Homeopathy not effective for treating any condition, Australian report finds

Report by top medical research body says ‘people who choose homeopathy may put their health at risk if they reject or delay treatments’

 

Australia’s National Health and Medical Research Council hopes report will discourage private health insurers from offering rebates on homeopathic treatments. Photograph: Alix/Phanie/Rex Features

Melissa Davey in The Guardian

Homeopathy is not effective for treating any health condition, Australia’s top body for medical research has concluded, after undertaking an extensive review of existing studies.

Homeopaths believe that illness-causing substances can, in minute doses, treat people who are unwell.

By diluting these substances in water or alcohol, homeopaths claim the resulting mixture retains a “memory” of the original substance that triggers a healing response in the body.

These claims have been widely disproven by multiple studies, but the National Health and Medical Research Council (NHMRC) has for the first time thoroughly reviewed 225 research papers on homeopathy to come up with its position statement, released on Wednesday.

“Based on the assessment of the evidence of effectiveness of homeopathy, NHMRC concludes that there are no health conditions for which there is reliable evidence that homeopathy is effective,” the report concluded.

“People who choose homeopathy may put their health at risk if they reject or delay treatments for which there is good evidence for safety and effectiveness.”

An independent company also reviewed the studies and appraised the evidence to prevent bias.

Chair of the NHMRC Homeopathy Working Committee, Professor Paul Glasziou, said he hoped the findings would lead private health insurers to stop offering rebates on homeopathic treatments, and force pharmacists to reconsider stocking them.

“There will be a tail of people who won’t respond to this report, and who will say it’s all a conspiracy of the establishment,” Glasziou said.

“But we hope there will be a lot of reasonable people out there who will reconsider selling, using or subsiding these substances.”

While some studies reported homeopathy was effective, the quality of those studies was poor and suffered serious flaws in their design, and did not have enough participants to support the idea that homeopathy worked any better than a sugar pill, the report found.

In making its findings the NHMRC also analysed 57 systematic reviews, a high-quality type of study that assesses all existing, quality research on a particular topic and synthesises it to make a number of strong, overall findings.

Glasziou said homeopathy use declined in the UK following a House of Commons report released in 2010 which found the treatments were ineffective, and that he hoped the NHMRC report would have a similar effect in Australia.

Dr Ken Harvey, a medicinal drug policy expert and health consumer advocate, said private colleges were charging thousands of dollars for courses in homeopathy, and he hoped students would reconsider taking them.

The government’s Tertiary Education Quality Standards Agency (TEQSA) should stop accrediting homeopathic courses, he said, while the private health insurance rebate should be not be offered on any policies covering homeopathy and other unproven treatments.

“I have no problems with private colleges wanting to run courses on crystal-ball gazing, iridology and homeopathy, and if people are crazy enough to pay for it, it’s their decision,” Harvey said.

“But if those courses are approved by a commonwealth body, that’s a different story and a real problem.”

Approved courses are reviewed by TESQA every seven years, with its own guidelines stating the content of a course should be “drawn from a substantial, coherent and current body of knowledge and scholarship in one or more academic disciplines and includes the study of relevant theoretical frameworks and research findings”.

A TESQA spokesperson said independent experts were used to assess whether or not a course complied with its standards. He said homeopathy courses already accredited would not be re-evaluated in light of the NHMRC’s findings, and would only be reviewed when their accreditation was next due for renewal.

In a statement responding to the NHMRC report, the Australian Homeopathic Association (AHA) claimed around a million Australians used homeopathy.

However, the NHMRC states there are no reliable estimates of Australians’ current use of homeopathic medicines, though a 2009 World Health Organisation review found Australians spent an estimated $9.59m on the industry annually.

“The Australian Homeopathic Association recommend to the NHMRC that it take a more comprehensive approach to the analysis of homeopathy’s efficacy, and consider a large-scale economic evaluation of the benefits of a more integrated system and one which respects and advocates patient choice in healthcare provision,” the AHA said.

Why you should begin well

Vikram Kapur in The Hindu

In life as in literature, there is nothing like making a great first impression.It is hard to overstress the importance of beginnings. I once heard the Booker Prize-winning Nigerian writer Ben Okri
say that if the first sentence of a book does not grab him, he is liable to close the book then and there. A bit extreme, perhaps, but it does illustrate how crucial beginnings are.


There are all kinds of first sentences — atmospheric, interrogative, informational, reflective, action-packed… One thing, however, all of them have in common is that they set the tone for the book that follows. This month let us look at some first sentences to see how they help forge an effective beginning.


Haruki Murakami’s novel Sputnik Sweetheart begins: “In the spring of her twenty-second year, Sumire fell in love for the first time in her life.” Over the course of this short sentence, Murakami introduces us to his main character and tells us that she is a young woman of 22. He also lets us know that this is going to be a novel about first love. While most of the sentence is literal, the use of the word “spring” lends it a deeper meaning. Instead of “spring”, Murakami could have said “April” which would have been a more accurate reflection of exactly when Sumire fell in love for the first time. However, he chose to use the more metaphoric “spring”. The season of spring, in many cultures, symbolizes passion. The use of the word here sets the tone for the extreme passion that Sumire goes on to feel for the object of her affection.


Beginning in the middle

On the other hand, instead of beginning with a statement, you can begin right in the midst of action. Take a look at this first sentence from Robert Ludlum’s The Bourne Identity: “The trawler plunged into the angry swells of the dark furious sea like an awkward animal trying desperately to break out of an impenetrable swamp.” A sentence like that instantly summons images of darkness, frenetic action, and the trawler being tossed about haplessly in the midst of it all. It isn’t surprising that Ludlum wrote thrillers. You would hardly expect a story of first love to ensue after reading such a beginning. 


Then there is this first sentence from the iconic Colombian writer Gabriel Garcia Marquez’s One Hundred Years of Solitude: “Many years later, as he faced the firing squad, Colonel Aureliano Buendia was to remember that distant afternoon when his father took him to discover ice.” The most interesting thing here is how Garcia Marquez instantly places the reader in two time frames. He is going to tell us about what happened on that afternoon. At the same time, however, he is inserting the burning question — how did Aureliano Buendia come to face a firing squad? — in the reader’s mind. Furthermore, Aureliano Buendia is being taken to “discover” ice. By using the word “discover”, Garcia Marquez captures the sense of wonder someone feels at seeing ice for the first time. Since the discovery was made many years ago when Aureliano Buendia was a boy, the whole effect of it on him would be magical.


From a completely different sensibility comes this first sentence from the prolific British Asian writer Hanif Kureishi’s novel Intimacy: “It is the saddest night, for I am leaving and not coming back.” Unlike Garcia Marquez’s two time frames, Kureishi is firmly entrenched in one time frame — the night before the parting. The despondent tone of the sentence instantly communicates the mental state of the narrator. He is suffused with regret and guilt, and is clearly talking about leaving loved ones. The tone suggests a failed marriage, and reading on, one is not surprised to learn that the narrator has decided to leave his wife and children the next morning for a younger woman.


Finally, here is the first sentence of Salman Rushdie’s Midnight’s Children: “I was born in the city of Bombay…once upon a time.” The sentence is, at once, a play on words, cleverly inverting the old way of beginning a story: “Once upon a time…” It also places the novel in Bombay and, consequently, in India. Finally, it tells us that the novel is going to take the form of a fictional autobiography. Only in this case it is an autobiography that tells us about the life of a person, as well as a country.


These are just five examples of beginnings. There are several more, and it would be worth your while to study them. Think of the beginning of a novel like a serve in tennis. It is, perhaps, the only time where you have the reader’s undivided attention. Hence, everything is in your hands. You can hit an ace, which will allow you to win over the reader. Or you can lose it all by hitting a fault.


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In the last week of February, I was writer-in-residence at Pondicherry Central University. There, during one of the lectures, a student asked: How should a writer live? Should a writer be a hermit? Or live out in the world?

As far as I am concerned, a writer must live out in the world. It is only when you engage in the world that you gather its sights, sounds and smells; that you get to experience its various paradoxes. Experience, as the great Latin American writer Roberto Bolano reminds us, is the seed from which great writing sprouts. A hermit can only write from memory, or what he or she can glean from books. The only current experience that he or she has to share is that of being a hermit, which most of the world does not care about. True, you have to retreat into your cave from time to time to be able to write. But a cave is not the place to live.

Riveting conversation

After coming home from Puducherry, I attended a discussion between the novelist and short story writer Bulbul Sharma and V.K. Karthika, Editor-in-chief of HarperCollins India, at the Alliance Francaise in New Delhi. It was a telling reminder of how enjoyable a literary conversation can be when the moderator and writer are in concert. At the Jaipur Literature Festival, the two often seemed to be on different planes. More often than not, that occurred because the moderator had not bothered to acquaint himself with the writer's body of work, and was clearly winging it. Thankfully, there was no chance of that happening here. Karthika is Bulbul Sharma's editor, and, therefore, knows her fiction intimately.

Bulbul's fiction illustrates the value of writing what you know. Bulbul, who is currently 60, got married at 19. In her stories, she deals chiefly with women in families. These are ordinary women, drawn mostly from her generation, who live caged lives within the confines of a traditional Indian family. Many of them only get to see the outside world after they are widowed. One of the stories from her collection My Sainted Aunts is about a character going abroad for the first time at the age of 70.

Listening to Bulbul read from her work, I was reminded of how compelling simplicity can be in fiction. Bubul's characters are ordinary people. Her prose is pared back rather than purple. Her stories deal with the small defeats and victories of people living a run-of-the-mill existence. They instantly evoke the iconic Hindi writer Premchand, who Bulbul mentioned as an influence. To me they are also reminiscent of Jane Austen in the way they hone in on women in family situations. They exemplify how resonant simplicity can be even in an age where writers are known more for their bag of tricks than what they write.

Two weeks after Bulbul's event, I wandered into the amphitheatre of the India Habitat Centre where Penguin India was holding its Spring Fever festival. That night Rahul Bhattacharya, who won The Hindu Literary Prize last year, and acclaimed fiction writer Anjum Hasan were in conversation with the critic Sunil Sethi. Regrettably, I could not stay for the entire discussion. But I did hear Rahul Bhattacharya read from his first book Pundits From Pakistan which has been re-issued by Penguin.

Characters come alive

Pundits From Pakistan is a cricket book dealing with the Indian team's historic tour of Pakistan in 2004. The passage the author read from dealt with an instance in the first Test match where Rahul Dravid, filling in for an injured Saurav Ganguly as captain, declared with Sachin Tendulkar close to a double hundred. While describing the reaction to that momentous declaration, the author effectively mimicked the voices of Tendulkar, V.V.S. Laxman, Imran Khan, Ian Chappell, and other well-known cricket personalities. He was using ventriloquism in a bid to enhance the audience's enjoyment of his performance. In the same way, a writer can employ his or her ability as a ventriloquist to bring various characters to life in a book. Many of the great writers are superb ventriloquists. Salman Rushdie gets into the skin of his characters in that manner. So does J.D. Salinger. The best ventriloquists in literature, though, are the playwrights for whom writing dialogue is their chief stock-in-trade. Most prose writers use dialogue in its most basic form, which is to move the story forward. They lack the ear to do anything more with it. Playwrights, on the other hand, utilise it as a key ingredient for building character, as well as negotiating between status shifts. As one of my old professors told me: If you want to learn how to write good dialogue, then read a good playwright.