of homeopathy, acupuncture, anthroposophic medicine and herbal medicine, all downloadable from the website. More publications are in the pipeline.
EICCAM has already obtained some funding, but more funding will be needed to keep the Centre running and to continue to produce regular research facts. Readers of this article who interested to make a donation to the funding of EICCAM or are aware of possible funding sources are encouraged to contact the Chair of the EICCAM Management Board, Dr Susanne Schunder-Tatzber, firstname.lastname@example.org.
Over the last few years complementary medicine has been politically marginalized in Switzerland. Therefore, the complementary medicine sector, including doctors, therapists, manufacturers and specialized traders, together launched and brought about a national popular initiative. This enabled Swiss voters to obtain a referendum for a constitutional amendment if they collected 100,000 valid signatures within 18 months.
Parliament availed itself of its right to oppose the proposers’ constitutional article and suggest a slightly diluted form. Since parliament’s counterproposal adopted all the core demands on a legal level, the original popular initiative was withdrawn. Therefore, the people only had to vote on a constitutional article, which, experience has shown, increases the chances of them voting in favour. Particularly because parliament and the government support the parliamentary proposal.
On 17 May 2009, Swiss voters clearly approved the constitutional article proposed by parliament. The majority of voters per canton also voted in favour, which is likewise a prerequisite for any constitutional amendment.
In accordance with the referendum, the Swiss Federal constitution will be expanded 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”.
On this constitutional basis, parliament and the authorities have to implement the following requirements:
1. Admission of doctors of complementary medicine in the fields of anthroposophic medicine, homeopathy, neural therapy, herbal medicine (phytotherapy) and Traditional Chinese Medicine into the obligatory public health insurance system.
2. Creation of national diplomas for CAM therapists without a full medical education.
3. Integration of complementary medicine into teaching and research.
4. Safeguarding of proven remedies.
On 10-12 December 2008 at the ‘Nosodes 2008’ conference in Havana (Cuba) the director-general of the Finlay Institute, an advocate of homeopathy herself, Dr. Concepción Campa Huergo, gave a presentation about controlling the local epidemic disease of leptospirosis by using a Leptospira nosode.
Leptospirosis is an infectious disease caused by the spirochaete Leptospira transmitted to humans from rats. In humans it may cause a wide range of symptoms including high fever, severe headache, chills, muscle aches, vomiting, jaundice, red eyes, abdominal pain, diarrhea, or a rash. If the disease is not treated, the patient could develop kidney damage, meningitis, liver failure, and respiratory distress. Cuba goes through a yearly cycle of Leptospirosis epidemic, especially after the hurricanes flood the countryside and water pollution reaches its height. Many people are left homeless, flooded out and under the stress of disaster situation.
A part of the Ministry of Public Health, the Finlay Institute is the Cuban research institute. It has WHO qualified facilities, produces allopathic vaccinations and acts as supporting institution for research, production and development of high quality homeopathic products. Since Cuba is outcast by the USA government, the Cubans have come to depend on themselves for the production of medicines, health care programs, etc. And since they have no pharmaceutical multi-nationals to stop them, they were able to conduct the leptospirosis project on a massive scale unknown in the history of homeopathy.
On October November 2007, three provinces of the eastern region of Cuba were affected by heavy rainfalls causing floods of big areas and damage to sanitary and health systems. The risk of leptospirosis infection raised extremely dangerous levels with about 2 million people exposed to potentially contaminated water.
Considering this situation, the Finlay Institute prepared a leptospira nosode 200 CH using 4 circulating strains and following international quality standards. A multidisciplinary team travelled to the affected regions to conduct the massive administration of the nosode. Coordinated action with public health system infrastructures allowed the administration of a preventive treatment consisting in two doses (7- 9 days apart) of the nosode to about 2,4 million people (4,8 million of doses). The coverage of the intervention rose up to 95% percent of total population of the three provinces at risk. Another dose, at a higher potency (10M), was given after the hurricane Ike hit the island.
The epidemiology surveillance after the intervention showed a dramatic decrease of morbidity two weeks after and a reduction to zero mortality of hospitalized patients. The number of confirmed leptospirosis cases remained at low levels and below the expected levels according with the trends and rain regimens. The usual expectancy of infection even with allopathic vaccination would have been around a few thousand, with some deaths included.
The costs of the leptospirosis project were US$ 200,000, whereas the costs of ‘normal’ vaccination, only for the most at-risk populations, ie children, pregnant women, and the elderly, are about US$3,000,000.
What is remarkable is their application to such a large population, and its dramatic success, with full scientific verification. This experience could be extended to other diseases and other countries. The Finlay Institute is offering their facilities and specialists to spread this alternative to all regions needing emergent alternatives for epidemic control and prevention.
More information can be found at the website of the Finlay Institute.
The event highlighted the need to raise awareness amongst politicians and decision makers in Brussels, on the important role that homeopathy plays in promoting individualised patient health and how integrated medicine must be added to the European health agenda.
Three out of four Europeans know about homeopathy and of these 29% use it for their own health care. In Europe there are 54,000 specialised homeopathic medical doctors and practitioners and between 25% and 40% of all European health care practitioners prescribe homeopathy.
“Homeopathy helped me enormously and continues to help me today. For the first time in my disease’s history, someone has understood, someone finally ‘got’ what I have been experiencing: I believe all patients should have access to the type of treatment I have received, if they so choose and doctors should be sufficiently trained to understand what homeopathy can achieve for patients and know when it is appropriate to recommend it, as in my case”, said Helen Llewelyn, a patient of homeopathy from UK.
The event was a joint initiative of the European associations of patients, practitioners, doctors and pharmacists of homeopathy and the European homeopathic industry association. They brought together speakers with varying perspectives to stress the importance of integrated medicine.
Speakers included: Dr Ton Nicolai, President of the European Committee for Homeopathy; Helen Llewelyn, a patient of homeopathic medicine; Professor George Lewith, from the University of Southampton, who spoke about the need for an integrated approach to medicine; Professor Jaap Sijmons, a health lawyer from Utrecht University who spoke on patients’ rights and the EU responsibility with respect to complementary medicine; and Dr Elio Rossi, from the Homeopathic Clinic and Campo di Marte Hospital, who spoke on behalf of the only region in Europe, Tuscany, where complementary medicine is integrated into the conventional healthcare system.
The event celebrated homeopathy as a worldwide medical system with its roots in Europe and commemorated the founder of homeopathy, German physician Samuel Hahnemann (1755-1843). Furthermore, it set the stage for World Homeopathy Awareness Week, which begins on 10 April.
The press release can be downloaded as pdf document.
George Lewith, Professor of Health Research at Southampton University comments: ‘The review gave no indication of which trials were analysed nor of the various vital assumptions made about the data. This is not usual scientific practice. If we presume that homeopathy works for some conditions but not others, or change the definition of a ‘larger trial’, the conclusions change. This indicates a fundamental weakness in the conclusions: they are NOT reliable.’
The background to the ongoing debate is as follows:
In August 2005, The Lancet published an editorial entitled ‘The End of Homeopathy’, prompted by a review comparing clinical trials of homeopathy with trials of conventional medicine. The claim that homeopathic medicines are just placebo was based on 6 clinical trials of conventional medicine and 8 studies of homeopathy but did not reveal the identity of these trials. The review was criticised for its opacity as it gave no indication of which trials were analysed and the various assumptions made about the data.
Sufficient detail to enable a reconstruction was eventually published and two recently published scientific papers based on such a reconstruction challenge the Lancet review, showing that:
- Analysis of all high-quality trials of homeopathy yields a positive conclusion.
- The 8 larger higher-quality trials of homeopathy were all for different conditions; if homeopathy works for some of these but not others the result changes, implying that it is not placebo.
- The comparison with conventional medicine was meaningless.
- Doubts remain about the opaque, unpublished criteria used in the review, including the definition of ‘higher quality’.
The Lancet review, led by Prof Matthias Egger of the Department of Social and Preventive Medicine at the University of Berne, started with 110 matched clinical trials of homeopathy and conventional medicine, reduced these to ‘higher-quality trials’ and then to 8 and 6 respectively ‘larger higher-quality trials’. Based on these 14 studies the review concluded that there is ‘weak evidence for a specific effect of homoeopathic remedies, but strong evidence for specific effects of conventional interventions’.
There are a limited number of homeopathic studies so it is quite possible to interpret these data selectively and unfavourably, which is what appears to have been done in the Lancet paper. If we assume that homeopathy does not work for just one condition (Arnica for post-exercise muscle stiffness), or alter the definition of ‘larger trial’, the results are positive. The comparison with conventional medicine was meaningless: the original 110 trials were matched, but matching was lost after they were reduced to 8 and 6. But the quality of homeopathic trials was better than conventional trials.
This reconstruction casts serious doubts on the review, showing that it was based on a series of hidden judgments unfavourable to homeopathy. An open assessment of the current evidence suggests that homeopathy is probably effective for a number of conditions including allergies, upper respiratory tract infections and ‘flu, but more research is needed.
Prof Egger has declined to comment on these findings.
The press release can be downloaded as PDF document.
- Lüdtke R, Rutten AL (2008) The conclusions on the effectiveness of homeopathy highly depend on the set of analyzed trials. Journal of Clinical Epidemiology, 61:1197-1204.
- Rutten ALB, Stolper CF (2008) The 2005 meta-analysis of homeopathy: the importance of post-publication data. Homeopathy, 97:169-177