MD, PhD, FMedSci, FSB, FRCP, FRCPEd

The WHO is one of the most respected organisations in all of health care. It therefore might come as a surprise that it features in my series of institutions contributing to the ‘sea of misinformation’ in the area of alternative medicine. I have deliberately selected the WHO from many other organisations engaging in similarly misleading activities in order to show that even the most respectable bodies can have little enclaves of quackery hidden in their midst.

In 2006, the WHO invited Prince Charles to elaborate on his most bizarre concepts in relation to ‘integrated medicine’. He told the World Health Assembly in Geneva: “The proper mix of proven complementary, traditional and modern remedies, which emphasises the active participation of the patient, can help to create a powerful healing force in the world…Many of today’s complementary therapies are rooted in ancient traditions that intuitively understood the need to maintain balance and harmony with our minds, bodies and the natural world…Much of this knowledge, often based on oral traditions, is sadly being lost, yet orthodox medicine has so much to learn from it.” He urged countries across the globe to improve the health of their  populations through a more integrated approach to health care. What he failed to mention is the fact that integrating disproven therapies into our clinical routine, as proponents of ‘integrated medicine’ demonstrably do, will not render medicine better or more compassionate but worse and less evidence-based. Or as my more brash US friends often point out: adding cow pie to apple pie is no improvement.

For many years during the early 2000s, the WHO had also been working on a document that would have promoted homeopathy worldwide. They had convened a panel of ‘experts’ including the Queen’s homeopath Peter Fisher. They advocated using this disproven treatment for potentially deadly diseases such as malaria, childhood diarrhoea, or TB as an alternative to conventional medicine. I had been invited to comment on a draft version of this document, but judging from the second draft, my criticism had been totally ignored. Fortunately, the publication of this disastrous advice could be stopped through a concerted initiative of concerned scientists who protested and pointed out that the implementation of this nonsense would kill millions.

In 2003, the WHO had already published a very similar report: a long consensus document on acupuncture. It includes the following list of diseases, symptoms or conditions for which acupuncture has been proved-through controlled trials-to be an effective treatment:

Adverse reactions to radiotherapy and/or chemotherapy
Allergic rhinitis (including hay fever)
Biliary colic
Depression (including depressive neurosis and depression following stroke)
Dysentery, acute bacillary
Dysmenorrhoea, primary
Epigastralgia, acute (in peptic ulcer, acute and chronic gastritis, and gastrospasm)
Facial pain (including craniomandibular disorders)
Headache
Hypertension, essential
Hypotension, primary
Induction of labour
Knee pain
Leukopenia
Low back pain
Malposition of fetus, correction of
Morning sickness
Nausea and vomiting
Neck pain
Pain in dentistry (including dental pain and temporomandibular dysfunction)
Periarthritis of shoulder
Postoperative pain
Renal colic
Rheumatoid arthritis
Sciatica
Sprain

If we compare these claims to the reliable evidence on the subject, we find that the vast majority of these indications is not supported by sound data (a fuller discussion on the WHO report and its history can be found in our book TRICK OR TREATMENT…). So, how can any organisation as well-respected globally as the WHO arrive at such outrageously misleading conclusions? The recipe for achieving this is relatively simple and time-tested by many similarly reputable institutions:

  • One convenes a panel of ‘experts’ all or most of whom have a known preconceived opinion in the direction on has decided to go.
  • One allows this panel to work out their own methodology for arriving at the conclusion they desire.
  • One encourages cherry-picking of the data.
  • One omits a meaningful evaluation of the quality of the reviewed studies.
  • One prevents any type of critical assessment of the report such as peer-review by sceptics.
  • If criticism does emerge nevertheless, one ignores it.

I should stress again that the WHO is, on the whole, a very good and useful organisation. This is precisely why I chose it for this post. As long as it is big enough, ANY such institution is likely to contain a little niche where woo and anti-science flourishes. There are far too many examples to mention, e.g. NICE, the NIH, UK and other governments. And this is the reason we must be watchful. It is all to human to assume that information is reliable simply because it originates from an authoritative source; the appeal to authority is appealing, of course, but it also is fallacious!

 

25 Responses to Drowning in a sea of misinformation. Part 6: The World Health Organisation, WHO

  • Guy Chapman says:

    Interesting that you say the WHO stepped back; homeoquacks are still promoting work from the homeopathy debate as “proof” that the WHO recommends homeopathy (of course the paper they cite was written by a homeopath). Is there an official statement or position paper form the WHO that explicitly states that homeopathy is inappropriate for people with real diseases?

  • Oliver Kershaw says:

    Edzard, great series, this latest one in particular. If you have the opportunity, please also take a look at the WHO’s stance on e-cigarettes: a minimally harmful technology which many smokers are currently switching to, but which the WHO is advising people not to use.

    This is in the face of an increasing body of science which underscores the safety of e-cigarettes relative to tobacco smoking (and in absolute terms). The WHO have obfuscated on this issue over and again, particularly over nicotine. In one particularly bizarre case they actually claimed that cigarettes are safer because “they have a filter so nicotine does not travel so deep into the lungs”.

    The WHO’s stance on this is contributing to a climate of fear which is deterring smokers from adopting these products. Further, it is causing governments to clamp down on them, stymying an innovation with huge potential to tackle the enormous harms of smoking. In this way the WHO and others are actively endangering smokers’ health.

    For a useful précis of the general issues, Peter Hajek’s recent Lancet article is a good place to start.

  • George says:

    http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)67159-0/fulltext

    “The acupuncture report stated that acupuncture had been shown to be effective in controlled clinical trials for more than a score of conditions, including bacillary dysentery and leucopenia. The evidence does not support such claims, said Betz. The acupuncture report and now the homoeopathy report are evidence that “WHO has been infiltrated by missionaries for alternative medicine”, Betz said.
    The 40-page draft on homoeopathy, entitled Homoeopathy: review and analysis of reports on controlled clinical trials, states that the “majority” of peer-reviewed scientific papers published over the past 40 years “have demonstrated that homoeopathy is superior to placebo in placebo-controlled trials and is equivalent to conventional medicines in the treatment of illnesses, in both humans and animals.”
    The report describes the findings of a selected group of systematic reviews, meta-analysis, controlled trials, cost-effectiveness and outcome studies, observational studies. Almost all of the studies cited support the practice of homoeopathy.
    Edzard Ernst, professor of complementary medicine at the Peninsula Medical School (Exeter, UK), said the draft “seems overtly biased, ie, it is based on data that are positive while ‘forgetting’ the negative studies and systematic reviews.”
    The randomised clinical trials cited, he said, “all happen to be positive; they are not the most rigorous ones, not the most recent. This does not inspire the reader to think the WHO report was even intended to be objective.”
    “I find it terribly worrying”, he added, “because WHO shouldn’t be promoting homoeopathy as it did acupuncture.””

    This is what I found…It also mentions you Dr. Ernst.

      • George says:

        They have not published anything as WHO – not as individuals about homeopathy to the best of my knowledge – it is a controversial matter among WHO – so it is not easy to say something definite -

        I know you are fantasizing that all scientists regard alt medicine as crap – but this is not the case – so far ..

        • Mojo says:

          George, what do you think of the statement made on behalf of the director of the WHO Department of Child and Adolescent Health and Development (a statement that the WHO director-general’s office says “clearly express[es] the WHO’s position”) that they “have found no evidence to date that homeopathy would bring any benefit to the treatment of diarrhoea in children…Homeopathy does not focus on the treatment and prevention of dehydration – in total contradiction with the scientific basis and our recommendations for the management of diarrhoea”?

          • George says:

            Is s/he the organization WHO or a person? It is a personal statement with some weight – you don’t believe the lancet ?

          • Mojo says:

            If a statement “clearly express[es] the WHO’s position”, then, clearly, it is clearly expressing the position of the organisation.

            So, where does this leave your much-vaunted paper about childhood diarrhoea?

          • Mojo says:

            As for what was written in the [i]Lancet[/i], you do realise that a statement that “WHO has been infiltrated by missionaries for alternative medicine” doesn’t actually support your cause, don’t you?

    • George says:

      I replied but I will duplicate my response to this thread – things got messed up…

      Mojo – I have no ……cause – it is it really hard to believe – if you have a cause –the lancet comment just shows the diversity of the opinions in the WHO. One might call these different views whatever name – but they exist – according to the Lancet…

        • George says:

          Whatever name you call them – the journal says they exist (-ed) in the WHO and that.s why they created this “biased” draft..

          I think you have to accept this fact – denying it does not help – you still can regard your views as valid – no matter what…After all it does not prove Homeopathy- it shows only a diversity of opinions in the WHO..

          At that time,,

          ,maybe by now they have fired all and there is no problem.

          • Mojo says:

            OK George. If we accept your assertion that the WHO has been infiltrated by significant numbers of “missionaries for alternative medicine”, what does this say about the 2003 paper about homoeopathy for the treatment of diarrhoea in children you have been pushing, given that in 2009 the WHO’s position was that they “have found no evidence to date that homeopathy would bring any benefit to the treatment of diarrhoea in children”?

  • Melissa Frank says:

    Currently I’m a Health and Wellness Psychology doctoral student writing my dissertation on health literacy in acupuncture. I’m having a very hard time explaining how the public can be literate on the decision to adopt acupuncture into their life. So, I’m looking at the acupuncture practitioner’s insights on this matter. I’m doing a Delphi study to see what their “expert” consensus is on what’s needed for literacy. It troubles me that I’m using research on something that is quackery. Too late to pull away from the time and work invested thus far, I also have one more migraine in which much of my data from WHO is junk, which is the backbone to knowing the existing research out there. While all this troubles me, I do appreciate this and it’s helping, if nothing more, to make the case that there’s no such thing as literacy for acupuncture.

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