risk/benefit
In the ever-evolving farce of populist politics, Robert F. Kennedy Jr. has launched yet another crusade, this time to expand access to a group of “natural” peptides that the FDA previously restricted because of safety concerns and inadequate human data. In 2026, that campaign acquired fresh momentum: Kennedy publicly urged the FDA to restore access to roughly 14 of the previously restricted peptides, and reports in late March indicated that the agency was expected to loosen some of those restrictions, though no final rule had yet been published.
Peptides — short chains of amino acids — have become the darlings of the “biohacking” crowd, praised as a fountain of youth and marketed for everything from rapid fat loss to cognitive enhancement. The compounds at the center of this controversy are largely those the FDA placed in Category 2, meaning bulk drug substances that raise significant safety concerns or lack sufficient data to support compounding. That classification effectively bars compounding pharmacies from making them for routine use unless the regulatory status changes.
Among the best-known substances in the dispute are the following:
- BPC-157: Often marketed as the “Body Protection Compound,” it is promoted for gut and tendon repair. The FDA’s concern has centered on the absence of adequate human safety data and unresolved safety questions.
- Thymosin Beta-4 (TB-500): Promoted for injury recovery. It has been flagged because of concerns about growth-related effects and the lack of a proper human evidence base.
- GHK-Cu: Used in some cosmetic products in topical form, but the injectable version has been controversial because of impurity risks and limited safety information.
- CJC-1295: Marketed for growth-hormone stimulation, with safety concerns tied to its endocrine effects and broader cardiovascular uncertainty.
- Ipamorelin: Another growth-hormone-related peptide, restricted because of unresolved safety and manufacturing concerns.
- Ibutamoren (MK-677): Often sold as a “SARM” alternative, though it is not one, and has raised concerns about metabolic and long-term safety.
- AOD-9604: A fragment of human growth hormone marketed for fat loss, but without a robust clinical safety record.
- Dihexa: Promoted for cognitive repair and Alzheimer’s-related claims, despite a lack of adequate human clinical evidence.
- Selank and Semax: Russian-developed nootropics marketed for anxiety and focus, but not supported by the kind of regulatory review expected for routine therapeutic use.
- Melanotan II: Known as the “Barbie drug,” used for tanning and libido, and associated with serious adverse-effect concerns.
- PT-141 (Bremelanotide): An approved version exists as Vyleesi, but compounded versions have raised concerns about dose consistency and safety.
Kennedy has framed the FDA’s crackdown as a kind of conspiracy by “Big Pharma” against so-called alternative medicine (SCAM). In reality, the agency’s restrictions were driven by the absence of convincing clinical data and, in some cases, by serious safety concerns. His push to reopen access presents itself as “liberating” healthcare, but it risks bypassing the very safeguards designed to keep experimental or poorly studied substances from being marketed as remedies.
Many of these compounds are produced in gray-market labs or loosely regulated compounding settings, where contamination and purity problems are a real concern. Peptides are biologically active signaling molecules, not harmless wellness supplements, and altering those signals can produce unpredictable effects, including effects on tumor growth, metabolism, blood pressure, and other systems. And the appeal to “naturalness” is a classic fallacy: a substance being naturally derived says nothing about whether it is safe, effective, or appropriate for widespread use.
The most troubling part of this campaign is the message behind it: distrust expert regulation, trust ideological certainty instead. Kennedy has turned a complex issue of drug safety and compounding oversight into a culture-war emblem. By pushing for broad access to experimental compounds without the normal evidentiary standards, he is not modernizing medicine; he is reviving the logic of patent-medicine quackery, where the promise of a cure mattered more than proof, and where the cure was often more dangerous than the disease.
The ‘Smallwood Report‘, entitled “The Role of Complementary and Alternative Medicine in the NHS” was published in October 2005. It recommended greater integration of so-called alternative medicine (SCAM) into the UK’s National Health Service and to address “effectiveness gaps” in treating chronic and psychosocial conditions, claiming potential cost savings.
Its core recommendations were:
- NICE assessment: Urged Health Ministers to task the National Institute for Health and Clinical Excellence (NICE) with a full review of the cost-effectiveness of therapies like acupuncture, chiropractic, osteopathy, herbal medicine, and homeopathy.
- Targeted applications: Suggested these SCAM options for lower back pain (manipulative therapies over conventional), asthma (homeopathy), common colds (echinacea), and other chronic issues where orthodox medicine falls short, potentially reducing absenteeism and NHS costs by hundreds of millions.
- Implementation steps: Promote GP referrals to SCAM, target deprived communities, prioritize research on cost-effectiveness/safety, address regulatory barriers, and use case studies showing reduced GP visits and secondary care savings.
At the time, I called its evidence “grossly misleading,” citing ignored Cochrane reviews showing no superiority for most of the claims. Many critics agreed with me, and the Lancet editor Richard Horton famoulsy called it “dangerous nonsense”.
As the recommendations were pure BS, it is comforting to note that – 20 years later – they have been largely ignored.
NICE assessments:
NICE has issued selective endorsements—e.g., acupuncture and manipulative therapies for low back pain—but stopped short of broad SCAM evaluations, often citing “insufficient evidence” or requiring further trials, directly countering the report’s call for comprehensive cost-effectiveness reviews. No large-scale NICE program emerged to validate the report’s claimed savings (hundreds of millions annually), and guidelines frequently dismiss or deprioritize unproven modalities like homeopathy.
NHS integration status:
- Limited GP referrals: Sporadic pilots exist (e.g., acupuncture in some pain clinics, osteopathy/chiropractic for musculoskeletal issues), often GP-led and adjunctive, but not systematic; social prescribing now favors mindfulness over traditional SCAM.
- Funding barriers: Most Integrated Care Boards (ICBs) classify SCAM as “low priority” absent robust evidence, funding only exceptional cases in palliative or pain management pathways; many services closed due to austerity post-2010.
- No deprived-community focus: The report’s equity push for high-need areas saw negligible uptake, with barriers like clinician resistance and regulatory hurdles persisting.
The report’s optimistic case studies (e.g., Glastonbury) proved anecdotal and unscaled, undermined by critiques highlighting flawed evidence (e.g., ignored Cochrane reviews). Today, NHS policy emphasizes evidence-based conventional care, with SCAM relegated to private or niche settings – realization sits at ~10-20% for endorsed therapies, 0% for broader vision.
In other words, ignoring the report has saved the NHS many millions. More importantly, it has prevented UK evidence-based healthcare from getting watered down by ineffective therapies.
Could that also have happened without my loud protests (e.g. here and here) at the time?
Nobody can know for sure?
But when I feel a little bit down, I tell myself that I had an important role in saving the UK millions!
How accurate are Dana Ullman’s articles? To answer this amusing question, I asked the AI platform ‘Gemini’ to find all the false statements in one of Dana’s articles (yes, I do admit that I am reluctant to read though an entire nonsensical paper – it would give me a headache or worse). This is the precise task I asked for:
Give me a bullet point list of all false statements in this text: Lessons from the Flu Epidemic of 1918: The Dangers of Using Fever Suppressing Drugs for Viral Infections.
[In case you want to read this lengthy paper yourself, here is the link]And here is the response I got from Gemini (bold emphasis by AI):
The text you provided is a well-known article by Dana Ullman that blends historical events with controversial medical theories. While some of the historical context (like the 1917 aspirin patent expiration) is accurate, the medical conclusions and the data regarding homeopathy are widely considered false or highly misleading by the scientific and medical communities.
Here is a bulleted list of the primary inaccuracies and misleading statements in the text:
1. Misrepresentation of the 1918 Pandemic Deaths
- The “Aspirin Theory”: The text suggests that a “large number” of the 50 million deaths in 1918 were due to aspirin overdose. This is based on a hypothesis by Dr. Karen Starko. While high doses of aspirin likely contributed to some deaths, the scientific consensus remains that the vast majority of deaths were caused by secondary bacterial pneumonia and the extreme virulence of the H1N1 virus itself, not aspirin poisoning.
- Aspirin and Bleeding Lungs: The text claims bleeding in the lungs is a “known side effect of aspirin overdose.” While salicylates can cause pulmonary edema, the “hemorrhagic” (bloody) lungs seen in 1918 victims are a hallmark of the severe viral pneumonia caused by that specific strain of influenza, not a specific marker for aspirin toxicity.
2. Inaccuracies Regarding COVID-19 and NSAIDs
- NSAIDs and Blood Clots: The text states that ibuprofen and naproxen are “known to lead to blood clots.” This is a significant mischaracterization. While chronic, long-term use of certain NSAIDs is linked to a slight increase in cardiovascular risk, they are not a primary cause of the acute “clotting storms” seen in COVID-19 patients. In fact, many COVID-19 protocols involve using blood-thinning agents (like aspirin) to prevent clots.
- The 80% Risk Claim: The claim that NSAID users have an 80% greater risk of venous thromboembolism is taken from observational studies that show correlation, not causation. People taking NSAIDs often have underlying inflammatory conditions that already increase their risk of clots.
3. False Claims About Homeopathy’s Success
- 1918 Mortality Rates: The text claims a 1.2% death rate in homeopathic hospitals vs. 29% in conventional hospitals. These figures are widely considered unreliable and anecdotal. They were self-reported by homeopathic practitioners at the time, lacked standardized diagnostic criteria, and did not account for “selection bias”.
- WHO Recognition: The WHO does not recognize homeopathy as the “second largest system of medicine” in terms of efficacy or official endorsement. It only recognizes it as a widely used traditional practice.
4. Scientific Misconceptions About Fever
- Fever Suppression Spreading Virus: The text claims that suppressing a fever “can enable the virus to spread throughout the body.” Clinical studies have generally shown that taking antipyretics does not significantly worsen disease outcomes or increase viral shedding.
- The “Cytokine Storm” Claim: The article suggests that when a fever-suppressing drug wears off, a person may experience a “cytokine storm.” This is medically incorrect.
5. Out-of-Context Quotes
- Paul Offit and Jane Brody: The text quotes them in a misleading way. They are vocal supporters of conventional medicine and vaccines, and the usage here is considered cherry-picking.
Summary Note: The FDA and the CDC have both clarified that there is no scientific evidence that taking ibuprofen or other NSAIDs worsens COVID-19.
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I know, this is just one of his many nonsensical papers. But it nevertheless suggests that Dana puts in quite a lot of effort into misleading the public.
Easter is the time to surprise our fellow humans, preferably with something nice. One does not need to be a clairvoyant to predict that many of us will use chocolate for this purpose. Overindulgence in chocolate is therefore not a rare event today.
How bad is that for your health?
Chocolate has both potential benefits and risks for our wellbeing. What makes the difference between good and bad are:
- the type (dark vs. milk/white),
- the quantity,
- individual health factors.
Its high (cocoa >70%) content antioxidants may improve heart health by lowering blood pressure, enhancing blood flow, and reducing LDL cholesterol oxidation. Some studies link moderate intake of dark chokolate (e.g., 20-45g weekly) to lower cardiovascular disease risk, better cognitive function, and mood boosts via endorphins and theobromine. It might also aid insulin sensitivity and reduce stroke risk in observational data. Some studies suggest small amounts (e.g., 30g daily of 70%+ cocoa) may reduce depressive symptoms by 50-70% compared to non-chocolate-eaters, via compounds like phenylethylamine, theobromine, and serotonin precursors that boost endorphins and calm inflammation. But, be warned: the evidence is promising but not definitive; large trials show inconsistent results, and overeating negates perks via weight gain.
Its high calorie, sugar and fat content promote weight gain, obesity, and tooth decay. Regular consumption can trigger migraines in sensitive people due to tyramine and phenylethylamine, and may weaken bone density over time. Multiple studies link chocolate consumption to increased acne lesions, especially in young adults. One study found men eating chocolate capsules developed more comedones, papules, and pustules within days, with dose-dependent effects. Mechanisms include sugar-induced insulin spikes boosting sebum, cocoa’s promotion of inflammation (e.g., IL-1β) and corneocyte desquamation, plus bacterial colonization on skin surfaces.
The conclusion, I guess, is that our habit of stuffing ourselves with chocolate over Easter is not altogether healthy, particularly if we consider that Easter eggs are often filled with the worst type. Yet it might still be healthier than what they do in Papua New Guinea.
In this country, “Easter tobacco trees” replace chocolate eggs, unsuited to the tropical climate, with trees or branches adorned by tobacco sticks and cigarette packets as communal offerings. The churches erect these “Easter tobacco trees” for Easter Sunday services. Congregants then decorate the trees with tobacco products before distributing them post-service as gifts or “treats,” akin to egg hunts elsewhere. Feasts of leftovers follow, blending Christian ritual with cultural adaptation.
Personally, I must say that I prefer chocolate overindulgence to proven carcinogens.
Dr. Dean Patterson, a consultant cardiologist in Guernsey, has been dismissed from his partnership at the Medical Specialist Group (MSG) following his public concerns about potential links between COVID-19 vaccines and myocarditis. Patterson had described as a notable rise in myocarditis. He claimed local figures of 5 cases in 2020 (pre-vaccine rollout), 25 in 2021, and 22 in 2022. Moreover, numbers declined as vaccinations tapered, he stated emphasizing that he was not anti-vaccine but sought open scientific debate and that other healthcare professionals feared reprisal for raising safety signals.
Speaking to ITV Channel in 2024, he said: “People think I must have come to this conclusion just like that, but I haven’t. It’s been running on guts, instinct at first, not being quite happy, trying to speak to people, then hoping to prove myself wrong. I think the scientific debate has been stifled. People and doctors have been threatened and lost their jobs, I’ve had nursing staff at the hospital contact me and say they can’t speak out because of disciplinaries.”
Eventually,Guernsey authorities commissioned an independent review by the Royal College of Physicians in late 2024 to check Patterson’s patient data for vaccine-related cardiac risks. The review found no substantiation for the scale of concerns Patterson had voiced. However, it uncovered unspecified “issues” that prompted MSG’s internal probe on patient safety grounds. Patterson had not treated MSG patients since February 2025, yet remained a partner until March 2026, when MSG ended his tenure after parallel internal processes concluded, separate from but informed by a still ongoing UK General Medical Council (GMC) investigation. The GMC had imposed a 12-month interim suspension of his license in February 2026, which Patterson is appealing, barring him from UK or Guernsey practice in the interim.
The MSG’s dismissal announcement on March 19, 2026, centred on patient safety and the review’s lack of support for his claims, without detailing specific allegations amid the GMC fitness-to-practise case. Local media framed it as a sacking tied to his vaccine critique, highlighting tensions over suppressed debate. MSG assured continuity via other cardiologists, reassigning patients, while the full review, precise issues, and the GMC outcomes all remain undisclosed.
The way I see it, this story might be a textbook example of confirmation bias. Confirmation bias is the tendency to listen more often to information that confirms our existing beliefs. Through this bias, people tend to favor information that reinforces the things they already think or believe.
It happens to us all: you drive your car through town and have to stop twice at a red light; subsequently you get the feeling that most trafic lights see you coming and turn red to annoy you. In fact, you only notice the red lights and forget about the many green ones that you passed.
Patterson seemed to have noticed one or two unusual cases which sensitised him to find more that seemed similar. Clinicians’ judgements are often biased in this way. In other words, the story could serve as a reminder that we need proper science rather than huntches to guide our decisions.
Sufficient evidence concerning the impact of traditional Chinese medicine (TCM) on clinical outcomes for breast cancer patients in Taiwan is not available. This study sought to examine the association between TCM integration and post-operative outcomes among women undergoing mastectomies.
Utilizing a large insurance database, the Taiwanese researchers identified a cohort of adult women who underwent breast cancer surgery during the 2010–2019 period. They compared sociodemographic profiles and comorbidities between TCM users and non-users. Multiple logistic regression models were employed to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for both mortality and postoperative complications.
Among 91,298 eligible patients, the one-year pre-operative prevalence of TCM utilization was 40%. Compared to the control group, TCM users demonstrated:
- a significantly lower likelihood of postoperative stroke (OR 0.76, 95% CI 0.62–0.93),
- and a reduced requirement for intensive care (OR 0.74, 95% CI 0.59–0.91).
Moreover, the cumulative exposure of more than 4 TCM consultations within the year preceding surgery was linked to a decreased risk of stroke (OR 0.76, 95% CI 0.61–0.95).
The authors concluded that “our findings indicate that integrating TCM during the year preceding breast cancer surgery is correlated with lower risks of postoperative stroke and a reduced requirement for intensive care. Nevertheless, these observed benefits warrant further verification through prospective and large-scale clinical investigations. Based on these results, we suggest that both Western medical practitioners and public health administrators should be mindful of TCM’s role in the comprehensive care of patients with breast cancer.”
In the paper itelf, the authors “hypothesize that pre-operative TCM integration contributes to the observed reduction in stroke risk and intensive care requirements following mastectomy. These prior insights provide a plausible biological foundation for the favorable outcomes observed in our study”. In other words, they believe that the associations is causal.
I beg to differ!
Much research has demonstrated that people who use so-called alternative medicine (SCAM) in addition to conventional therapies differ from those who don’t. In general, they tend to be more health concious – if not, they would not go to the trouble of using and paying for SCAM. This difference alone suffices to bring about the observed outcomes – even if TCM has no or perhaps a slightly negative overall health effect.
But let’s be generous!
Let’s assume the authors are correct in assuming that the association is causal and that TCM brought about the observed outcomes.
What does that actually mean?
TCM consists of many different modalities. If we just focus on oral medications and assume that there are 1000 different ones [in fact, the number is about 6 times higher], which one do we take to experience the observed outcome? Perhaps all of them?
What I am trying to point out that such research is meaningless; it has zero practical consequences, even if its results were real – which they probably are not.
In the end, it boils down to one main thing: the promotion of unproven (and occasionally dangerous) TCM.
Although currently the COVID-19 pandemic is no longer a public health challenge, the unprecedented utilization and integration of Ayush therapeutics and principles for the COVID-19 response in India represent a critical health systems and policy experiment which needs a systematic evaluation.
A systematic review and meta-analysis was conducted, and the data were extracted till 9th July 2024 using three databases: Scopus, PubMed and DOAJ. A total of seven articles were included for the review, following the PICOS criteria of inclusion and exclusion. Of the 667 articles, seven articles were finally selected, and these articles underwent quality assessment using the AXIS assessment tool. The pooled proportion of the Indian population that utilized the Ayush systems was estimated at a 95% confidence interval, using a random effects model assuming potential heterogeneity. The pooled estimate, publication bias, heterogeneity and sensitivity analysis were graphically represented using a forest, funnel, Galbraith plots and leave-one-out meta-analysis. Additionally, the effects of the small studies were assessed using Egger’s and Begg’s tests. The total sample across the included studies was 789,735. Of the seven articles, six focused on the general population, and five focused on the utilization of the Ayurveda system of medicine. The pooled proportion of the Indian population that utilized the Ayush systems for COVID-19 was 40% (95% CI: 25% − 57%). Based on the policy relevance, risk of exposure, access to guidelines and pattern of utilization two subgroup analyses were carried out. Utilization of multiple systems of Ayush (48%) and utilization among the general population (46%) showed the highest proportion compared to Ayurveda and healthcare workers, respectively. The high heterogeneity (I2 = 99.98%) suggests that the pooled estimate should be interpreted with caution, and the sensitivity analysis found one study had a modest upward influence on the overall estimate.
The authors concluded that this systematic review found a 40% pooled estimate of utilization of Ayush systems from the included studies, suggesting the utilization of these systems to manage mild and asymptomatic conditions and for preventive purposes.
This review reports a 40% pooled utilization rate of Ayush systems for COVID-19 in India, based on just seven studies with a massive sample but extreme heterogeneity (I²=99.98%). Such high heterogeneity undermines the reliability of the pooled estimate, as noted in the study’s own caution and sensitivity analysis showing one study’s outsized influence.
Only seven articles met PICOS criteria from 667 screened, mostly surveys on self-reported use among general populations, without assessing clinical efficacy or outcomes. Quality via AXIS tool is mentioned, but broader Ayush COVID evidence reveals high risk of bias in many trials due to poor randomization, blinding, and variability in interventions. No causal link is drawn between Ayush use and health impacts; the paper merely quantifies popularity amid government promotion.
India faced ~2.4-4.7 million excess deaths in 2020-2021, 7-10x official COVID figures, driven by Delta wave surges, oxygen shortages, and healthcare collapse. Widespread Ayush integration for prevention and mild cases – endorsed by Ministry of Ayush! – did not correlate with better results; high utilization (40-48% in subgroups) coincided with catastrophic mortality levels. Sound evidence for Ayush benefits does not exist. One might therefore speculate that the promotion of Ayush may have diverted resources from proven measures like vaccination and antivirals. In other words, it seems likely that it cost many lives.
Today, there is a strong scientific and medical consensus that homeopathy lacks reliable evidence of efficacy. Many of the strongest rejections come, after independent evaluations of the evidence, from national and international scientific bodies of undoubted repute. Here is my list:
- Advertising Standards Authority (UK) The ASA requires that efficacy claims for homeopathic products be supported by robust clinical evidence and has ruled that unsupported claims are misleading.
- American Academy of Pediatrics (USA) Warns that unproven alternative treatments, including homeopathy, should not delay or replace effective medical care, particularly in children.
- American College of Medical Toxicology & American Academy of Clinical Toxicology (USA) Jointly stated “no evidence exists” homeopathy is effective, noting it can be harmful by delaying evidence-based care; they recommended “against using homeopathic treatment for disease or prevention.”
- American Medical Association (USA) Issed statements that there is “no good-quality evidence” homeopathy is effective for any condition and opposed its integration into mainstream practice.
- Argentine Medical Association (AMA, Argentina) The AMA has criticized homeopathy’s inclusion in medical practice, stating it lacks scientific evidence and warning against its promotion as a valid treatment.
- Belgian Health Authority The Belgian Federal Public Service Health halted reimbursement for homeopathy in 2020, following advice from the College of Physicians that it lacks scientific evidence.
- Canadian Health Authorities Health Canada mandates warning labels on unlicensed claims: “This product is neither approved nor authorized for any indication,” aligning with evidence that homeopathy lacks reliable clinical support.
- Canadian Medical Association (CMA) Via editorials in its journal (CMAJ), the CMA has condemned the licensing of homeopathy as a “loophole” that implies efficacy without scientific proof, stating it “makes a joke of the regulatory process.”
- Chief Medical Officer for England (Dame Sally Davies) Publicly called homeopathic preparations “rubbish” that function only as placebos with no therapeutic benefit beyond psychological effects.
- European Academies’ Science Advisory Council (EASAC) Issued a 2017 statement finding “no evidence that homeopathic products are effective” and reiterated that explanations for homeopathy’s efficacy are “scientifically implausible.”
- Federal Trade Commission (USA) Requires that homeopathic products must not claim effectiveness without evidence; otherwise, they must clearly state a lack of scientific support.
- Federation of American Societies for Experimental Biology (FASEB) Asserted “no convincing evidence” for homeopathy’s clinical efficacy, as its mechanisms contradict established chemistry and physics.
- Food and Drug Administration (USA) States “No homeopathic product is FDA-approved”; products are not reviewed for safety or effectiveness. The FDA also warns they may pose risks.
- French Academy of Medicine Rejected homeopathy as scientifically invalid, stating its theoretical basis and clinical evidence are inadequate or absent.
- German Medical Association (Germany) In 2020, removed homeopathy from the model further education curriculum for doctors, declaring it “is not a medical procedure based on scientific findings.”
- House of Commons Science and Technology Committee (UK) In its 2010 report, concluded “the systematic reviews and meta-analyses conclusively demonstrate that homeopathic products perform no better than placebos.”
- Medicines and Healthcare products Regulatory Agency (UK) Followed committee advice by restricting licensing; homeopathic products should not make medical claims without evidence and are no longer endorsed as medicines.
- National Cancer Institute (USA) States homeopathy has “not been shown to be effective” for cancer treatment or symptom relief, with no rigorous studies supporting benefit beyond placebo.
- National Health and Medical Research Council (NHMRC, Australia) After reviewing over 1,800 studies, it concluded “there are no health conditions for which there is reliable evidence that homeopathy is effective.”
- National Health Service (NHS, England) Formally stated “no NHS funding will be spent on homeopathic medicines,” with guidance that homeopathy performs “no better than placebos.”
- National Institute for Health and Care Excellence (UK) NICE does not recommend homeopathy in any clinical guideline and bases its recommendations on the best available evidence.
- Royal Society (UK) Numerous Fellows have publicly criticized homeopathy, and the Society has supported evidence-based medicine principles incompatible with homeopathy’s claims.
- Russian Academy of Sciences Described homeopathy as “pseudoscience” with principles that “contradict known laws of chemistry, physics, and biology.”
- Spanish Medical Associations (Collegiate Medical Organization of Spain) In 2018, rescinded recognition of homeopathy as a “medical procedure,” declaring it “not scientifically sound.”
- Swedish Medical Association The Swedish Medical Association and National Board of Health declared homeopathy scientifically unfounded in 2010, advising against its use in healthcare.
- Swiss Academy of Medical Sciences Concluded homeopathy lacks scientific evidence and should not be reimbursed by health insurance.
- Swiss Federal Office of Public Health After a 2005-2011 review, it rejected renewed inclusion in basic health insurance (though it was later reintroduced in 2017 under specific political conditions).
- World Health Organization (WHO) Explicitly stated homeopathy “should not be used” for serious diseases like HIV, tuberculosis, or malaria, warning reliance “can be dangerous.”
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And what about institutions supporting homeopathy? I am aware of just one:
- Ministry of AYUSH (India) “Homoeopathy is a cost-effective system of medicine and is widely practiced for both acute and chronic conditions.”
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Across decades of systematic reviews and independent evaluations by scientific and medical authorities worldwide, no credible evidence has emerged to support the efficacy of homeopathy. Its principles conflict with well-established scientific laws, and its effects are indistinguishable from those of placebo in rigorous studies. The broad convergence of expert opinion is therefore this: homeopathy has no effects beyond placebo. Its continued use represents a divergence from evidence-based medicine, and reliance on it, particularly as an alternative to effective care, poses a clear risk to public health.
In the early 19th-century Austrian Empire, few figures held as much power over the physical and institutional health of the state as Dr. Andreas Joseph von Stifft (1760–1836) – after all, he was the personal physician to Emperor Franz I! He had risen from fairly modest origins, studied and trained at the University of Vienna, gained attention with a reform plan for the Josephinum, was then appointed second Stadtphysikus, and subsequently Hofarzt and imperial Leibarzt. As long‑serving director of medical studies and high state official, he reorganised curricula, promoted new disciplines and institutions, and helped shape public health policy in the Austrian Empire. In a nutshell: he was one of the most influencial doctors of his time.
His place in the history of medicine is well-documented. But his role in the history of homeopathy is less well-known: Stifft was homeopathy’s most formidable antagonist, employing his influence to orchestrate a near-total ban of the practice. His power was rooted in his commitment to the influencial Vienna Medical School and in the rigorously state-controlled medical hierarchy of the Austrian Empire. He considered the medical profession to be an important pillar of the conservative Restoration era. To Stifft, Samuel Hahnemann’s “Law of Similars” was therefore not merely a medical deviation; it was a threat to the scientific and administrative order he had spent building all his life.
Stifft’s most direct blow against homeopathy was the Imperial Decree of 1819 prohibiting the use of homeopathy altogether. He had managed to convince the Emperor that homeopathy was a “danger to the public” because it bypassed the well-established pharmacy system. By encouraging physicians to prepare their own remedies, homeopathy threatened the economic stability of apothecaries, who were vital tax-paying entities and strictly monitored by the state.
Under Stifft’s guidance, the decree framed homeopathy as:
- Scientifically Unsound: Stifft dismissed the concept of potentization (extreme dilution) as mystical nonsense.
- A Threat to Public Safety: He feared that patients would forgo “proven” treatments like bloodletting or mercury-based purges in favour of “sugar pills.”
- Administrative Chaos: If every doctor became their own pharmacist, the state’s ability to regulate drug quality and safety would collapse.
Stifft’s influence was so absolute that even high-ranking aristocrats who supported homeopathy had to seek treatments in secrecy. Practicing homeopathy could lead to the loss of a medical license or even imprisonment. Ultimately, Stifft represented the medical establishment’s attempt to use state power to control heathcare. Yet homeopathy’s survival among the nobility and its perceived success during epidemics eventually led to the repeal of his ban in 1837, only months after Stifft had died.
The 1831 cholera epidemic pitted the aggressive, often debilitating methods of the medical establishment against the placebos of homeopathy. The outcome of this comparison was so statistically undeniable that it effectively broke the political stranglehold Stifft had maintained over Austrian medicine.
When cholera first reached Europe in 1831, the medical establishment was helpless. The “heroic” treatments of the time – championed by Stifft – involved:
- Excessive bloodletting (often until the patient fainted).
- Strong purgatives (like Calomel/Mercury) to “flush out” the disease.
- Blistering agents applied to the skin.
In cholera characterised by rapid dehydration and exhaustion, these treatments proved to be more lethal than the disease itself. Mortality rates in regular hospitals often soared between 40% and 60%. In contrast, Samuel Hahnemann recommended remedies like highly diluted Camphor, Cuprum, and Veratrum. They had no effect, of course, but no effect was miles better that killing patients with ‘heroic medicine’. While Stifft had argued that homeopathy was a threat to “public safety,” the public could see that people were surviving in homeopathic wards while dying in state-run ones.
By 1837, just one year after Stifft’s death, Emperor Ferdinand I (the successor to Franz I) officially repealed the ban of homeopathy. The “miracle” of 1831 had proven that the state could no longer justify the suppression of a method that seemed to “do no harm” during a time when official medicine was doing plenty.
I find the story fascinating not least for one reason: the success of homeopathy is mainly due to the failures of conventional medicine. This was true at the time of Stifft, and it is true today when far too many conventional doctors fail to realize how important time, compassion and empathy (which homeopaths often have in spades) are for curing patients.
The regualtion of so-called alternative medicine (SCAM) differs from country to country which can and does cause a lot of confusion. Here are very brief summaries of some of the countries that I know best:
UK Policy
The UK government adopts a cautious, evidence-based stance on SCAM, with the Medicines and Healthcare products Regulatory Agency (MHRA) regulating herbal and homeopathic products for safety and quality, requiring accurate labelling without efficacy claims. Practitioner oversight is largely voluntary through bodies like the Complementary and Natural Healthcare Council (CNHC), while the NHS tends to fund mainly therapies demonstrating clinical efficacy, cost-effectiveness, and safety per NICE guidelines. This approach, shaped by responses to inquiries like the 2000 House of Lords report, prioritizes patient protection, clinician discretion, and avoidance of unproven treatments to safeguard public resources, without mandating statutory registration for most SCAM practitioners.
US Policy
In the US, much of SCAM falls under the FDA’s oversight as dietary supplements via the 1994 Dietary Supplement Health and Education Act (DSHEA), mandating pre-market safety notification but exempting efficacy proof, with strict rules against disease-treatment claims. The National Center for Complementary and Integrative Health (NCCIH) at NIH funds some research into SCAM but does not regulate practice; Medicare and Medicaid offer no routine reimbursement, except for acupuncture as a treatment of chronic low back pain. Licensing varies by state—e.g., naturopaths are regulated in 25 states, without federal endorsement of unproven therapies to balance innovation and safety.
Germany Policy
Germany integrates SCAM into its statutory health insurance system, reimbursing popular therapies like homeopathy, herbalism, acupuncture, and anthroposophic medicine when prescribed by doctors, often via the “IGeL” self-pay catalog for non-standard uses. Non-physician practitioners require Heilpraktiker certification under federal law, while products follow the Medicines Act (AMG) with simplified registration for SCAM remedies. This tradition-rooted policy, supported by major insurers like TK and AOK, fosters a hybrid model that aims at combining some regulatory rigor with broad access for patient choice in primary care settings.
France Policy
France regulatesSCAM through the National Agency for the Safety of Medicines (ANSM), requiring marketing authorization for homeopathy and herbal products based on safety dossiers, though simplified for traditional use. Assurance Maladie reimburses select therapies at reduced rates, phasing out full coverage amid efficacy critiques, with practitioners either physicians or under voluntary syndicates like the Syndicat des Médecins Homéopathes. Post-2021 policy shifts emphasize evidence-based medicine, restricting public funding to proven interventions while allowing private practice, reflecting a tension between cultural acceptance and demands for evidence to justify taxpayer expense.
Austria Policy
Austria’s policy mirrors Germany’s, with social health insurers reimbursing SCAM therapies like acupuncture, homeopathy, osteopathy, and herbal medicine when delivered by licensed physicians under the Ärztegesetz, or voluntarily via the Austrian Umbrella Organization for Quality in Complementary Medicine (ÖZK). Austria does not allow ‘Heilpraktiker’ to practice. Products align with EU standards, including simplified authorizations for SCAM remedies through the Austrian Agency for Health and Food Safety (AGES). This integrative approach aims at prioritizing evidence from clinical studies for coverage decisions, supporting patient-centred care within universal healthcare while mandating professional qualifications to ensure safety, with ongoing evaluations balancing tradition and scientific validation.
What ever the regulatory details are, we should, I think, bear in mind something that I state whenever SCAM regulation is being discussed:
Even the most rigorous regulation of nonsense must result in nonsense.
