The recent global activity featured in the Integrator Blog News and Reports and re-posted by ISCMR, an international society of researchers in traditional, complementary, alternative and integrative medicine and health, has shown an unmistakable pattern: multiple governments are acting to remove recognition of homeopathy and certain of other complementary and integrative practice deemed “psuedo-scientific.” It’s not the only pattern. There hjave been recent positive governmental steps in Switzerland, India, the US and elsewhere. Still, the regulatory integrative ectomies in Spain, France, the UK, Australia, Canada – and here in the USA – are worth a collective heads up.

Caveat emptor. The information that follows is all based on reports in other media. None of it has been independently affirmed. Nor have obvious questions been pursued. An overarching concern of some about whether these actions are in someway coordinated – or merely the spontaneous appearance of dormant antagonism amidst a global flowering of integrative practices – is only briefly approached. The goal here is mainly to provide a picture of the activity. The focus is on governmental action, but strays into related news. I searched back to the Integrator Blog links for 13 months.

Spain

In November 2018, the Socialist Party government of Prime Minister Pedro Sánchez recommended plan to fight “the rise of pseudo-therapies such as homeopathy which promise to have a positive health impact but have no scientific evidence to support their claims.” The plan, presented as unprecedented in the European Union, “aims to eliminate so-called alternative therapies from health centers and universities.” The multi-pronged approach includes:

• A “communication strategy” to urge stronger attention to science.
• An effort to “stop misleading communication.”
• Plans to “eliminate pseudo-therapies from health centers” and “guarantee” that only health professionals with “officially recognized qualification” work at such centers.
• Remove any academic degree “that includes pseudo-therapies” from the country’s universities. (This will follow a government report determining which will be targeted.)

In the coverage, homeopathy, mainly, but also acupuncture are targeted with orthomolecular medicine and salt baths also noted. One stimulus to action was reported cancer deaths of individuals who used alternatives that prompted 400 medical doctors to call for the change. The Spanish government has notified Brussels of the action. Spain’s Association for Protection against Pseudo-Scientific Therapies welcomed the campaign. Spain’s largest circulation free weekly stoked the flames, with this headline: “Death toll fears amid claims patients choose ‘natural remedies’ over conventional medicine” and this subheading: “THOUSANDS of people could be dying each year in Spain because they trust alternative medicine.”

France

In February 2018, faculty of medicine of Lille Unversity suspended its degree in homeopathy for the 2018-19 academic year “while waiting for France’s national health authority to rule on the practice, “which many conventional medicine practitioners regard as a pseudoscience.” A month later in March 2018, a Le Figaro article noted that a letter by 124 medical doctors “protesting the use of alternative medicines such as homeopathy that have no scientific basis.” Their demands are to “to stop recognising alternative treatments as medical, stop teaching them in medical training, and call for a halt to covering the costs of such treatments.” The Academy of Medicine and the Academy of Pharmacy supported the latter position in filing a joint report urging the end of reimbursement of homeopathy As debate rages – 72% for the French people believe homeopathy is valuable – the High Authority of Health is expected this Spring “to rule over the continuous use or otherwise of this alternative medical practice.”

Australia

In January 2019, the Australian government’s Department of Health noted that certain natural therapies will not receive insurance coverage. The list: Alexander technique, aromatherapy, Bowen therapy, Buteyko, Feldenkrais, Western herbalism, homeopathy, iridology, kinesiology, naturopathy, Pilates, reflexology, Rolfing, shiatsu, tai chi, and yoga. A TV show highlighted “yoga, naturopathy and pilates” in examining the  regulatory exclusion. A systematic scoping review on whole systems naturopathic treatment recently published in JACM by Australian researchers was featured in this  media account that examined the evidentiary debate on the challenges to the naturopathic profession. Separately, new guidelines from the Medical Board of Australia are governing conversations with patients about alternatives.

There has been push back from practitioner – besides the presentation of the systematic review by the naturopaths. The Australasian Integrative Medicine Association protested the Medical Board’s move that they fear will restrict access to complementary treatments. Natural medicine practitioners hailed the election of a strongly supportive politician on whom they anticipate leaning to push back against the government actions. Meantime, in this same time frame, the professional naturopaths in Australia, who have met academic standards to enter the practice of naturopathy there, have taken the government to task for not better regulating the field and thus limiting the chance of public harm from practitioners who don’t meet the standard. Ironically, this all took place as a formal governmental agreement enhanced the recognition of the role of Aboriginal traditional medicine within the Australian health system.

Canada

Homeopathy has also been under the gun in Canada. The nation’s health agency, Health Canada, warned the population against using homeopathic nosodes in place of vaccinations. The government also cancelled its support of some limited  foreign aid to Honduras that was used to pay for homeopathic remedies used as part of a medical mission by Canadian medical homeopaths there. In the perspective of 200 family medicine doctors, the limits should pertain to more than homeopathy. They organized a petition against the College of Family Physicians of Canada to keep companies that “that sell homeopathic and naturopathic products” from exhibiting at the most important annual conference for that field, the Family Medicine Forum. The organization has established a committee to create a policy for venders starting next year.

United Kingdom

Key antagonistic moves toward acupuncture took place in 2015 and 2016 when a government panel unevenly applied science to oust acupuncture from low back pain and knee osteoarthritis guidelines, thus ending coverage. (Briefly, they refused to accept real world trials that routinely showed that acupuncture outperforms analgesics.) More recently, a long period of activity against homeopathy led to the decision of the National Health Service to stop funding homeopathy in the “largest alternative medicine hospital”. Not long after, the end of routine coverage of homeopathic care in the UK arrived with the stoppage of payment in this Bristol clinic. The action isn’t unnoticed in Ireland where a reporter was recently exploring whether Ireland has necessary regulations to protect against “pseudoscience”.

Adding insult to injury, Prince Charles – a long-time banner waver for alternatives, was blasted in a documentary for that support. Antagonism to his stances hasn’t stopped his support: Prince Charles recently participated in a ceremony opening an Ayurvedic institute. And if the most influential work in one’s life is one’s parenting, Prince Charles – with these strong views – will certainly be pleased to see that Prince Harry and wife Megan are big fans of natural healing methods. They are also planning a water-birth. Meantime, apparently art, music, dance, singing lessons and museum visits are not considered woo energy medicine or woo woo: this story suggests that NHS doctors may soon be prescribing these creative arts therapies.

Some Comments

In the USA, homeopathy has also been in the cross-hairs of the FDA and of the Federal Trade Commission over the last 3 years. Notably, homeopathy treatment was never an official offering in more than one or two of the medical schools in the Academic Consortium for Integrative Health and Medicine. Nor is part of the functional medicine body of practice. So any formal action to chuck it has had virtually no target.

Notably, however, in the one physician level profession where homeopathy has had a significant role, the naturopathic medical curriculum, it is in decline and in some institutions only an elective. A recent, controversial paper from a set of recognized North American leaders in that field argues that its time for homeopathy to be kicked out the door altogether: The Bell Tolls for Homeopathy: Time for Change in the Training and Practice of North American Naturopathic Physicians. Remarkably, all of this activity, here and elsewhere, is against the backdrop of a forecast that the global homeopathy market will grow 14.6% by 2023.

Acupuncture and naturopathic medicine meantime have been on an opposite trajectories. The Veterans Administration’s issued personnel standards for hiring licensed members of the field. Medicare declared interest in research on acupuncture’s value for those aging. And despite an ongoing policy of opposition to naturopathic licensing from the AMA and the American Academy of Family Medicine, that profession recently gained regulated status in two new states of New Mexico and Idaho.

The fact is, that the vast majority of this effort focuses on divesting Europe and parts of the former British Commonwealth with a historic affection for homeopathy. As a friendly agnostic on homeopathy and a user when my naturopathic doctor spouse suggests it (and who sometimes grabs me by the figurative lapels in a non minimal dose sort of way to remind me of nights when our children went straight from wailing to sleep after a dose), I am not compelled to defend or attack. I am disposed, however, to require critics to consider any harm from homeopathy comparatively with the harm from gross over-prescription of all manner of pharmaceutical agents, starting with antibiotics.

Some colleagues, echoing the speech from German Lutheran pastor Martin Niemöller about atrocities against Socialists and gypsies that led up to the Jewish Holocaust, have warned that if we let them take homeopathy, what will be next? Clearly, there is a “they” group among the polarization-based medicine crowd who would wipe clean virtually everything integrative. What is also true at the same time is that there is a grip of pseudo-science in the realm of “alternative and complementary medicine” and in some a salesy looseness with application of the supportive science that does exist. It may become increasingly imperative for responsible members of the integrative practice fields to become more engaged in helping draw the lines.