India Needs Evidence-Based, Ethics-Driven Medicine

Context: 

Recently, supporters of Homoeopathy have argued in the “Lancet Regional Health – Southeast Asia” for expanding its use by citing demand and decolonisation, disregarding its flaws.

About Homoeopathy in India:

• Introduction: Homoeopathy was introduced in 1839 in India by Austrian physician J.M. Honigberger. 
• It believed that the body can cure itself. 
• Its practitioners use tiny amounts of natural substances like plants and minerals. 
• World Homoeopathy Day: The day is observed on every 10th April.
  • The theme of World Homoeopathy Day 2023 is “One Health, One Family”.
  • This day is celebrated to mark the birth anniversary of Dr. Samuel Hahnemann, who is the founder of homoeopathy.
• A Pluralistic Approach: In India, homoeopathy is for adopting a pluralistic approach in medicine, which can decolonise medicine. 
• Unrealistic Traditional Tag: Homoeopathy was introduced quite recently in India’s history during the colonial period. 

Support to Homoeopathy:

• Historical & Popular Use: Homoeopathy has its long historical usage and widespread popularity.
  • Around the world, more than 300 million people in at least 70 countries use homoeopathy either alone or in combination with other care to treat themselves.
  • Homoeopathy is popular in India and Africa and is getting popular in the UAE, Iran, Singapore, Japan and also in China. 
• Personalized Approach: Homoeopathy is a so-called “individualized” therapy since it considers each individual as unique, taking into account their individual reaction. 
  • Each homoeopathic treatment, even at the symptomatic level, can thus be personalized.
• A Global Approach to the Patient: Homoeopathic therapy makes it possible to take charge of the patient and his/her illness, and not just the illness.
• Minimal Side Effects: Homoeopathic remedies are highly diluted which makes them safe for use, even in sensitive patient populations.
• Holistic Approach: It is asserted by homoeopathy supporters that homoeopathy focuses on a holistic view of health, i.e., all physical, mental and emotional aspects of a person’s well-being.
• Testimonials by Famous Personalities: Homoeopathy supporters cite testimonials from famous personalities like Gandhi and Tagore.

Concerns with Homoeopathy:

• Low Evidence Quality: Reviews that support homoeopathy’s efficacy also caution over the low evidence quality and raise concerns about its clinical use.
• Concerning Validity & Reliability: Recently, researchers demonstrated that more than half of the 193 homoeopathic trials in the last two decades were not registered, which are throwing the validity and reliability of evidence thus generated into doubt.
• Warning by WHO: The World Health Organization (WHO) has warned that there is no treatment available in homoeopathy for various diseases like HIV, tuberculosis, and malaria, as well as flu, diarrhea in infants, etc. 
• No Treatment in Cancer: There is various evidence which is proving that homoeopathy does not work for cancers and may not help to reduce the adverse effects of cancer treatments.
• Accelerating Disease Problems: Seeking homoeopathic care delays the application of evidence-based clinical care. 
  • In several cases, it has caused injuries and sometimes death.
• Lack of Clinically Significant Effects: Multiple systematic reviews and meta-analyses have found that, across diseases, population groups, study types, and treatment regimes homoeopathic treatments lack clinically significant effects. 
• Lack of Alternative Evidence Synthesis Framework: Homoeopathy advocates have failed to invent valid alternative evidence synthesis frameworks suited for testing its efficacy and safety.
• Escapist Arguments: The argument to reject homoeopathy is based on its lack of evidence for efficacy, lack of safety, no substantive progress on mechanisms of action, and homoeopathic practitioners’ escapist arguments.
• Lacking Testimonials: While supporters asserted for testimonials by famous personalities but Gandhi’s writings have scant mentions and there is no any archival evidence of favorable comments by Tagore. 

The Path Ahead:

• Prioritizing of Safety & Efficacy: The recent push to integrate ‘AYUSH’ medicinal systems into mainstream health care to achieve universal health coverage and ‘decolonise medicine’ is a pluralistic approach that would require every participating system to meet basic safety and efficacy standards. 
• Evidence with Ethics: India’s path to universal health care must be grounded in evidence-based and ethics-driven medicine.
• Awareness & Education: To promote informed decision-making process and under the right to choice, related education and awareness should be promoted.
  • It would help healthcare professionals and the public about the strengths and limitations of homeopathy. 
• An Ongoing Process: To become better is an ongoing process and for that proper research, evidence and clinical trials should be performed in an accountable and transparent manner.

News Source: The Hindu