How Homeopathy Can Help Address The Current Major Public Health Issues

Presentation at the Humanitarian Homeopathic Organisation (H2O) online symposium- 16 October 2020 by Hélène Renoux MD , President of the European Committee for Homeopathy (ECH) and of the Société savante d’homéopathie (SSH)

Abstract :

Current environmental and economic challenges lead us to reconsider the existing paradigms in medicine and public health, and to acknowledge the holistic paradigm as a necessary evolution.

Antimicrobial resistance, the severe environmental pollution, the global economic crisis are facts that won’t change until we find adapted solutions to tackle them. And now the Covid 19 crisis even worsens the situation.

Complementary and alternative medicine, generally speaking and especially homeopathy among them have some of the needed solutions to offer, and should be considered and endorsed by our health authorities. WHO has already drafted an ambitious strategy plan in regards to that.

This presentation aims at describing the added value and the impact homeopathy can have in the future healthcare system. It also underlines the necessary changes in its promotion and presentation to reach this goal.

Keywords:

Homeopathy – Public health issues – antimicrobial resistance – environmental crisis – Covid crisis

Introduction : Current Situation Of Homeopathy Throughout Europe

Homeopathy is already de facto an important existing system of medicine in the world. In Europe 29% of the population is using homeopathy for its daily healthcare [1]  Homeopathic practice is regulated different ways in the different european countries. In some countries the government is in charge of supervising its practice, in other ones the governments have delegated this supervision to the national orders.

Some countries allow non medical homeopaths to practice while others don’t and restrict this practice to medical doctors only[2]. European medical doctors can now benefit from a European standard which defines the expected services and training they have to fulfill to justify their additionnal qualification in homeopathy

This standard is a voluntary regulation, which doesn’t overrule the laws when they exist but can fill the gap when they’re missing[3]. Homeopathic medicinal products are regulated by the European Directive 2001/83 EC which ensures an equal quality and safety for them all around the continent [4].

At the international level the World Health Organisation has issued a strategic plan which aims at enhancing the integration and promotion of complementary and alternative medicines for the benefit of the patients’ rights and safety[5].

This is the global frame in which homeopathy has to exist and to reach its full potential in spite of the many oppositions we are facing throughout the continent.

Homeopathy and Major Public Health Issues

Antimicrobial resistance

The antimicrobial overuse, as it has been reported by the WHO ( World Health Organization) [6], is responsible for the growing resistance of the bacterial strains to the avalaible antibiotics.

For many bacterial diseases, such as tuberculosis, some pneumonias and sepsis, the antibiotics are no longer efficient, and we cannot treat them. This explains why deadly infections reappear, and we may fear to see more and more in the coming years, as it was before the antibiotics era.

This is the reason why the World Health Assembly decided in 2015 to endorse an international action plan aiming at raising awareness among the member states about this issue, decreasing the occurrence of infections and optimizing antibiotic use. In 2016 the leaders involved in the United Nations General Assembly pledged to coordinate their actions against antimicrobial resistance, regarding human health, but also animal health and agriculture [7]

Actually all homeopathic practitioners have known for long that their therapeutic works against infections and helps reduce the healing time for their patients, human and animal patients, pets or livestock.

The individualized treatments used by qualified homeopaths are particularly effective. But due to the scepticism of some colleagues, and the demanding criteria of the current Evidence Based Medicine, it becomes necessary to formalize this knowledge with reliable and reproducible proofs. This has been done by some of our more prominent researchers during the last ECH conference in Paris, in November 2019, which you can now read in La Revue d’Homéopathie [8]

Controversies based on prejudice have jeopardized the exchanges, and still do, preventing quality information to be spread through the scientific and medical community. But environmental and public health concerns are such, that it is our duty to overcome these quarrels.

We remain grateful to those in politics who express their open mindedness and their curiosity in taking time to consider the arguments and the assets of homeopathy.

At the same time, the homeopathic community is committed to endeavour to make its work understood, and increase the quality of its researche so that it can be fully involved in the global scientific world, as one of its branches instead of a dissent.

Observational trials[9] have shown the good results of practitioners using homeopathy to reduce antibiotic use. But our oponents say this design of study is not robust enough, and we would be biased because our patients tend to have a healthier lifestyle which explains part of our good results. But these observational trials are being confirmed by RCTs, especially in two conditions : otitis media {10] and childhood diarrhea (11) and laboratory settings have begun to shed light on what could happen at the cellular level [12]. Even if these works need to be reproduced and confirmed, at least the doubt should benefit homeopathy in the challenging situation we’re facing

Covid 19 crisis

Since the beginning of the Covid crisis homeopathic physicians have been present for their patients. The homeopathic approach, which relies on symptoms and not on physiopathological assumptions, fits the situation very well. We just observe, accurately the lived experience of the patients, and try our best to soothe the sufferings.

And we therefore noticed encouraging results that were shared informally in our internal networks. Preventive treatment attempts and advice on successful prescriptions have been circulating among us. It clearly appeared that there was the need to organise this data collection in order to make it usable later on.

The European Committee for Homeopathy (ECH) and the Liga Medicorum Homoeopathica Internationalis (LMHI) have decided to cooperate for this purpose, and have identified 3 main projects which covered the main purposes of such a collection.

• Lex Rutten, a dutch epidemiologist has began a prognosis factor research based on Covid 19 cases treated with homeopathy, in order to identify the most successfully prescribed homeopathic medicines, with their more prominent symptoms that could be included in an application for lay persons to use it.[13]
• Robbert van Haselen, dutch epidemiologist, also has developed with the software ‘Vithoulkas Compass’, another data collection of Covid cases successfully treated with homeopathy, the quality criteria for these cases relying on the HomCase Care guidelines [14]
• The Clificol programme, developed by Carlo Rezzani and his colleagues, and originally based on Radar software, has also launched its Clificol Covid project. The Clificol Covid project intends to collect cases of Covid treated by homeopaths, be it successfully or not, in order to reflect the reality of the situation.(15]

Thanks to these works we should have afterward a faithful picture of the input of homeopathy, and the involvement of homeopaths during the pandemic. But more ambitious goals can be envisioned.

We can already observe which are the medicines that give results, and even follow the changes of the symptomatology in time and space, according to the evolution of the prescriptions, which can give information on the possible mutations of the virus(es).

The ultimate goal would be to identify one or a few genus epidemicus remedies  to facilitate the prescriptions, even though the labile aspect of the symptoms makes it really difficult.

The lack of recognized effective treatment of Covid 19 gives us the right to apply our symptomatic medicines to take care of our patients. Th efuture will teach us a lot about the relevance of this approach.

Non-communicable diseases

They are also responsible for a high mortality rate, and conventional medicine often fails at stopping them. Cancer is especially a major public health issue.

A new case of cancer is diagnosed in the EU every 9 seconds. It is the second leading cause of mortality after cardiovascular disease and it places a massive burden on our health and social systems, puts pressure on governmental budgets and negatively impacts the productivity and growth of the economy, including a healthy workforce.

Tackling cancer is of fundamental importance for Europe’s future. By 2035, there will be a doubling of cancer cases and an estimated 40% of the population will face cancer at some point in their lives. However, at the same time, 40% of all cancers can be prevented if we implement what we know already. This is the rationale of the EU Beating Cancer Plan launched in February 2019 by the European Commission, (It is remarkable that economic issues are considered prior to human needs).

CAM and among them homeopathy has something to offer, at two levels

• We have now enough evidence to state that homeopathy is highly relevant as a supportive treatment in oncology.[16]. Several centers throughout Europe offer such services, and the fruitful cooperation with the oncologists has shown that, thanks to homeopathy, patients can get benefit from conventional therapies with less side effects and better results
• We have less convincing evidence for the curative effect of homeopathy in cancer, but the Banerji protocols have shed some light on this possibility which definitely needs further explorations [17]

Climate change and environmental issues

They become  recurrent concerns, and our youth ask us why we don’t prepare for them a healthy or at least a viable and sustainable world. Homeopathy can offer interesting alternatives to environmentally toxic drugs, when we know that all rivers over the world are polluted with hormones and antibiotics [18]. This shows the necessity to look for alternative and viable solutions like homeopathy.

The same considerations apply in agriculture, where agrohomeopathy is a way forward to escape the deadly ballet of pesticides [19]

The Economic Crisis also becomes a health issue, when most of the sophisticated medicines are no longer affordable by a large part of the population, which fosters the diffusion of infectious diseases and poverty-related diseases. In this regards too, homeopathy’s cost effectiveness is a relevant answer and has already been considered as such by developping countries.

Changes in Public Attitudes And Expectations About Healthcare

A ongoing sociological study led in France, then in Poland by a French team coming from Dijon University, aimed at exploring the reasons for the current controversy about homeopathy, has presented the opportunity to draw up the mental attitudes of the different protagonists: scientists, students and users. In the first published report [20] of this work, we can read that the paradigms identified among the pro and the cons of the scientific community belong to the modern versus post-modern ways of thinking.

While the conventional scientific community bases its thoughts and belief on the modern paradigm, which relies on statistically proved data, avoiding any external, environmental influence, and sequencing the observations, the homeopathic community uses the post-modern paradigm.

This post-modern postulation is more holistic ; it approaches the person’s mind and body as a whole, and this whole is not ‘off-ground’ but interacting with environmental factors.

Both have as a main concern the well-being of their patients, but the way to reach it is different. The difference is to addresses only the suffering part of a body, ignoring the rest, or to address the suffering part of a body as the expression of the rest.

When questioning the global population of the patients it appears that the post-modern thinking is the more popular, and this explains why, in spite of repeated defamation of homeopathy it remains one of the most attractive medicines among patients (if we refer to recent polls [21]). The ethics of care is a growing concern, among people, worldwide, and homeopathy is in line with this evolution, while the gap between the conventional scientific community and the public is widening. [22]

Needs for the future of homeopathy

Homeopathy is now at a turning point in its history. The critical moment the world is facing makes our therapeutic appear, finally, like one of the solutions for the future, at least for the health future of the world. It offers alternatives to the old recipes that have shown their limits, and it accommodates the changes in the global mentalities.

The homeopathic community needs to act wisely, to restore the bridge with the global scientific community to show its seriousness, its reliability, its relevance, and on the other hand, it needs to remain faithful to its very philosophy.

To achieve this double aim we need new tools. We need to find a specific way to assess homeopathy’s efficacy, fullfilling the demanding EBM criteria as well as the demanding homeopathic expectations.

Observational studies, with large cohorts and strict protocols are a first step, and they can reflect our practice. For this purpose the high quality cases collections are a valuable tool not to overlook, and we all should get involved in such projects to give them the needed size to be considered.

EBM randomized clinical trials with individualized homeopathic treatments are also key arguments to address our oponents, speaking their language, and playing in their courtyard.

Mixed trials combining qualitative then quantitative studies could also fullfill both demanding expectations. The first qualitative part of the trial, very similar to proving processes, would identify the real outcomes of homeopathic treatments as experienced by the patients themselves [23], and these outcomes then chosen as quality criteria for the second step, quantitative. RCTs, would do justice to the real effects of homeopathic treatments. If we are able to combine our efforts to realize these works and to communicate proudly about them, we should obtain our due recognition.

Conclusion

Homeopathy is probably the future of medicine, and it is our duty to make it known, understandable, and evident. Our oponents are struggling against the end of an era, and we must reassure them and show them the hope we carry, instead of fighting their prejudices.  Let’s be the change we wish to see in the world. [24]

References

1- CAMbrella report : https://cordis.europa.eu/project/id/241951/reporting

2 – ECH website :  https://homeopathyeurope.org/fr_FR/regulatory-status/

3 – CEN website :  https://standards.cen.eu/dyn/www/f?p=204:110:0::::FSP_PROJECT,FSP_ORG_ID:41763,1214414&cs=1967841B314EEFF1FDADDD82CE35E11C3

4 – EU Directive :

5 – WHO strategy plan 2014/2023 for TCM :

6 –

7 – https://www.who.int/fr/news-room/detail/21-09-2016-at-un-global-leaders-commit-to-act-on-antimicrobial-resistance

8 – La Revue d’Homéopathie Vol 10 – N° 4 – décembre 2019 – P. 151-e73 – © Elsevier Masson – Homéopathie et antibiorésistance

https://www.em-consulte.com/revue/REVHOM/10/4/table-des-matieres/

9 – Grimaldi-Bensouda L, Begaud B, Rossignol M, Avouac B, Lert F, et al. Management of upper respiratory tract infections by different medical practices, including homeopathy, and consumption of antibiotics in primary care: the EPI3 Cohort Study in France 2007-2008. PLoS ONE 2014; 9: e89990.

10 – Jacobs J, Springer DA, Crothers D. Homeopathic treatment of acute otitis media in children: a preliminary randomized placebo-controlled trial. Pediatr Infect Dis J 2001; 20: 177–183.

11- Jacobs J, Jiménez LM, Gloyd S, Gale JL, Crothers D. Treatment of acute childhood diarrhea with homeopathic medicine: a randomized clinical trial in Nicaragua. Pediatrics 1994; 93:719-725.

12 – de Paula Coelho C, Motta PD, Petrillo M, de Oliveira Iovine R, Dalboni LC, Santana FR, Correia MS, Casarin RC, Carvalho VM, Bonamin LV. Homeopathic medicine Cantharis modulates uropathogenic E. coli (UPEC)-induced cystitis in susceptible mice. Cytokine 2017; 92:103-109. doi: 10.1016/j.cyto.2017.01.014.

13- Rutten L. Prognostic factor research in Homoeopathy. Indian J Res Homoeopathy 2016;10:59-65

14- Van Haselen RA. Homeopathic clinical case reports: Development of a supplement (HOM-CASE) to the CARE clinical case reporting guideline. Complement Ther Med 2016 : 25:78-85

15 – https://www.clificol.net/

16 – Bagot JL. L’homéopathie, une réponse intéressante aux effets secondaires des thérapies ciblées revhom. 2017 ;8(3) :130-136 DOI: 10.1016/j.revhom.2017.07.020

17 – Sen Pathak,, Asha S. Multani, Pratip Banerji & Prasanta Banerji – Ruta 6 selectively induces cell death in brain cancer cells but proliferation in normal peripheral blood lymphocytes: A novel treatment for human brain cancer  – International Journal of Oncology  23: 975-982, 2003

18 – Joel, L. (2019), Antibiotics are flooding Earth’s rivers, Eos,100,   https://doi.org/10.1029/2019EO127001. Published on 05 July 2019.

19- Sushobhan S & al. Agrohomeopathy : an emerging field of agriculture for higher crop productivity and protection of plants against various stress conditions. 2018 IJRAR October 2018, Volume 5, Issue 4
20- Di Scala E & al. L’homéopathie en question. HOMEOCSS projet de recherche sociétal sur la controverse au sujet de l’homéopathie. Editions l’Harmattan (2020)

21-Barthelemy L Desforges Z. Les français et l’homéopathie. Ipsos Public Affairs ( 2018)

22- Tronto JC. Moral Boundaries: a Political Argument for an Ethic of Care. Routledge Publishers (September 2015)

23- Sibeoni, J., Verneuil, L., Manolios, E. et al. A specific method for qualitative medical research: the IPSE (Inductive Process to analyze the Structure of lived Experience) approach. BMC Med Res Methodol 20, 216 (2020)

24- Quote attributed to Mahatma Gandhi according to Gandhi’s family. https://quoteinvestigator.com/2017/10/23/be-change/