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

WHO

While medical experts across the world have expressed dismay at Trump’s appointment of Robert Kennedy, the ‘International chiropractors Association’ has just published this remarkable note:

Donald J. Trump made it official that he was nominating Robert F. Kennedy, Jr. to serve as the Secretary of Health and Human Services. Secretary-designee Kennedy has spent his entire career championing the health of the nation through education, advocacy, research and when needed litigation.

Among his many accomplishments are protecting the environment with Riverkeeper and the Natural Resources Defense Council His work at Riverkeeper succeeded in setting long-term environmental legal standards. Kennedy won legal battles against large corporate polluters. He became an adjunct professor of environmental law at Pace University School of Law in 1986 and founded the Pace’s Environmental Litigation Clinic which he co-directed for a decade.

It would be in the Pace Law Review that the landmark paper, “Unanswered Questions from the Vaccine Injury Compensation Program: A Review of Compensated Cases of Vaccine-Induced Brain Injury” (https://digitalcommons.pace.edu/cgi/viewcontent.cgi?article=1681&context=pelr) would be published in 2011.

Kennedy became laser focused on the autism epidemic while giving lectures on the dangers of mercury in fish, he was repeatedly approached by the mothers of children born healthy who regressed into autism after suffering adverse reactions from childhood vaccines, including their concern about the mercury-based preservative, thimerosal, being used in vaccines including the Hepatitis B vaccine given at birth. Kennedy’s approach to the issue was the same as it always, looking at the science. He assembled a team who gathered all the science and reviewed the issues with him. This resulted in the publication of the book, Thimerosal: Let the Science Speak
The Evidence Supporting the Immediate Removal of Mercury—a Known Neurotoxin—from Vaccines.

After establishing and leading the nonprofit Children’s Health Defense, last year Kennedy stepped back from the organization to throw his hat in the ring to be President. Becoming the embodiment of his uncle John F. Kennedy’s famous quote, “Ask not what your country can do for you, but what you can do for your country!”, Kennedy reached out to President Trump to form an alliance to focus on the crisis of chronic disease in the United States, and suspended his campaign to focus on the Make American Healthy Again (MAHA) Initiative.

ICA President, Dr. Selina Sigafoose Jackson, who is currently in Brazil promoting the protection of chiropractic as a separate and distinct profession stated, “Many ICA members have been supporters of Robert F. Kennedy, Jr.’s philanthropic activities and are all in on the MAHA Initiative. The Mission, Vision, and Values of the ICA align with the stated goals of the MAHA Initiative. We stand ready to provide policy proposals and experts to serve as advisors to the incoming Administration and to Secretary Kennedy upon his swearing in.”

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Perhaps I am permitted to contrast this with some health-related truths about Robert F. Kennedy, Jr. (my apologies, if the list is incomplete – please add to it by posting further important issues):

  • Robert F. Kennedy, Jr. has, since about 20 years, been a leading figure of the anti-vaccine movement.
  • During the epidemic, he pushed the conspiracy theory that “the quarantine” was used as cover to install 5G cell phone networks.
  • He claimed that “one out of every six American women has so much mercury in her womb that her children are at risk for a grim inventory of diseases, including autism, blindness, mental retardation and heart, liver and kidney disease.”
  • He wrote that, “while people were dying at the rate of 10,000 patients a week, Dr. Fauci declared that hydroxychloroquine should only be used as part of a clinical trial. For the first time in American history, a government official was overruling the medical judgment of thousands of treating physicians, and ordering doctors to stop practicing medicine as they saw fit.”
  • He pushed the conspiracy theory that COVID-19 had been “ethnically targeted” to spare Ashkenazi Jews and Chinese people.”
  • He claimed in a 2023 podcast interview that “There’s no vaccine that is safe and effective”.
  • In a 2021 podcast, he urged people to “resist” CDC guidelines on when kids should get vaccines.
  • He founded Children’s Health Defense’ that spreads fear and mistrust in science. One chiropractic group in California had donated $500,000 to this organisation.
  • In 2019, he visited Samoa where he became partly responsible for an outbreak of measles, which made 5,700 people sick and killed 83 of them.
  • He called mercury-containing vaccines aimed at children a holocaust. In 2015, he compared the horrors committed against Jews to the effects of vaccines on children. “They get the shot, that night they have a fever of a hundred and three, they go to sleep, and three months later their brain is gone. This is a holocaust, what this is doing to our country.”
  • He repeatedly alleged that exposure to chemicals — “endocrine disruptors” — is causing gender dysphoria in children and contributing to a rise in LGBTQ-youth. According to him, endocrine disruptors are “chemicals that interfere with the body’s hormones and are commonly found in pesticides and plastic.”
  • He stated “Telling people to “trust the experts” is either naive or manipulative—or both.”
  • He plans to stop water fluoridation.
  • He slammed the FDA’s “suppression” of raw milk.
  • He said that a worm ate part of his brain which led to long-lasting “brain fog.”
  • He has a 14-year-long history of abusing heroin from the age of 15. The police once arrested him for possession; he then faced up to two years in jail for the felony but was sentenced to two years probation after pleading guilty.
  • He stated: “WiFi radiation … does all kinds of bad things, including causing cancer…cell phone tumors behind the ear.”
  • He claimed that rates of autism have increased even though “there has been no change in diagnosis and no change in screening either.” Yet, both have changed significantly.
  • He wrote: (Fauci’s) “obsequious subservience to the Big Ag, Big Food, and pharmaceutical companies has left our children drowning in a toxic soup of pesticide residues, corn syrup, and processed foods, while also serving as pincushions for 69 mandated vaccine doses by age 18—none of them properly safety tested.”
  • He stated that cancer rates are skyrocketing in the young and the old – a statement that is evidently untrue.
  •  He authored a viral post on X: “FDA’s war on public health is about to end. This includes its aggressive suppression of psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, hydroxychloroquine, vitamins, clean foods, sunshine, exercise, nutraceuticals and anything else that advances human health and can’t be patented by Pharma. If you work for the FDA and are part of this corrupt system, I have two messages for you: 1. Preserve your records, and 2. Pack your bags.”
  • He has also aligned himself with special interests groups such as anti-vaccine chiropractors.
  • He stated categorically: “You cannot trust medical advice from medical professionals.”
  • He said he’s going to put a pause on infectious diseases research for 8 years.
  • He promoted the unfounded theory that the CIA killed his uncle, former President John F. Kennedy.
  • He linked school shootings to the increased prescription of antidepressants.
  • An evaluation of verified Twitter accounts from 2021, found Kennedy’s personal Twitter account to be the top “superspreader” of vaccine misinformation on Twitter, responsible for 13% of all reshares of misinformation, more than three times the second most-retweeted account.

 

PS

Let me finish with a true statement: The World Health Organization has estimated that global immunization efforts have saved at least 154 million lives in the past 50 years.

 

 

Many fans of so-called alternative medicine have, as discussed ad nauseam on this blog, an irrational attitude towards vaccinations. They frequently claim that they do more harm than good. I wonder whether the data from a very large study might convince them other wise.

The WHO launched the ‘Expanded Programme on Immunization’ (EPI) in 1974 to make life-saving vaccines available to all globally. To mark the 50-year anniversary of EPI, this analysis sought to quantify the public health impact of vaccination globally since the programme’s inception.

his modelling study used a suite of mathematical and statistical models to estimate the global and regional public health impact of 50 years of vaccination against 14 pathogens in EPI. For the modelled pathogens, we considered coverage of all routine and supplementary vaccines delivered since 1974 and estimated the mortality and morbidity averted for each age cohort relative to a hypothetical scenario of no historical vaccination. These modelled outcomes were then used to estimate the contribution of vaccination to globally declining infant and child mortality rates over this period.

Since 1974, vaccination has averted 154 million deaths, including 146 million among children younger than 5 years of whom 101 million were infants younger than 1 year. For every death averted, 66 years of full health were gained on average, translating to 10·2 billion years of full health gained. Vaccination has thus accounted for 40% of the observed decline in global infant mortality, 52% in the African region. In 2024, a child younger than 10 years is 40% more likely to survive to their next birthday relative to a hypothetical scenario of no historical vaccination. Increased survival probability is observed even well into late adulthood.

The authors concluded that since 1974 substantial gains in childhood survival have occurred in every global region. We estimate that EPI has provided the single greatest contribution to improved infant survival over the past 50 years. In the context of strengthening primary health care, our results show that equitable universal access to immunisation remains crucial to sustain health gains and continue to save future lives from preventable infectious mortality.

>So, will this excellent and compelling analysis concince many irrational anti-vaxers? Somehow, I have my doubts.

The WHO has just released guidelines for non-surgical management of chronic primary low back pain (CPLBP). The guideline considers 37 types of interventions across five intervention classes. With the guidelines, WHO recommends non-surgical interventions to help people experiencing CPLBP. These interventions include:

  • education programs that support knowledge and self-care strategies;
  • exercise programs;
  • some physical therapies, such as spinal manipulative therapy (SMT) and massage;
  • psychological therapies, such as cognitive behavioural therapy; and
  • medicines, such as non-steroidal anti-inflammatory medicines.

The guidelines also outline 14 interventions that are not recommended for most people in most contexts. These interventions should not be routinely offered, as WHO evaluation of the available evidence indicate that potential harms likely outweigh the benefits. WHO advises against interventions such as:

  • lumbar braces, belts and/or supports;
  • some physical therapies, such as traction;
  • and some medicines, such as opioid pain killers, which can be associated with overdose and dependence.

As you probably guessed, I am particularly intrigued by the WHO’s positive recommendation for SMT. Here is what the guideline tells us about this specific topic:

Considering all adults, the guideline development group (GDG) judged overall net benefits [of spinal manipulation] across outcomes to range from trivial to moderate while, for older people the benefit was judged to be largely uncertain given the few trials and uncertainty of evidence in this group. Overall, harms were judged to be trivial to small for all adults and uncertain for older people due to lack of evidence.

The GDG commented that while rare, serious adverse events might occur with SMT, particularly in older people (e.g. fragility fracture in people with bone loss), and highlighted that appropriate training and clinical vigilance concerning potential harms are important. The GDG also acknowledged that rare serious adverse events were unlikely to be detected in trials. Some GDG members considered that the balance of benefits to harms favoured SMT due to small to moderate benefits while others felt the balance did not favour SMT, mainly due to the very low certainty evidence for some of the observed benefits.

The GDG judged the overall certainty of evidence to be very low for all adults, and very low for older people, consistent with the systematic review team’s assessment. The GDG judged that there was likely to be important uncertainty or variability among people with CPLBP with respect to their values and preferences, with GDG members noting that some people might prefer manual
therapies such as SMT, due to its “hands-on” nature, while others might not prefer such an approach.

Based on their experience and the evidence presented from the included trials which offered an average of eight treatment sessions, the GDG judged that SMT was likely to be associated with moderate costs, while acknowledging that such costs and the equity impacts from out-of-pocket costs would vary by setting.

The GDG noted that the cost-effectiveness of SMT might not be favourable when patients do not experience symptom improvements early in the treatment course. The GDG judged that in most settings, delivery of SMT would be feasible, although its acceptability was likely to vary across
health workers and people with CPLBP.

The GDG reached a consensus conditional recommendation in favour of SMT on the basis of small to moderate benefits for critical outcomes, predominantly pain and function, and the likelihood of rare adverse events.

The GDG concluded by consensus that the likely short-term benefits outweighed potential harms, and that delivery was feasible in most settings. The conditional nature of the recommendation was informed by variability in acceptability, possible moderate costs, and concerns that equity might be negatively impacted in a user-pays model of financing.

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This clearly is not a glowing endorsement or recommendation of SMT. Yet, in my view, it is still too positive. In particular, the assessment of harm is woefully deficient. Looking into the finer details, we find how the GDG assessed harms:

WHO commissioned quantitative systematic evidence syntheses of randomized controlled
trials (RCTs) to evaluate the benefits and harms (as reported in included trials) of each of the
prioritized interventions compared with no care (including trials where the effect of an
intervention could be isolated), placebo or usual care for each of the critical outcomes (refer to Table 2 for the PICO criteria for selecting evidence). Research designs other than RCTs
were not considered.

That explains a lot!

It is not possible to establish the harms of SMT (or any other therapy) on the basis of just a few RCTs, particularly because the RCTs in question often fail to report adverse events. I can be sure of this phenomenon because we investigated it via a systematic review:

Objective: To systematically review the reporting of adverse effects in clinical trials of chiropractic manipulation.

Data sources: Six databases were searched from 2000 to July 2011. Randomised clinical trials (RCTs) were considered, if they tested chiropractic manipulations against any control intervention in human patients suffering from any type of clinical condition. The selection of studies, data extraction, and validation were performed independently by two reviewers.

Results: Sixty RCTs had been published. Twenty-nine RCTs did not mention adverse effects at all. Sixteen RCTs reported that no adverse effects had occurred. Complete information on incidence, severity, duration, frequency and method of reporting of adverse effects was included in only one RCT. Conflicts of interests were not mentioned by the majority of authors.

Conclusions: Adverse effects are poorly reported in recent RCTs of chiropractic manipulations.

The GDG did not cite our review (or any other of our articles on the subject) but, as it was published in a very well-known journal, they must have been aware of it. I am afraid that this wilfull ignorance caused the WHO guideline to underestimate the level of harm of SMT. As there is no post-marketing surveillance system for SMT, a realistic assessment of the harm is far from easy and needs to include a carefully weighted summary of all the published reports (such as this one).

The GDG seems to have been aware of (some of) these problems, yet they ignored them and simply assumed (based on wishful thinking?) that the harms were small or trivial.

Why?

Even the most cursory look at the composition of the GDG, begs the question: could it be that the GDG was highjacked by chiropractors and other experts biased towards SMT?

The more I think of it, the more I feel that this might actually be the case. One committee even listed an expert, Scott Haldeman, as a ‘neurologist’ without disclosing that he foremost is a chiropractor who, for most of his professional life, has promoted SMT in one form or another.

Altogether, the WHO guideline is, in my view, a shameful example of pro-chiropractic bias and an unethical disservice to evidence-based medicine.

 

The SPECTATOR recently published an article about the World Health Organisation’s (WHO) tendency to push so-called alternative medicine (SCAM). Here are a few excerpts from it: An Introduction of the WORLD HEALTH ORGANIZATION

World Health Organisation (WHO) is meant to implore us to ignore hearsay and folklore, and to follow the scientific evidence. So why is it now suddenly promoting the likes of herbal medicine, homeopathy and acupuncture? In a series of tweets this week, the WHO has launched a campaign to extol the virtues of what it calls ‘traditional medicine’. ‘Traditional medicine has been at the frontiers of medicine and science, laying the foundation of conventional medical texts’, it asserts. It goes on to claim that ‘around 40 per cent of approved pharmaceutical products in use today derive from natural substances’ …  it then poses the question: ‘which of these have you used: “acupuncture, Ayurveda, herbal medicine, homeopathy, naturopathy, osteopathy, traditional Chinese medicine, unani medicine?”’

… That some folk medicines might sometimes appear to work – in spite of apparently having no active ingredients – is itself explained by scientific inquiry: there is a proven ‘placebo effect’ that causes people to report an improvement in their symptoms as a result of taking something that they think will make them better.

The WHO should be having nothing to do with promoting any medicine which has not been proven without rigorous trials. So why is it suddenly pushing all kinds of dubious cures? It is hard not to see the latest campaign as part of the fashionable campaign to ‘decolonise’ medicine – which means refusing to see western science as superior to belief systems that have derived from elsewhere in the world. The WHO published a podcast on this subject in May, in which a Canadian medical historian, for example, denounced the concept of ‘tropical’ medicine as a construct by colonial powers to try to promote the false idea that the Third World presented a danger to Europe. …

… the WHO has achieved a massive amount by unashamedly exporting rigorous scientific inquiry to parts of the world which it had yet to reach. It wasn’t folk medicine that eradicated smallpox; it was western medicine, and the WHO should not be apologising for that. Promoting quackery seems an odd – and potentially disastrous – direction for the organisation to take.

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Personally, I concur fully – except for the notion that the WHO started its SCAM-promotion only recently. The truth is that it has done so since many years, and since many years we have on this blog discussed this bizarre trend. In my view, it is a relfection not of the science but of the politics that inflence the WHO to a very large extend in the realm of SCAM.

I was asked by NATURE to provide a comment on the WHO Traditional Medicine Global Summit: Towards health and well-being for all which is about to take place in India:

The First WHO Traditional Medicine Global Summit will take place on 17 and 18 August 2023 in Gandhinagar, Gujarat, India. It will be held alongside the G20 health ministerial meeting, to mobilize political commitment and evidence-based action on traditional medicine, which is a first port of call for millions of people worldwide to address their health and well-being needs.

The Global Summit will be co-hosted by WHO and the Government of India, which holds the presidency of the G20 in 2023. It will be a platform for all stakeholders, including traditional medicine workers, users and communities, national policymakers, international organizations, academics, private sector and civil society organizations, to share best practices and game-changing evidence, data and innovation on the contribution of traditional medicine to health and sustainable development.

For centuries, traditional and complementary medicine has been an integral resource for health in households and communities. It has been at the frontiers of medicine and science laying the foundation for conventional medical texts. Around 40% of pharmaceutical products today have a natural product basis, and landmark drugs derive from traditional medicine, including aspirin, artemisinin, and childhood cancer treatments. New research, including on genomics and artificial intelligence are entering the field, and there are growing industries for herbal medicines, natural products, health, wellness and related travel. Currently, 170 Member States reported to WHO on the use of traditional medicine and have requested evidence and data to inform policies, standards and regulation for its safe, cost-effective and equitable use.

In response to this increased global interest and demand, WHO, with the support of the Government of India, established in March 2022 the WHO Global Centre for Traditional Medicine as a knowledge hub with a mission to catalyse ancient wisdom and modern science for the health and well-being of people and the planet. The WHO Traditional Medicine Centre scales up WHO’s existing capacity in traditional medicine and supplements the core WHO functions of governance, norms and country support carried out across the six regional Offices and Headquarters.

The Centre focuses on partnership, evidence, data, biodiversity and innovation to optimize the contribution of traditional medicine to global health, universal health coverage, and sustainable development, and is also guided by respect for local heritages, resources and rights.

cross-regional expert panel will advise on the Summit’s theme, format, topics and issues to address. All updates will be posted here and on the forthcoming webpages for the First WHO Traditional Medicine Global Summit.

In case you are interested, the programme can be seen here.

And my comment? I am afraid, it was not very encouraging. I doubt that Nature will publish it in full. So, allow me to show you my unabridged comment:

The WHO has a long history of uncritically promoting alternative therapies. The Indian government has recently advocated irresponsibly dangerous nonsense, such as the use of homeopathy for the prevention and treatment of covid infections. The two together make an ominous initiative when it comes to alternative medicine.
Of course, there is nothing wrong in hosting a constructive dialogue about this subject. What seem ill-conceived, however, is the fact that the conference exclusively includes speakers who are staunch proponents of alternative medicine, a subject that, after all, remains highly controversial. Progress is not created by voicing one-sided, biased opinions. I fear that this meeting will result in the often before voiced platitudes and wishful thinking which no true scientist is then able to take seriously.

Guest post by Derk P. Kooi

Political lobbying is not only restricted to major companies, even quackery lobbies extensively in Dutch politics as well as at a European and global level. The EUROpean Complementary and Alternative Medicine Stakeholder Group (EUROCAM) has been active in Europe for some time. EUROCAM recently attracted attention with a statement on antibiotic resistance during the European Antibiotics Awareness Day.[1] EUROCAM claims that Complementary and Alternative Medicine (CAM) could enhance the immune system and could therefore contribute to the fight against antibiotic resistance. An early study conducted by the anthroposophist Erik Baars was referenced, inter alia. However, this medical claim turns out to be pure nonsense.

EUROCAM regularly publishes so-called ‘position papers’ on the contribution CAM could provide to the European health care system. EUROCAM is currently cautious with its medical claims, and rightly so, as it has seriously overstepped the mark in the past. For example, claims about the efficacy of CAM for infections referred to research by Erik Baars, doctor, anthroposophical healthcare lector at the University of Applied Sciences Leiden and researcher at the Louis Bolk Institute. Baars is an associate of the society due to his misleading statements in his publications on the usefulness of CAM, more specifically of the anthroposophical variant.

Where does this fairly unknown club actually come from, what does it do and how seriously should we take it? Well, EUROCAM is an umbrella organisation for various alternative therapists and their patients. We are talking about Ayurveda, homeopathy, osteopathy, anthroposophy, herbal medicine, traditional (Chinese) medicine, Reiki and acupuncture. The Dutch Registry of Complementary Care Professionals (RBCZ) is also affiliated with EUROCAM. Classical homeopath Annemieke Boelsma is the contact person of the RBCZ at EUROCAM.

It is unclear precisely when EUROCAM was created, the LinkedIn page says 2009. The figurehead of the club is “secretary general” Ton Nicolaï. This homeopathic doctor is also well known to Vereniging tegen de Kwakzalverij, (www.kwakzalverij.nl) the Dutch Society against Quackery. The treasurer of EUROCAM is business administrator Wim Menkveld. Menkveld is on the Advisory Board of the Hortus Botanicus of Leiden. He is also active on the board of the European Patients’ Federation of Homeopathy. EUROCAM thus seems to have originated mainly from Dutch homeopathic circles.

Furthermore, TV producer Miranda Eilert-Ruchtie from Hilversum sits on the EUROCAM board. According to the EUROCAM website, she acts as their “operations manager” and communications advisor. The German Heilprakterin Sonja Maric, an anthropologist and “specialist in Tibetan medicine”, also acts as a communications consultant.

The European Transparency Register shows that in 2020 the total budget of the organisation was 40,498 euros; no more recent data is available. In the year 2018, 5,000 euros were reserved as an honorarium for Mr Nicolaï, for the 0.5 FTE that he works for the organisation. Miranda Eilert-Ruchtie works a number of hours a week for EUROCAM, as a freelancer. Sonja Maric does this on a voluntary basis.

EUROCAM is a member of the European Public Health Alliance (EPHA), the European Union Health Policy Platform. The World Health Organisation (WHO) recognises the organisation as a non-state actor, which means that both the EU and the WHO consider EUROCAM to be a serious legal entity. In the past, EUROCAM has intervened in public EU consultations in the fields of aging, pharmaceutical strategy, cancer, and digital data and services.

EUROCAM provides the secretariat of the MEP Interest Group on Integrative Medicine and Health, a group of five European parliamentarians who have set themselves the goal of promoting integrative medicine at the European level. Co-chairs are Finish Sirpa Pietikäinen, a European parliamentarian for the Christian Democrats, and French Michèle Rivasi, a European parliamentarian for the Greens. The other members are Luxembourg’s Tilly Metz, the Italian Eleonara Evi, and the Danish Margrete Auken. It is noteworthy that they are European parliamentarians for the Greens. They are all members of the European Parliament’s Committee on the Environment, Public Health and Food Safety (ENVI). Eleonara Evi was part of the illustrious Five Star Movement until 2020, known for its anti-vaccination stance. The Member of European Parliament (MEP) Interest Group organises annual events with speakers who are the same people who perform at EUROCAM symposia. These include the aforementioned anthroposophist Erik Baars. Baars worked closely with EUROCAM boss Ton Nicolaï in a European research project on CAM alternatives to antibiotics. More about his bad science later.

The texts EUROCAM produces nowadays (on its website) are carefully written, and the medical claims are carefully formulated. The texts are larded with synonyms for “possible”, known in linguistics as hedging. For example “Several CAM methods have shown high potential to reduce cancer pain”.[2] Generic health claims are also often used to suggest medical benefits, for example in the context of COVID-19, ‘In building and maintaining resistance to infectious illness, CAM modalities as a part of Integrative Medicine & Health can play an important role because they mobilise and stimulate people’s self-regulating capacity, thus increasing their resilience, their immune system.’.[3]

Furthermore, claims are put in the mouths of others, which can be read, for example, in quoting patient expectations: ‘While improving quality of life is the major rationale for CAM use, there is a definite undercurrent of expectation, particularly among the younger patients, that some therapies might have an anticancer effect (prolongation of remission periods) and slow/stagnate tumour growth (prolongation of survival periods), boost the immune system, making it easier to overcome the disease.’.[4]

The educated reader will immediately see through these strategies, but the question is whether the lobbied politicians targeted by EUROCAM understand these subtleties. EUROCAM has not always been so cautious, by the way. In an undated (presumably 2013) interview with the Dutch Association for Classical Homeopathy, “secretary general” Ton Nicolaï made a number of remarkable statements. For example, he claimed at the time that research shows “that for a number of herbal medicines there is a reasonable amount of evidence that scientifically confirms their effectiveness in respiratory infection treatments”. [5] Nicolaï bases his assertion on recent research by Erik Baars conducted as part of a European research programme that aimed to find CAM alternatives to antibiotics.

The report of this project, which ended in 2018, can be found on the EUROCAM website.[6] The authors of this report are, not surprisingly, Erik Baars and Ton Nicolaï. The report contains practically no hard science. Sub-studies focus on, for example, the frequency of antibiotic prescribing among alternative-working GPs and on the best practice of CAM believers. A so-called systematic review of systematic reviews offers good starting points to evaluate Mr Nicolaï’s claim: ‘A systematic review of systematic reviews demonstrates that there are specific, evidence-supported, promising CAM treatments for acute, uncomplicated RTIs [uncomplicated respiratory tract infections, ed.] and that they are safe.’

Here, a medical claim is made, which is weakened by the use of the hedge term “promising”. The conclusion can be summarised with “There would be ‘promising’ CAM treatments for respiratory infections, and they would be safe”. However, surprisingly, the project report does not refer to this “systematic review of systematic reviews”, nor to any of the other concrete results of the project!

Due to the lack of references, we cannot but conclude that the claim is based on a 2019 article by Erik Baars. One of the co-authors is Ton Nicolaï.[7] The article was published in the journal Evidence Based Complementary and Alternative Medicine (EBCAM), which has a shady reputation. Even one of the founders of EBCAM states that the peer-review system is a farce, and therefore the majority of the articles published in it are useless nonsense.[8] In this article, besides a large amount of vagueness about the “worldview differences” between CAM and medicine, systematic reviews are discussed about the effectiveness and safety of CAM treatments. From this systematic review of systematic reviews, it is concluded that there are promising CAM treatments for respiratory, urinary tract and skin infections and that there is even evidence that some CAM treatments are effective for respiratory infections, but what is this based on?

The reviews that were looked at were split into Cochrane and non-Cochrane reviews. Among the Cochrane reviews, there is one that would demonstrate the efficacy of CAM. It is a review on the use of immunostimulants for the prevention of respiratory tract infections in children.[9] Of the 35 studies that were analysed, six involve small molecules, such as isoprinosine, levamisole and pidotimod. In other words, regular medicine, if it turns out to work, but describing it as being experimental would be more appropriate. Baars’ article states that the review also contains herbal medicine. This is somewhat exaggerated: only one of the 35 studies deals with herbs. Of the remaining 28 studies, 25 cover bacterial extracts and three thymus extracts. Again: Baars does not make clear what this has to do with the CAM that EUROCAM represents.

In summary, EUROCAM is a small European lobbying organisation with perhaps some influence at both European and WHO level. One keeps coming across the same names. The organisation is currently using woolly, disguising language to mask medical claims and to fend off criticism. In the past, this was different when EUROCAM, by means of Ton Nicolaï among others, made very reprehensible statements about the role of CAM in (respiratory tract) infections. For the time being, this little club does not seem to pose much of a threat, but European politicians should, of course, ignore this hobby club.

 

References

1. ‘Improving patient resilience to reduce the need to rely on anti-infection treatment: the role of Integrative Medicine’. EUROCAM. https://cam-europe.eu/statement-on-amr-2021/ (visited on 28 December 2021) 2. EUROCAM. https://cam-europe.eu/contribution-of-cam-for-a-better-health/cam-in-the-context-of-cancer/ (visited on 3 October 2021) 3. EUROCAM. https://cam-europe.eu/contribution-of-cam-for-a-better-health/cam-in-the-context-of-cancer/ (visited on 3 October 2021) 4. EUROCAM. https://cam-europe.eu/contribution-of-cam-for-a-better-health/cam-in-the-context-of-cancer/ (visited on 3 October 2021)

5. Miranda Ruchtie. In gesprek met Ton Nicolaï, CAM integreren in de Europese gezondheidszorg. [In discussion with Ton Nicolaï, integrating CAM into the European health care system]. Nederlandse Vereniging van Klassiek Homeopaten. [Dutch Association of Classical Homeopaths] https://www.nvkh.nl/nieuwsbrieven-nvkh/interview-met-ton-nicolai (visited on 3 October 2021)

6. Erik Baars, et al. Reducing the need for antibiotics, the contribution of Complementary and Alternative Medicine. EUROCAM, 2018. https://cam-europe.eu/wp-content/uploads/2019/01/CAM-AMR-EUROCAM-Post-Conference-Paper-2018.pdf (visited on 3 October 2021)

7. Erik W. Baars et al. The Contribution of Complementary and Alternative Medicine to Reduce Antibiotic Use: A Narrative Review of Health Concepts, Prevention, and Treatment Strategies. Evid. Based Complement. Alternat. Med., 2019:5365608. DOI: 10.1155/2019/5365608

8. Edzard Ernst. “EBCAM: an alt med journal that puzzles me a great deal”, URL: http://edzardernst.com/2016/05/ebcam-an-alt-med-journal-that-puzzles-me-a-great-deal/ (visited on 8 January 2022)

9. B. E. Del-Rio-Navarro, F. J. Espinosa-Rosales, V. Flenady, and J. J. Sienra-Monge, “Cochrane Review: Immunostimulants for preventing respiratory tract infection in children,” Evidence-Based Child Health: A Cochrane Review Journal, 2012, 7 (2), 629–717.

A press release informs us that the World Health Organization (WHO) and the Government of India recently signed an agreement to establish the ‘WHO Global Centre for Traditional Medicine’. This global knowledge centre for traditional medicine, supported by an investment of USD 250 million from the Government of India, aims to harness the potential of traditional medicine from across the world through modern science and technology to improve the health of people and the planet.

“For many millions of people around the world, traditional medicine is the first port of call to treat many diseases,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Ensuring all people have access to safe and effective treatment is an essential part of WHO’s mission, and this new center will help to harness the power of science to strengthen the evidence base for traditional medicine. I’m grateful to the Government of India for its support, and we look forward to making it a success.”

The term traditional medicine describes the total sum of the knowledge, skills and practices indigenous and different cultures have used over time to maintain health and prevent, diagnose and treat physical and mental illness. Its reach encompasses ancient practices such as acupuncture, ayurvedic medicine and herbal mixtures as well as modern medicines.

“It is heartening to learn about the signing of the Host Country Agreement for the establishment of Global Centre for Traditional Medicine (GCTM). The agreement between Ministry of Ayush and World Health Organization (WHO) to establish the WHO-GCTM at Jamnagar, Gujarat, is a commendable initiative,” said Narendra Modi, Prime Minister of India. “Through various initiatives, our government has been tireless in its endeavour to make preventive and curative healthcare, affordable and accessible to all. May the global centre at Jamnagar help in providing the best healthcare solutions to the world.”

The new WHO centre will concentrate on building a solid evidence base for policies and standards on traditional medicine practices and products and help countries integrate it as appropriate into their health systems and regulate its quality and safety for optimal and sustainable impact.

The new centre focuses on four main strategic areas: evidence and learning; data and analytics; sustainability and equity; and innovation and technology to optimize the contribution of traditional medicine to global health and sustainable development.

The onsite launch of the new WHO global centre for traditional medicine in Jamnagar, Gujarat, India will take place on April 21, 2022.

__________________________

Of course, one must wait and see who will direct the unit and what work the new centre produces. But I cannot help feeling a little anxious. The press release is full of hot air and platitudes and the track record of the Indian Ministry of Ayush is quite frankly abominable. Here are a few of my previous posts that, I think, justify this statement:

 

WATCH THIS SPACE!

Please take a moment to read this short letter by the ‘LIGA MEDICORUM HOMOEOPATHICA INTERNATIONALIS’:

As you know, the World Health Organization (WHO) is predicting that civilization faces a crisis of antibiotic-resistant diseases that may soon result in as many as 10 million deaths per year while pushing as many as 24 million people into extreme poverty.

We, the undersigned, are duly licensed healthcare professionals practicing homeopathy, with the authority to diagnose and treat disease, who have reviewed the extensive research literature demonstrating the clear therapeutic value of homeopathy.  Each of us has had extensive clinical experience successfully treating hundreds of thousands of patients suffering from infectious diseases worldwide.

Homeopathy works, does not cause further antibiotic resistance, is generally devoid of side effects, is inexpensive, and is good for health of the planet.

We are calling upon the WHO to encourage the international medical community to immediately begin training in homeopathy as an adjunctive therapeutic measure to avoid this catastrophic loss of life and would like a meeting with you or your representative to discuss the grave challenge of antibiotic resistance at your earliest convenience.

Thank you for considering this urgent appeal.

________________________

I stated above that this is a letter. In fact, it is more – it is a petition directed to the Director-General of the World Health Organization (WHO), Dr. Tedros Adhanom Ghebreyesus, to immediately begin training physicians in homeopathy as an adjunctive therapeutic measure to combat the looming crisis of antibiotic-resistant diseases.

The Liga Medicorum Homoeopathica Internationalis (LMHI) represents homeopathic physicians in more than 70 countries all over the world. The purposes of the association are the development and securing of homeopathy worldwide and the creation of a link among licensed homeopaths with medical diplomas and societies and persons who are interested in homeopathy. The LMHI is exclusively devoted to non-profit activities serving philanthropic benefits.

The LMHI might ring a bell for regular readers of this blog. A few years ago, I reported that its president advocates curing cancers with homeopathy. And in 2014, I reported that a journey to Liberia of leading homeopaths was co-organized by the LMHI; its purpose was to cure Ebola patients of their disease with homeopathy.

I find all of this seriously worrying – not because I fear that the WHO will now start training physicians across the globe in homeopathy. It is worrying, I feel, because it shows how hopelessly deluded homeopaths are. The fact that clinicians so far detached from reality treat ill and vulnerable patients frightens me.

Protection against electromagnetic fields has been a topic before (see here and here). In so-called alternative medicine (SCAM) entrepreneurs have been quick to sell all sorts of ‘protective’ gadgets to the often all too gullible public. The devices are based on two main assumptions:

  1. EMF causes ill health.
  2. The device prevents this from happening.

Neither of them is correct, and the harm done by the claim is substantial. It can be measured in £ or $, because these gadgets are, of course, not cheap. Now a new type of harm is in the spotlight.

It has been reported that the Dutch authority for nuclear safety and radiation protection (ANVS) found several of these devices claimed to protect against 5G networks gave off harmful ionising radiation. It urged people not to use the products, which could cause harm in the long term.

The World Health Organization assures us that 5G mobile networks are safe, and not fundamentally different from existing 3G and 4G signals. They emit non-ionizing radio waves that do not damage DNA. But the marketers of these devices claim otherwise and many consumers believe them. This explains why there have been attacks on transmitters by people who believe 5G is harmful. The Guardian reported that, last year, 15 EU member states called on the European Commission to address a spate of conspiracy theories that had led to arson attacks against telecommunications masts.

The products identified included:

  • “Energy Armor” sleeping mask,
  • “Energy Armor” bracelet,
  • “Energy Armor” necklace,
  • Magnetix Wellness, a device for children.

Despite clear evidence that EMF protection is an expensive scam, Kim Jobst, Visiting Professor of Healthcare and Integrated Medicine Oxford Brooks University UK and former editor of the notorious JACM, stated the following about such a gadget: “Emerging evidence from early clinical, cellular and molecular studies of the effects of QLink on cardiovascular, immune and central nervous systems is startling.”

In May 2020, the UK’s Trading Standards sought to halt sales of a £339 USB stick that claimed to offer “protection” from 5G. “Anti-radiation stickers” have also been sold on Amazon. On this blog, we have discussed EMF devices that cost well over £4000.

A second look at old research suggested that the recommended dose for vitamin C is far too low. Here is the abstract of the recently published  paper:

A double-blind controlled trial initiated in 1944 has led to the common narrative that a 10-mg daily vitamin C intake is adequate to prevent and treat impaired wound healing, and by inference, other collagen-related diseases such as heart disease or stroke. The WHO relies on this narrative to set the recommended nutrient intake for vitamin C. This narrative, however, is based on what is known as the eyeball method of data assessment. The 1944 trial published individual participant data on scar strength providing an opportunity to statistically probe the validity of the 10-mg narrative, something which has not yet been done. The findings show that a vitamin C intake that averages to 10 mg/d over a mean follow-up of 11.5 mo was associated with a 42% weakened scar strength when compared with 80 mg vitamin C intake/d (P < 0.001). The observed dose-response curve between scar strength and vitamin C intake suggests that the daily vitamin C intake needed to prevent collagen-related pathologies is in the range recommended by the National Academy of Medicine and the European Food Safety Authority (75 to 110 mg/d), not the WHO recommendation (45 mg/d). The findings also show that a vitamin C intake that averages to 65 mg/d over a mean follow-up of 6.5 mo failed to restore the normal wound-healing capacity of vitamin C-depleted tissues; such tissues had a 49% weaker scar strength when compared with nondepleted tissues (P < 0.05). Thus, average daily vitamin C intakes ∼50% higher than the WHO recommends may fail to treat existing collagen-related pathologies. It is concluded that the prior lack of statistical analyses of a landmark trial may have led to a misleading narrative on the vitamin C needs for the prevention and treatment of collagen-related pathologies.

The lead author of the recent re-analysis, Professor Philippe Hujoel from the Department of Epidemiology, School of Public Health, University of Washington, Seattle, said: “The vitamin C experiment is a shocking study. They depleted people’s vitamin C levels long-term and created life-threatening emergencies. It would never fly now. The findings of the re-analyses of the Sorby data suggest that the WHO’s recommendation is too low to prevent weak scar strength. Robust parametric analyses of the trial data reveal that an average daily vitamin C intake of 95mg is required to prevent weak scar strength for 97.5 percent of the population. Such a vitamin C intake is more than double the daily 45mg vitamin C intake recommended by the WHO but is consistent with the writing panels for the National Academy of Medicine and (other) countries.”

The original research of 1944 was headed by the British-German biologist and Nobel-prize winner Sir Hans Adolf Krebs. At the time, researchers conducted an experiment that controlled and monitored vitamin C consumption of just 20 volunteers. They were each given varying amounts of vitamin C,  which helps the body to produce collagen – and given wounds to observe how quickly their scar tissue healed. The research aimed to ascertain how much vitamin C navy members living off rations is required in order to prevent them from developing scurvy, rather than how much is needed to boost health overall.

Prof Hujoel concluded that: “The failure to reevaluate the data of a landmark trial with novel statistical methods as they became available may have led to a misleading narrative on the vitamin C needs for the prevention and treatment of collagen-related pathologies.”

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