India Needs Evidence-Based, Ethics-Driven Medicine

Relevance: GS 2 - Issues relating to the development and management of Social Sector/Services relating to Health;

(Source: The Hindu, 08/04/23)

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Why in the news?

• Recently, there has been a growing push to integrate traditional and alternative medicinal systems into mainstream healthcare to achieve universal health coverage in India.
• However, a key challenge lies in ensuring that these systems meet essential safety and efficacy standards.

What is Homeopathy?

• Homeopathy, also known as homeopathic medicine, is a medical system that was developed in Germany more than 200 years ago. It’s based on two unconventional theories:
• “Like cures like”—the notion that a disease can be cured by a substance that produces similar symptoms in healthy people.
• “Law of minimum dose”—the notion that the lower the dose of the medication, the greater its effectiveness. Many homeopathic products are so diluted that no molecules of the original substance remain.

What are the pros and cons of homeopathy?

Arguments against

• Efficacy and safety of homeopathy: Early trials, like the Nuremberg Salt Test of 1835, questioned the validity of its claimed effects.
• Systematic reviews and meta-analyses have consistently found limited clinical significance across different conditions, patient groups, and treatment methods.
• Recent research has also revealed issues of trial registration and reporting bias, raising doubts about the credibility of the evidence.
• WHO’s warning: The World Health Organization (WHO) has warned against the use of homoeopathic treatments for HIV, tuberculosis, and malaria, as well as flu and diarrhea in infants.
• Increasing evidence suggests homeopathy's inefficacy in cancer treatment and its potential to exacerbate adverse effects
• Standards measuring holistic effects: Homoeopathy proponents argue that conventional evidence-based standards don't account for its holistic effects. However, these standards are collaboratively developed by a global community of experts.
• The lack of alternative, credible evidence synthesis frameworks and the compatibility of holistic approaches within evidence-based medicine raise questions about such claims.
• Mechanism: There is no molecular, physiological, biochemical, or other evidence to explain how concepts such as “like cures like”, “extreme dilution”, and “dematerialised spiritual force” result in better health.
• Lack of credible testimonials by historical figures: Supporters of homeopathy cite endorsements from historical figures like Gandhi and Tagore. However, the credibility of such testimonials is limited due to scarce mentions in their writings and a lack of archival evidence.

Arguments for

• Scientific Framework of Homoeopathy- Evidence Based Homeopathy’ consists of research worldwide and ‘Homoeopathy -Science of Gentle healing’ focused on Research in India has enlisted hundreds of scientific trials including basic research showing strong evidence towards the beneficial role of homeopathy.
• It gives patients the freedom of choosing the treatment method for their health.
• low-cost, low technological inputs, absence of medicinal side effects and growing popularity of natural and organic products.
• It can play a very important role in providing quality health and medical care to Indian citizens, particularly in under-served, remote and tribal areas

Conclusion

• The argument to reject homeopathy is not just based on its coloniality, but chiefly on the lack of evidence for efficacy, some evidence for lack of safety, no substantive progress on mechanisms of action in the last century, and homeopathic practitioners’ escapist arguments.
• India’s path to universal health care must be grounded in evidence-based and ethics-driven medicine.

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FAQs

MCQ

Question: Consider the following statements:

1. Homeopathy is a medical system that was developed in Germany more than 200 years ago.
2. Homeopathy is based on the theory of “like cures like”.

Which of the above statements is/are correct?

(a) 1 only

(b) 2 only

(c) Both 1 and 2

(d) Neither 1 nor 2