India needs evidence-based, ethics-driven medicine

Source– The post is based on the article “India needs evidence-based, ethics-driven medicine” published in “The Hindu” on 4th August 2023.

Syllabus: GS3- Science and Technology

Relevance: Issues related to taditional system of medicine

News–  Supporters of Hameopathy have argued in The Lancet Regional Health – Southeast Asia recently for expanding its use by citing demand and decolonisation, disregarding its flaws.

What are issues related to safety and efficacy of Homeopathy?

The evidence supporting the efficacy of homoeopathy is lacking in strength.

The initial double-blind randomized controlled trial (RCT), conducted and well-documented is known as the Nuremberg Salt Test (1835).

It concluded that the symptoms or changes attributed to the effects of homoeopathic medicines were merely products of imagination and preconceived notions.

Multiple systematic reviews have consistently found that homoeopathic treatments lack clinically significant effects across different ailments, population groups, study types.

Recently, researchers discovered that over half of the 193 homeopathic trials conducted in the last two decades were not registered.

Unregistered trials displayed some evidence of efficacy, but registered trials did not. It cast doubt on the validity and reliability of the evidence.

The World Health Organization  has issued warnings against homoeopathic treatments for HIV, tuberculosis, malaria, flu, and infant diarrhea. It has asserted that it has no place in their treatment protocols.

There is a growing body of evidence suggesting that homoeopathy does not effectively treat cancers.

On the contrary, homoeopathic treatments have been linked to both non-fatal and fatal adverse events, and exacerbation of existing conditions.

What are issues related to standards used in evidence-based medicine for judging the effects of homoeopathy?

Supporters of homoeopathy argue that the standards commonly used in evidence-based medicine are not appropriate for evaluating its “holistic effects.” However, this claim can be refuted for several reasons.

1. The standards used in evidence-based medicine are not arbitrary choices made by allopathic practitioners for their own benefit.

They are established through collaboration among a global community that includes epidemiologists, biostatisticians, quality improvement researchers, implementation managers, and others.

Various disciplines outside of medicine, such as psychology, economics, community health, implementation science, and public policy, have successfully adapted evidence synthesis methods to support their claims.

On the other hand, proponents of homoeopathy have not been able to develop valid alternative evidence synthesis frameworks to test its efficacy and safety.

2. The argument that evidence-based medicine is “reductionist” and cannot accommodate holistic approaches is not entirely accurate.
3. Evidence-based medicine does not solely focus on establishing empirical evidence. It also seeks to explain the underlying mechanisms that support the evidence.

However, over the past century, there has been no substantial evidence to explain the proposed mechanisms of action for homoeopathy.

There is an argument that a pluralistic approach in medicine can help to decolonize medicine.

However, homoeopathy’s introduction in India was during the colonial period. It raises questions about its traditional tag, as it was brought in during colonial times for colonial benefits.

Some homoeopathy supporters offer testimonials from prominent figures like Gandhi and Tagore. However, there is limited mention of homoeopathy in Gandhi’s writings. There is no evidence that Tagore favoured it.