Must all alternative therapies be backed by scientific evidence?

In November 2018, a group of Brazilian scientists launched the Instituto Questão de Ciência, the country’s first organisation to focus on the necessity of scientific evidence in public policies. Among the initial priorities, the founders cited the fight against the adoption of “pseudo-scientific therapies” in the Brazilian Unified Health System, including homeopathy, Traditional Chinese Medicine, hand laying, geotherapy (the use of clay and mud in healing) and aromatherapy.

“The use of these treatments in the public health system is both a waste of public money and a disrespect for the citizen, who becomes a victim of ineffective procedures,” said USP biologist Natalia Pasternak Taschner, President, Instituto Questão de Ciência. “Unfortunately, there is a lot to fight against, like the anti-vaccination movement that comes to Brazil or the lack of solid information about genetically modified foods.”

Legislation in biodiversity, genetic heritage and food labelling, and the fight against scientific misinformation in advertising and the media will also come under the organisation’s focus.

While there are arguments both for and against this initiative, if the scientific community does little to step out of its cosy realm and keep an open mind where scientific research is thin, or step in to defend the rational thinking and clear evidence put forward during issues focusing on alternative therapies where is the world heading?

The case for evidence-based practice

Evidence-based practice is the “best practice”, being a combination of research, clinical expertise and patient values. What happens when these three areas are not equal and one (for example, patient values) is dominated by the others? Are the practitioners of complementary medicine, alternative therapies and traditional medicine all “quacks” if their modalities don’t come with tomes of scientific research and evidence, despite practising their healing for centuries and receiving documented client satisfaction?

While evidence and results are unquestionably important (see www.wellnessevidence.com for evidence backing some therapies), it can take science some time to catch up.

In the meantime, do we allow big-pharma and the multinationals to take the lead while willingly following along behind, accepting that only scientific evidence-based services can be practised in our public health care systems? Do we really need there to be scientific evidence for everything when we are yet to fully understand the placebo effect, the power of the mind over the body, and how our body can heal itself?

Even if regulators want to keep practices that do not come with the required amount of evidence out of public health services, can they at least approach this issue with an open mind and accept that if something has been practiced for centuries it may have tangible health benefits behind it? And can they allow those who seek them out in the private sector do so without harassment?

The institute will back scientific facts and existing public policies, contacting authorities and decision makers (members of parliament, public policy management, magistrates etc) to make their points. It will issue public hearings, parliamentary committees and lawsuits, produce studies and reports, create a scientific fact-checking service, and publish and disseminate journalistic, educational and scientific literacy content to schools, universities and newsrooms amongst others.

Therefore it is vitally important that the wellness industry, much of which is based on alternative therapies and traditional medical practices, also speaks up and voices their knowledge and experience, be it anecdotal or evidentiary.

Consider TCM, which has a long history of practice, as do Ayurvedic therapies and both are practiced by millions of people around the world on a daily basis.

Consider Homeopathic medicine, which has a relatively short 200-year plus history and is a research challenge in that treatments are highly individualized, with no uniform prescribing standard for practitioners. Hundreds of homeopathic remedies can be prescribed in a variety of different dilutions for thousands of symptoms. How do you measure all of these? And how do you describe in scientific terms how a product containing few or no active ingredients can have any effect on the human body?

When science catches up…

The International Standards Organisation (ISO), an independent, non-governmental organization with a membership of 162 national standards bodies around the globe, has established international standards for Thalassotherapy (ISO 17680), Medical Spa (ISO 21426) and Wellness Spa (ISO 17679). It is currently at the working stage for developing standards for Traditional Chinese Medicine (ISO/TC 249) and Health Informatics (ISO/TC 215), under which there is the working group (ISO/TC 215/TF 2) Traditional Medicines Task Force (TMsTF).

It is clear the world continues to research and try to understand and standardise the traditional healing practices, but this will still take time.

In 2002 the Annual Report on Essential Drugs and Medicines by the World Health Organisation (WHO) reported a multitude of traditional medicine (TM) projects in China (the establishment of a clinical research centre in the Chinese Academy of Traditional Chinese; preparation of guidelines on safe use of Chinese herbal medicines), Korea (analysis of the effectiveness of acupuncture). WHO also organised training courses on the use of TM in China, Mongolia and Vietnam, as well as aiding Guinea, Philippines, Sao Tome and Principe, Tanzania, Uganda and Vietnam to develop national policies/masterplans and programmes for Traditional Medicine.

So there is a growing body of evidence across the international community that the scientists not only in Brazil, but around the world need to take into consideration.

On behalf of the wellness industry I ask that scientists be objective in their approach to this subject while bearing in mind long histories and anecdotal, not just scientific, evidence.

Based on article published 10 October 2018 on https://www.csicop.org/specialarticles/show/skeptical_organization_to_launch_in_brazil

 

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