MD, PhD, MAE, FMedSci, FRCP, FRCPEd.

conflict of interest

I must admit that, in recent months, I neglected my ALTERNATIVE MEDICINE HALL OF FAME. As my regular readers will know, this is an assembly of extraordinary researchers – extraordinary in the sense that they all have been busy studying so-called alternative medicine (SCAM) without ever managing to publish a single negative result.

At present, the ALTERNATIVE MEDICINE HALL OF FAME includes the following 27 men and women:

  1. Miek Jong (homeopathy, Norway)
  2. Josef M Schmid (homeopathy, Germany)
  3. Meinhard Simon (homeopathy, Germany)
  4. Richard C. Niemtzow (acupuncture, US)
  5. Helmut Kiene (anthroposophical medicine, Germany)
  6. Helge Franke (osteopathy, Germany)
  7. Tery Oleson (acupressure , US)
  8. Jorge Vas (acupuncture, Spain)
  9. Wane Jonas (homeopathy, US)
  10. Harald Walach (various SCAMs, Germany)
  11. Andreas Michalsen ( various SCAMs, Germany)
  12. Jennifer Jacobs (homeopath, US)
  13. Jenise Pellow (homeopath, South Africa)
  14. Adrian White (acupuncturist, UK)
  15. Michael Frass (homeopath, Austria)
  16. Jens Behnke (research officer, Germany)
  17. John Weeks (editor of JCAM, US)
  18. Deepak Chopra (entrepreneur, US)
  19. Cheryl Hawk (chiropractor, US)
  20. David Peters (osteopathy, homeopathy, UK)
  21. Nicola Robinson (TCM, UK)
  22. Peter Fisher (homeopathy, UK)
  23. Simon Mills (herbal medicine, UK)
  24. Gustav Dobos (various SCAMs, Germany)
  25. Claudia Witt (homeopathy, Germany/Switzerland)
  26. George Lewith (acupuncture, UK)
  27. John Licciardone (osteopathy, US)

Today, an article by Stephanie Benz published in L’Express caught my attention. It mentions a man who might well qualify as a candidate for my illustre assembly. As it is in French, let me summarise it for you.

The article focusses on the bixarre actions of Professor Julien Nizard. He is the vice-dean of Nantes University’s medical school, who stands accused of abusing his academic standing to promote SCAM, while suppressing scientific critique. Serving as an institutional shield for pseudo-sciences, Nizard uses his leadership at the university and within the Collège Universitaire de Médecine Intégrative et Thérapies Complémentaires (CUMIC) to introduce SCAM into official medical training.

The article explicitly notes Nizard’s defense, instruction, or validation of several SCAM practices, including:

  • Acupuncture
  • Hypnosis / Hypnotherapy
  • Osteopathy
  • Socio-aesthetic care (often used as part of supportive cancer care)
  • Auriculotherapy (ear acupuncture)
  • Various other “soft medicines” and non-medicinal interventions (INMs) lacking robust, peer-reviewed clinical proof.

To shield his SCAM programs from internal dissent, Nizard has allegedly turned to unusual administrative and legal pressures against critical faculty members and advocates of evidence-based medicine, like the Collectif No Fakemed. His tactics are said to include:

  • Legal Threats and Institutional Action: Nizard has reportedly threatened to drag critical colleagues before the National Order of Physicians (CNOM) or pursue defamation lawsuits to silence them.
  • Professional Hostility: Internal whistleblowers and professors attempting to uphold strict evidence-based standards report facing a hostile work environment, administrative stonewalling, and explicit professional pressure meant to damage their academic standing if they publicly oppose his pseudo-scientific initiatives.
  • Political Manipulation: He uses behind-the-scenes lobbying at the ministerial level to bypass traditional university peer-review processes, relying on political influence to institutionalize practices that fail to meet baseline clinical research standards.

The article motivated me to look up Julien Nizard in order to find out what papers he has published in the realm of SCAM. The result is impressive. I found 7 abstracts of his SCAM-related papers listed on Medline.

Numner 1

Recent guidelines for managing fibromyalgia highlight the importance of a graded-care approach, tailoring treatment to predominant symptoms, and appropriately integrating nonpharmacological treatments and complementary medicine (CM). Many fibromyalgia patients turn to nonpharmacological treatment and CM for various reasons, including concerns about medication side effects and persistent symptoms despite pharmacological treatment. In addition, these approaches are sometimes mistakenly, but often, perceived as natural and, therefore, widely accepted as well-tolerated with minimal risks. However, as with many patients using CM, fibromyalgia patients frequently engage in these practices without informing their physicians, often because of fear of a negative reaction. This can occur in contexts that lack adequate safeguards, such as treatment by noncertified practitioners, undocumented practices, excessive costs, or unsafe environments. In this narrative review, we first provide updated definitions of these practices, discuss their potential benefits and associated risks, and explore the challenges in their evaluation. We then summarize key findings from the literature before proposing a structured approach for discussing these practices with fibromyalgia patients. This includes assessing their prior experiences, expectations, and motivations for long-term adherence. We also offer guidance on selecting qualified practitioners and ensuring a sufficiently safe treatment environment. Finally, we highlight essential “red flags” that pain specialists and health care providers should discuss with patients, emphasizing the need for caution or even discontinuation of certain practices when these warning signs are present.

Number 2

The majority of nurses have a favourable opinion of complementary therapies. This makes it easier to identify the therapies used by patients. Being trained in and practising a complementary therapy strengthens the nursing skills and helps to give it new meaning. Nurses must play an active part in the ongoing structuring of integrative medicine in France.

Number 3

Neuropsychiatric disorders are one of the frequent complications of neurocognitive disease, and have an impact on the quality of life of patients and caregivers. Non-phamacologic interventions are recommended as first-line treatment. The Snoezelen method is a multisensory stimulation method based on the assumption that acting on sensoriality can improve neuropsychiatric symptoms and thus quality of life, but its level of evidence is controversial. To explore this, we performed a systematic literature review of randomized controlled articles focusing on the use of the Snoezelen method in patients with cognitive disorders. Eighteen studies were included. The clinical outcomes studied were multiple (behavior, mood, cognition, functional capacities and biomedical parameters). When the Snoezelen method was compared to the “standard activities” group, it appears to be effective on short-term behavior. This was more negligible when the method was compared to others non-pharmacological interventions. Although the Snoezelen method could be effective on mood, cognition, and functional abilities, its level of evidence remains low. Furthers mixed studies (quantitative and qualitative) would be an interesting approach to delve into this topic in the most holistic way by integrating the patients, the caregivers and the cost of the method.

Number 4

Background: Low Back Pain (LBP) is the leading cause of disability worldwide, 90% of which is nonspecific. Manual therapy is one of the recommended treatment modalities. However, reported outcomes may be variable. This review aims to identify their scope in the context of the development of a Core Outcome Set (COS), which is defined as « an agreed standardised set of outcomes that should be measured and reported, as a minimum, in all clinical trials in specific areas of health or health care ».

Methods: A scoping review with risk of bias assessment of randomised controlled trials (RCTs) of manual therapy for nonspecific LBP was conducted using MEDLINE, CENTRAL, PEDro, WebOfScience and ClinicalTrials.gov, from 2010 up to August 2024. Manual therapy was considered the use, alone or in combination, of manipulations (high velocity, low amplitude), mobilisations (low-grade velocity, small-to-large amplitude) or soft tissue relaxation (especially massage, trigger points, muscle contractions).

Results: Out of 3929 articles, 147 RCTs and 74 protocols were included. Two main outcomes emerged: pain intensity (assessed by numerical rating scale or visual analogue scale) and disability (mostly assessed by Rolland-Morris Disability Questionnaire or Oswestry Disability Index). Range of motion is the most frequent clinical outcome assessed. Psychological factors such as fear-avoidance beliefs, kinesiophobia and catastrophising, and healthcare consumption, particularly medication, are also frequent. Most of the outcomes were patient-reported outcomes.

Conclusion: Consistent with a previous COS on nonspecific low back pain, manual therapy appears to address the same outcomes. Clinical trials in manual therapy should focus on using the existing COS by measuring pain intensity using a numerical rating scale, disability using the ODI 2.1a or the 24-item RMDQ, health-related quality of life using the SF-12 or the 10-item PROMIS. Additionally, due to the gap between clinical research and pain experience, trials should consider conducting subgroup analyses to identify effects on outcomes related to gender or age, paying particular attention to health inequalities by carrying out analyses based on socioeconomic status, as these factors are well known to significantly impact pain experience and access to care.

Number 5

Background: Deep brain stimulation (DBS) is an effective technique to treat patients with advanced Parkinson’s disease. The surgical procedure of DBS implantation is generally performed under local anesthesia due to the need for intraoperative clinical testing. However, this procedure is long (5-7 h on average) and, therefore, the objective that the patient remains co-operative and tolerates the intervention well is a real challenge.

Objective: To evaluate the additional benefit of electroacupuncture (EA) performed intraoperatively to improve the comfort of parkinsonian patients during surgical DBS implantation.

Methods: This single-center randomized study compared two groups of patients. In the first group, DBS implantation was performed under local anesthesia alone, while the second group received EA in addition. The patients were evaluated preoperatively, during the different stages of the surgery, and 2 days after surgery, using the 9-item Edmonton Symptom Assessment System (ESAS), including a total sum score and physical and emotional subscores.

Results: The data of nine patients were analyzed in each group. Although pain and tiredness increased in both groups after placement of the stereotactic frame, the ESAS item “lack of appetite”, as well as the ESAS total score and physical subscore increased after completion of the first burr hole until the end of the surgical procedure in the control group only. ESAS total score and physical subscore were significantly higher at the end of the intervention in the control group compared to the EA group. After the surgical intervention (D2), anxiety and ESAS emotional subscore were improved in both groups, but the feeling of wellbeing improved in the EA group only. Finally, one patient developed delirium during the intervention and none in the EA group.

Discussion: This study shows that intraoperative electroacupuncture significantly improves the tolerance of DBS surgery in parkinsonian patients. This easy-to-perform procedure could be fruitfully added in clinical practice.

Number 6

Background: It is currently considered that around 30% of chronic pain patients are totally refractory to medical treatment. Among patients who remain responsive to medical treatment, it is estimated that between 20% and 50% are likely to discontinue treatment due to severe side effects. Given these therapeutic difficulties, a significant number of patients turn to complementary therapies.

Objective: The LineQuartz® is a medical device that combines 3 complementary therapies, namely, music therapy, light therapy, and chromotherapy. We propose to evaluate its effectiveness in chronic pain patients.

Methods: Between October 2021 and October 2022, 44 patients aged between 23 and 85 years (mean: 55.4 years) were included in a prospective study. All patients had background pain intensity greater than 4/10 on the Numerical Pain Scale (NS). Treatment consisted of 4 half-hour sessions, divided into one session per week for 3 weeks (21 days). Patients were assessed by the Brief Pain Inventory (BPI) and the Hospital Anxiety and Depression scale (HAD) the day before starting treatment (Day 0) and the day after the end of treatment (Day 22).

Results: Apart from the BPI item, “relationship with others,” all items improved significantly (p < 0.050). Background pain intensity (NS) and frequency of painful attacks improved very significantly (p < 0.001). The HAD anxiety subscore was also significantly improved (p < 0.001). Discussion. This open pilot study supports the idea that LineQuartz® has a place among complementary therapies dedicated to the treatment of chronic pain. However, these results need to be confirmed by a controlled study.

Number 7

Context: In addition to curative care, supportive care is beneficial in managing the anxiety symptoms common in patients in sterile hematology unit. We hypothesize that personal massage can help the patient, particularly in this isolated setting where physical contact is extremely limited. The main objective of this study was to show that anxiety could be reduced after a touch-massage® performed by a nurse trained in this therapy.

Methods: A single-center, randomized, unblinded controlled study in the sterile hematology unit of a French university hospital, validated by an ethics committee. The patients, aged between 18 and 65 years old, and suffering from a serious and progressive hematological pathology, were hospitalized in sterile hematology unit for a minimum of three weeks, patients were randomized into either a group receiving 15-minute touch-massage® sessions or a control group receiving an equivalent amount of quiet time once a week for three weeks. In the treated group, anxiety was assessed before and after each touch-massage® session, using the State-Trait Anxiety Inventory questionnaire with subscale state (STAI-State). In the control group, anxiety was assessed before and after a 15-minute quiet period. For each patient, the difference in the STAI-State score before and after each session (or period) was calculated, the primary endpoint was based on the average of these three differences. Each patient completed the Rosenberg Self-Esteem Questionnaire before the first session and after the last session.

Results: Sixty-two patients were randomized. Touch-massage® significantly decreased patient anxiety: a mean decrease in STAI-State scale score of 10.6 [7.65-13.54] was obtained for the massage group (p ≤ 0.001) compared with the control group. The improvement in self-esteem score was not significant.

Conclusion: This study provides convincing evidence for integrating touch-massage® in the treatment of patients in sterile hematology unit.

_________________________

Are you as impressed as I am?

Not only has this vice-dean of a medical school shown how to properly defend SCAM by innovative means including legal threats, he has also found the time to publish 7 Medline-listed papers on various forms of SCAM! I am even more impressed that someone with so little valid SCAM research can become such an ardent “defender of the indefensible”. But what impresses me most is this: in all his publications, I cannot find a single negative result, nor a word of SCAM-related criticism.

This, by Jove, is a remarkable achievement!

I hope you all agree that it deserves inclusion into my ALTERNATIVE MEDICINE HALL OF FAME.

Bienvenue Julien!

 

 

 

Tolerance is widely regarded as a moral virtue, a cornerstone of pluralistic societies and a safeguard against dogmatism. Yet, tolerance can sometimes be misplaced. Thomas Mann suggested that “tolerance becomes a crime when applied to evil”. In a similar vein, I propose that tolerance can become unethical when applied to homeopathy.

Homeopathy presents itself as a benign and natural alternative to or complement of conventional medicine. Its appeal lies partly in its historical pedigree and partly in its promise of gentle healing without side effects. However, beneath this veneer lies a system of belief that is fundamentally incompatible with science and ethics. Its core principles –  the notions that like cures like and that substances become more potent through extreme dilution – contradict basic laws of physics, chemistry and pharmacology. After more than two centuries of use and more that 500 clinical studies, there is no credible evidence that homeopathic remedies perform better than placebos.

In many areas of life, tolerance for differing beliefs is both appropriate and necessary. However, medicine is different. It is not merely a matter of opinion; it is a field grounded in empirical evidence, where opinions can have direct and drastic consequences for health and survival. To tolerate ineffective and therefore potentially harmful treatments within this domain risks legitimizing misinformation and undermining public trust in evidence-based care.

The ethical problem intensifies when homeopathy is integrated into healthcare systems or endorsed by public institutions. Such endorsement conveys an implicit message of efficacy and legitimacy, misleading patients who may lack the expertise to critically evaluate medical claims. This is particularly concerning in cases where patients choose homeopathic remedies as an alternative therapy, i.e.in place of effective treatments, potentially resulting in preventable harm. Here, tolerance can easily degenerate into complicity.

Defenders of homeopathy often invoke patient choice and patient autonomy. While these are important principles, they do not justify the abdication of professional responsibility. True respect for patients involves providing accurate information and protecting them from ineffective or deceptive practices. Allowing patients to choose homeopathy without clear, despite all the evidence that speaks against it is not an expression of respect but a failure of duty.

Moreover, the commercial dimension of homeopathy raises additional ethical concerns. The marketing of homeopathic products often exploits the language of science and medicine while evading the standards that govern them. Consumers are led to believe they are purchasing effective treatments. In reality, they are buying fake medicines that contain no active ingredients. This practice tolerance has degenerated into exploitation.

A society that prides itself on scientific progress and rational inquiry cannot afford to suspend its critical faculties in the name of tolerance. While civility and openness are essential virtues, they must not be confused with randomness or indiscriminate acceptance. Tolerance has limits, particularly when it intersects with matters of public health and scientific integrity.

Thus, the tolerance extended to homeopathy is not merely misplaced; it is ethically problematic. By granting homeopathy a status it does not merit, we risk eroding the very standards that protect patients and uphold the credibility of medicine. In this context, I feel that intolerance is not a vice but a necessary stance, one that affirms the primacy of evidence, reason, and the ethical obligation to do no harm.

A recent paper entitled “Research Ethics and Integrity and the Different Forms of Misconduct: Applications and Challenges in Traditional, Complementary, and Integrative Medicine Research” caught my eye. As the subject is close to my heart and often covered on this blog, I studied it carefully. Here is the abstract:

Research ethics and integrity are foundational to the credibility, safety, and societal trust of scientific inquiry. As the use of traditional, complementary, and integrative medicine (TCIM) grows globally, concerns about research misconduct (including fabrication, falsification, and plagiarism) have become increasingly salient. With up to 80% of populations in certain countries utilizing TCIM, the field’s expansion underscores the need for rigorous, ethically grounded evidence to guide practice and policy. However, around 470 TCIM-related articles have been retracted to date, as indicated on the Retraction Watch database, which may be due to ethical or non-ethical concerns. This educational article critically examines the state of ethics and integrity in TCIM research, drawing on case studies of misconduct and highlighting the broader consequences for patient safety, scientific credibility, and healthcare integration. In addition, the educational article explores emerging ethical dilemmas posed by artificial intelligence (AI), including risks of automated fabrication, falsification, plagiarism, and opacity in research reporting. To strengthen ethical conduct, we propose strategies spanning four domains: 1) improving education and fostering interdisciplinary collaboration to enhance research literacy, 2) embedding open science practices to promote transparency and reproducibility, 3) leveraging meta-research to monitor and advance research quality, and 4) developing policies and safeguards for responsible AI use. Upholding high ethical standards in TCIM research is essential not only to ensure reliable evidence but also to protect patients, sustain public trust, and enable meaningful integration of TCIM within evidence-based healthcare systems.

The full conclusions of the authors are as follows: “With the increasing global use of TCIM therapies, it is crucial for TCIM researchers to uphold high ethical standards to ensure the feasibility, validity, efficacy and safety of TCIM interventions. TCIM research challenges such as heterogeneity, complexity, and lack of standardization practices, alongside issues with research training and funding, create both transformative opportunities and ethical dilemmas that require reflection. Addressing these challenges requires a firm commitment to enhancing research ethics and integrity in TCIM. This commitment must be translated into action through multifaceted strategies: improving research and ethics literacy, fostering open science practices, and ensuring the transparency, integrity, and reproducibility of TCIM research. Strengthening ethical and research practices will not only support its continued development as a discipline but also maximize its potential to contribute to global health.”

I find it most commendable that this subject has finally been addressed by a group of researchers, most of who are known advocates of so-called alternative medicine (SCAM). I hope that this is proves to be a step in the right direction for the fileld of SCAM.

Yet, I fear that it is a small or even tiny step. The reason for my fear is that several important issues related to research ethics and integrity in SCAM are let untouched by the authors. In my view, the one of the most important amongst them is the SCAM researcher him/herself. As often discussed on this blog, SCAM research is unique amongst all areas of medical research for being populated by individuals who have a strong ideological bias in favour of SCAM.

These (pseudo)scientists tend to abuse science by trying to prove that their beliefs are correct. Rather than trying to falsify their hypotheses, they would bend over backwards to show that their favourite SCAM is effective. I tried to demontrate this clearly by establishing my ALTERNATIVE MEDICINE HALL OF FAME on this blog.

As to the many other omissions of important ethical concerns from the above paper, I recommend having a look at our book “More Harm than Good?: The Moral Maze of Complementary and Alternative Medicine“. It offers a much more complete review of the ethical issues involved in SCAM research (amusingly, it was not cited in the paper above).

In the US, scientific research is facing a new bureaucratic obstacle marked by a stringent escalation in research security enforcement by major federal funding bodies. Traditionally, the US has positioned itself as the vanguard of open, globalized scientific inquiry, a model predicated on the understanding that breakthrough discoveries thrive on cross-border intellectual synergy. However, recent regulatory shifts initiated by the National Institutes of Health (NIH) and the National Aeronautics and Space Administration (NASA) indicate a retreat from this paradigm. By retroactively and rigidly redefining international authorship as a national security risk, federal grant managers threaten to balkanise academic collaboration and stifle scientific progress.

At the core of the current crisis is the administrative weaponization of the “foreign component” clause. Historically, the NIH mandated prior approval only when federal funds were explicitly exported or when critical project segments were physically conducted abroad. Contemporary enforcement, however, relies heavily on automated digital auditing systems that flag any international institutional affiliation on published papers as evidence of an unauthorised foreign component. This algorithmic surveillance penalizes benign, routine academic practices. US-based principal investigators have been forced to expunge highly cited, peer-reviewed publications from their federal progress reports simply because a co-author was an international scholar, a foreign student working within an US lab, or a colleague who provided isolated research materials.

This bureaucratic overreach is amplified by a lack of institutional transparency. Rather than issuing clear, standardized guidelines through formal rule-making channels, agencies are executing these directives via private, ad-hoc communications between individual grant managers and researchers. This strategy of decentralised intimidation leaves academic institutions without uniform legal recourse, compelling university compliance offices to draft defensive internal policies. For instance, researchers are now advised to attach granular, defensive footnotes to their manuscripts explicitly certifying the physical, geographic location of every contributor during the research process to avoid automated funding freezes.

The ramifications extend beyond administrative inconvenience, posing a existential threat to the integrity of global science. Faced with the existential threat of funding termination or legal prosecution, US scientists are disincentivised from pursuing crucial international partnerships. Others may choose to obfuscate federal sponsorship on collaborative papers to circumvent algorithmic detection, thus undermining the transparency of research funding.

Update:

In June 2026 the White House OMB released proposed revisions to the federal Uniform Guidance that would tighten oversight of federal awards, explicitly addressing foreign collaborations, reporting, and recipient responsibilities; commentators warn these changes could widen the administrative burden on grantees and institutional compliance offices. Coverage in major science outlets and policy analyses framed these actions as part of a broader administration push to overhaul transparency and control in federal research funding. Critics argue some proposals risk politicising grant making and chilling international collaboration.

News pieces and policy briefs describe more aggressive enforcement by grant managers (including retrospective audits and requests to remove or explain foreign co‑authorship), plus institutions drafting defensive procedures to avoid triggering automated audits. Scientists, scientific societies, and international collaborators have expressed concern that tighter rules and algorithmic detection of foreign affiliations will disincentivize open co‑authorship and complicate routine global partnerships.

The proposed Uniform Guidance revisions will follow a formal notice-and-comment process; watch for the final rule text and agency-specific implementing guidance because those will determine the precise legal obligations and whether the most burdensome interpretations survive.

Ten years after Brexit, it seems reasonable to ask what effects Brexit has caused on health-related matters for the UK and beyond. Here is my attenpt to provide an answer; these are the 8 issues that come to my mind:

  1. Workforce Disruption and Recruitment Shift: The ending of free movement led to a sharp drop in EU-trained doctors, nurses, and social care staff. To plug these vacancy gaps, the UK was forced into recruiting heavily from non-EU nations. This created a fragile reliance on international recruitment from countries facing their own healthcare worker shortages. In turn, this further supported the xenophobic sentiments of some UK citizens.
  2. Medicine Supply Problems: Leaving the EU single market introduced significant customs and regulatory friction. This friction directly contributed to the frequency and severity of local pharmaceutical shortages in the UK.
  3. Loss of Regulatory Leverage: By exiting the European Medicines Agency (EMA), the UK became a standalone market. Pharmaceutical companies now regularly prioritize the much larger EU and US markets for rolling out cutting-edge new treatments, leaving the UK Medicines and Healthcare products Regulatory Agency (MHRA) to act as a “rule-taker” by fast-tracking approvals already granted elsewhere.
  4. Cross-Border Friction: Reciprocal healthcare arrangements became more complex under the new Global Health Insurance Card (GHIC) system. While basic travel is covered, specialized cross-border medical networks face ongoing administrative and legal hurdles. Many British ex-pats’ found themselves without health cover.
  5. Regulatory Divergence in Training and Innovation: The UK has increasingly diverged from EU rules, such as lowering the mandatory clinical training hours required for a nursing degree to get staff into hospitals faster. Additionally, medical technology and AI developers now face double-compliance costs (clearing separate UK and EU hurdles). This makes the UK a more expensive market to launch new health technologies.
  6. The Macro-economic Squeeze: The overall economic downturn resulting from Brexit reduced UK GDP, shrinking the available tax revenues. This has directly limited the government’s financial capacity to fund the NHS, to clear post-pandemic backlogs, and to invest in long-term social care reform.
  7. Exacerbating Health Inequalities: As inflation, food costs, and supply chain disruptions damaged the UK, vulnerable socioeconomic groups have been hit the hardest. These economic pressures, combined with a chronically strained social care sector, significantly widen UK health inequalities.
  8. Compounding Pressure on Patient Outcomes: While ultimate health metrics, such as mortality rates and overall life expectancy, are influenced by dozens of complex variables, an underfunded NHS, chronic staffing vulnerabilities, and restricted access to new drugs create a persistent, negative headwind against public health which, in the long run, can only negatively affect patient outcomes.

All of these effects are clearly negative.

Can anyone think of a positive effect?

I can’t!

The claim that Elon Musk might be “killing millions” sounds like hyperbolic rhetoric, but it is an entirely predictable mathematical projection of his policy choices. Peer-reviewed global health modeling showed that the systematic dismantling of USAID—spearheaded by Musk’s Department of Government Efficiency (DOGE)—will result in over 14 million preventable deaths by 2030, millions of whom are children. By freeze-framing and terminating programs that provide life-saving vaccines, malaria bed nets, and HIV therapeutics, these actions have directly triggered the resurgence of entirely controllable diseases.

Hard to believe?

See for yourself; here is the abstract of the paper published in the Lancet:

Background: Official development assistance (ODA) accounts for the majority of humanitarian and development assistance in the world’s most vulnerable countries and has played a pivotal role in advancing global health. We aimed to comprehensively evaluate the impact of ODA funding on mortality across the past two decades, and to project the potential consequences of current defunding trends.

Methods: We conducted an integrated retrospective evaluation and forecasting analysis using longitudinal panel data from 93 low-income and middle-income countries (LMICs). First, we estimated the association between ODA per-capita funding and mortality outcomes from 2002 to 2021 using a two-ways fixed-effects multivariable Poisson regression model with robust standard errors, adjusted for all relevant demographic, socioeconomic, and health-system covariates. We then assessed age-specific and cause-specific effects, performing extensive sensitivity and triangulation analyses to test the robustness and causal interpretation of results. Finally, we integrated the retrospective impact estimates into validated country-level microsimulation models to forecast mortality under three defunding scenarios up to 2030: a business-as-usual trajectory, a severe defunding scenario, and a mild defunding scenario.

Findings: Higher ODA funding levels were associated with a 23% reduction in age-standardised all-cause mortality (rate ratio [RR] 0·77; 95% CI 0·70-0·85) and a 39% reduction in under-5 mortality (0·61; 0·49-0·75). ODA funding was associated with large mortality declines in major communicable diseases: 70% for HIV/AIDS (RR 0·30; 95% CI 0·24-0·39), 56% for malaria (0·44; 0·35-0·56), 56% for nutritional deficiencies (0·44; 0·30-0·65), and 54% for neglected tropical diseases (0·46; 0·36-0·59). Significant reductions were also observed in mortality from tuberculosis, diarrhoeal diseases, lower respiratory infections, and maternal and perinatal causes. Forecasting analyses projected that ongoing reductions in ODA funding could, under a severe defunding scenario, result in 22·6 million (95% uncertainty interval [UI] 16·3-29·3) additional deaths across all ages by 2030, including 5·4 million (4·1-6·8) among children younger than 5 years. Under a mild defunding scenario-defined as a continuation of current downward trends-the projected excess deaths would be 9·4 million (95% UI 6·2-12·6) overall and 2·5 million (1·8-3·2) among children younger than 5 years.

Interpretation: ODA funding has played a decisive role in reducing preventable mortality across LMICs over the past two decades, and the abrupt withdrawal of this support threatens to cause millions of avoidable deaths, reversing decades of progress in global health.

Funding: RF Catalytic Capital and the Spanish Ministry of Science and Innovation.

Attempting to shield Musk from the moral indictment of these deaths by hiding behind bureaucratic complexity is a cop-out. Musk is not a passive advisor suggesting minor budgetary trims; he has aggressively engineered and celebrated the destruction of these aid mechanisms on his public platform, explicitly branding the defunding of life-saving infrastructure as “clipping waste.” When an individual wields unchecked power to eliminate interventions with legally and medically proven survival rates, the line between “efficiency” and institutional negligence disappears. He is fully aware of the survival benefits of these programs, making the choice to dismantle them a calculated acceptance of mass mortality.

While defenders argue that epidemiological models deal in macro-statistics rather than localized causality, this defense elides the nature of modern accountability. Musk cannot hand-select which specific child dies of malaria, but he did hand-select the budget line that funded their treatment. Pretending this is just a structural or collective government failure sanitizes the reality: a single billionaire used his leverage to treat global survival infrastructure like an unprofitable corporate acquisition, making him materially and morally responsible for the human body count that follows.

In March 2025, a federal judge ruled that DOGE’s effort to dismantle USAID likely violated the Constitution and ordered restoration of access to key systems, saying USAID had been effectively eliminated. That matters because it weakens any claim that the dismantling was merely speculative or rhetorical: courts have already treated the shutdown effort as legally serious.

For a deeper look into the systemic impact of these specific health program suspensions and the firsthand accounts of how these funding disruptions unfolded on the ground, you can watch this France 24 Interview with a USAID Whistleblower.

Critics of so-called alternative medicine (SCAM) often point out that much of it lacks plausibility. Proponents of SCAM tend to think that this is an irrelevance. So, what is plausibility, and why does it matter?

Think of scientific plausibility as a reality check. Before scientists spend time and money testing a new idea, they ask a basic question: Does it actually line up with what we already know about how the universe works? While an idea being plausible doesn’t automatically make it true, it acts as a crucial filter. It helps us separate ideas that are worth investigating from those that break the fundamental laws of logic, physics, chemistry, biology, etc.

This is exactly where many SCAMs fall apart. Their claims often contradict basic science before a study even begins. Take homeopathy, for example. It relies on the idea that a substance can cure an illness, even if it is diluted over and over again, often to the point where not a single molecule of the original ingredient is left. This directly defies molecular theory and the well-established “dose-response relationship,” which simply states that the amount of a substance matters. Similarly, practices like “energy healing” postulate mysterious vital energies that cannot be seen, felt, or measured by any instrument known to modern science.

This matters because it changes how we look at “proof.” In science, if an idea is highly unlikely from the start, a single positive study usually isn’t a breakthrough. Instead, it’s much more likely to be a fluke, a statistical error, the result of a flawed experiment or even fraud.

Instead of trying to fix these scientific contradictions, proponents of SCAM often change the subject or move the goalpost. They might, for instance, that claim the scientific method is closed-minded or simply ignore negative results. But you cannot bypass the rules of reality. If a treatment claims to do something that contradicts everything we know about nature, it requires extraordinary proof to be taken seriously.

I do understand why SCAM enthusiasts try to ignore the issue of plausibility. But ignoring it runs several risks. For instance, it risks doing research that is entirely wasteful. More importantly perhaps, it risks paying undue attention to false positive results which, in turn, can seriously harm vulnerable patients – just think of a cancer patient who has fallen victim to the claims of homeopaths – backed by multiple, implausible and fase-positive results – suggesting that homeopathy can cure cancer.

The Trump administration is trying to introduce new rules that would put political appointees, rather than career scientists and civil servants, in the decisive role on federal research grants. The proposal would make senior appointees review grants for compliance with law and the Trump’s priorities, and it would make it easier to terminate grants already awarded.

The proposal was published by the White House budget office in late May 2026 and is part of a broader effort to tighten political control over federal spending rules. The administration plans to implement the proposal on 1 October. The comment period is open through 13 July*.

Under the draft rules, political appointees would have oversight over grants and could decide whether funding aligns with Trump’s wishes. The new rules would let appointees terminate grants after they have already been awarded. Scientists therefore warn that ongoing projects could be put at risk. Peer review would be weakened and expert views treated as advisory rather than decisive.

This would decisively move funding decisions away from scientific merit and toward political criteria which would chill work on politically sensitive topics and give non-experts the power to shape what gets investigated.

Crucially, this is not a one-off move: Trump has already signed an executive order in August 2025 directing agencies to give appointees oversight of grants so they would advance his priorities. The new proposal is the regulatory mechanism that would turn that earlier order into a permanent system.

In practical terms, this legislation is a major shift from expert-led grant to politically supervised grant-making. It constitutes a direct threat to scientific independence.

You can submit your public comment on the OMB proposed rule at:

https://www.regulations.gov/docket/OMB-2026-0034

Steps:

  • Go to that link and click the “Open for Comments” button (or directly click “Comment” on the docket page).
  • Scroll to the bottom and click “Comment.”
  • Start your comment by including the relevant section number in brackets, for example [200.461], so OMB can route it properly.
  • Write in your own words, focusing on specific impacts on your work or institution.
  • Avoid including private details like your home address or phone number, since comments are posted publicly.

“Science and pseudoscience diverge particularly sharply in their ethical and moral foundations. While science is built upon principles of honesty, openness, and responsibility, pseudoscience undermines these values often by placing ideology and belief over evidence and truth. Science is not least an ethical enterprise, and the divide between science and pseudoscience is a matter of profound moral importance. The ethical stakes become especially acute when pseudoscience causes harm…”

These lines come from my recent book, THE LEOPARD LILY PROJECT, which is only marginally about so-called alternative medicine (SCAM). Yet they do apply well to SCAM which does not merely fail the test of scientific rigor but also fails the test of medical ethics. When a practice trades empirical validation for dogmatic ideology, it ceases to be an innocent alternative and becomes a profound moral transgression. SCAM regularly promises holistic salvation while actively undermining the principles of honesty, openness, and responsibility, effectively replacing rigorous scrutiny with profitable mystique.

The ethical stakes transition from academic to tragic whenever a vulnerable patient is guided away from effective treatments. SCAM cloaks itself in the gentle language of empathy and natural, holistic, individualised healing, yet its business model relies on exploiting the desperation of the sick. Informed consent is rendered impossible when patients are fed misleading or even fabricated data and disproven promises. By substituting anecdotes for evidence, SCAM weaponizes false hope, monetizing the fear of illness under the guise of medical autonomy. SCAM fosters a broader culture of conspiratorial thinking that systematically erodes public trust in collective public health infrastructure.

When conventional physicians prescribe a treatment, they are bound by evidence, medical ethics, regulatory oversight, and a legal duty of care. When SCAM practitioners prescribe an unproven therapy, they operate in an ethical void, often shielded from accountability by vague disclaimers.

Science remains an ethical enterprise acknowledging its own limitations and subjecting its claims to rigorous correction. Pseudoscience demands faith instead of evidence and leaves its patients to bear the physical consequences of its intellectual dishonesty. To pick up and rephrase the theme from my recent book: evidence-based medicine and SCAM diverge particularly sharply in their ethical and moral foundations.

Internal HHS and CDC communications leaked by the US Senate HELP Committee expose a truly scary crisis of institutional integrity. Secretary Robert F. Kennedy Jr. systematically dismantled evidence-based public health infrastructure to implement his personal, ideological and dangerous agenda. This was not merely a shift in administrative policy; it was an aggressive, top-down politicisation of science that directly compromised public safety.

It is now clear that less than 24 hours after his confirmation on 29/30 January 2025 – in the midst of a severe flu season that had already claimed 16,000 lives, including 68 children – Kennedy issued a direct mandate to halt active flu vaccine public service advertisements. Internal communications from HHS Director of Communications Andrew Nixon explicitly confirm this “was a direct ask from Secretary Kennedy.”

The institutional damage caused by Kennedy’s actions extends far beyond suppressed messaging into structural purges. In fact, it seems likely that Kennedy committed perjury. During his confirmation hearings, Kennedy misled lawmakers regarding his intentions to restrict vaccine access and his past anti-vaccine interventions. Once in power, his chief of staff enforced an “absolute need for political review” over career scientists. Kennedy subsequently fired the entire 17-member Advisory Committee on Immunization Practices (ACIP), replacing them with people with strong anti-vaccine views. When career CDC Director Susan Monarez resisted rubber-stamping these politically motivated recommendations, Kennedy fired her, triggering a wave of high-level resignations among the agency’s top medical officers.

The leaked emails also confirm that Kennedy bypassed standard scientific clearance protocols to dispatch handpicked researchers into confidential CDC databases. This was a deliberate attempt to weaponize raw public health data to manufacture evidence for a spurious vaccine-autism link that has been thoroughly debunked by global longitudinal studies involving millions of children.

By substituting ideological loyalty for empirical evidence, the US administration has compromised the foundational mechanics of medicine. When a federal health agency is forced to prioritize dogma over data, the ultimate cost is inevitably paid in preventable human disease and death.

The conclusion: Kennedy has likely committed the serious crime of perjury, has shown to be a danger to our (the damage can quickly spread beyond the US) health, and in my view has to be removed from office asap.

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