Alternative medicine is ascendant in Canada. From the dubious remedies that are now stocked by nearly every pharmacy, to the questionable “integrative” medicine at universities, there’s a serious move to embrace treatments and practices that are not backed by credible evidence. Canada’s support for alternative medicine, and for its “integration” into conventional health care is arguably is worse than many other countries. Canada’s drugs regulator, Health Canada, has approved hundreds of varieties of sugar pills and declared them to be “safe and effective” homeopathic remedies. Some provinces are even moving to regulate homeopaths as health professionals, just like physicians, nurses and pharmacists. Given the regulatory and legislative “veneer of legitimacy” that homeopathy is being granted, you can see how consumers might be led to believe that homeopathic remedies are effective, or that homeopaths are capable of providing a form of health care. The reality is far uglier, and the consequences may be tragic. Canadian homeopaths are putting the most vulnerable in society at risk by selling sugar pills to consumers, while telling them that they’re getting protection from communicable diseases.
CBC Marketplace, a consumers affairs show, recently used hidden cameras to record reporters asking homeopaths about vaccines. The show sent young mothers (with their babies) to speak with homeopaths about immunizations and vaccines in Toronto and Vancouver. The entire episode is about 22 minutes, and it’s well worth watching:
Of the five homeopaths filmed, four warned the mothers against vaccines, and advised them to avoid giving basic vaccinations like MMR (measles, mumps and rubella). Only brief clips are shown in the episode, but the standard antivaccination tropes and misinformation are all there, such as saying that vaccines “overwhelm” the immune system, or blaming autism on vaccines. After the fear is created, then the sales pitch comes. Homeopaths just happen to have a substitute for real medicine and its toxic vaccines. The solution is sugar pills. The homeopaths pull out their homeopathic “nosodes” and offer them as “risk free” substitutes, claiming that they have effectiveness rates of “93-95%”. It’s appalling and frightening. As I watched the sales pitch, I wondered how many times homeopaths have counseled parents against vaccines – and how many parents actually knew that they’d been sold an expensive placebo, with zero ability to protect their children from infectious disease.
How did it ever come to this?
If you’re new to the world of alternative medicine, you might think of homeopathy as a variation of herbalism. The marketing and labeling of homeopathic “remedies” encourages you to think this, describing it as a “gentle” and “natural” system of healing, and putting cryptic “30C” codes beside long Latin names. But with herbalism, at least you’re getting some herb. Homeopathy’s remedies contain no medicine at all – herbal, natural or otherwise. They are inert. Homeopathy is the air guitar of alternative medicine, going through the motions of medicine, without actually providing medicine. How water and sugar pills are thought to heal is based on nonsensical, prescientific ideas about biology, biochemistry and medicine itself. Homeopathy is based on the idea that “like cures like” (which is simply a form of magical thinking) and then performing successive dilutions of substances in water. Each dilution is believed to increase, not decrease, the “potency” of the final product. And these are serious dilutions. Think of putting one drop of a substance into a container of water. Only that container is 131 light-years in diameter. That’s the “30C” dilution you’ll see on packages. Homeopaths believe that the water molecules retain a “memory” of the original substance (while somehow forgetting all the other products it has come in contact with). The final remedy is diluted so completely that most “remedies” don’t contain a single molecule of the original substance you started with. The CBC used a great image to illustrate the absurdity – a tablet the size of the Earth might contain a single molecule of the original substance. The rest is sugar.
You might wonder how homeopathy could ever be approved as “safe and effective” by a drug regulator. It comes down to how you define “effective”. In the case of homeopathy, regulators diluted the standards just like homeopaths dilute their remedies. Health Canada was required to collect and evaluate some sort of evidence of effectiveness for each product it was responsible for regulating. But it realized that homeopathy could never meet conventional scientific standards of evidence. Consequently it allows citations about homeopathy from texts that date back to the 1800’s as “evidence” that homeopathy is effective. To put this in perspective, this means that homeopaths can cite “evidence” that precedes germ theory. Forget about randomized controlled trials – this is anecdote-based medicine.
Through this process, Health Canada approved 82 homeopathic “nosodes” for sale over the years. A “nosode” is a remedy that starts with infectious material, like polio, measles or smallpox, and then it’s diluted sequentially until mathematically, there’s nothing left but water. Those appear to be the remedies the CBC caught the homeopaths selling as vaccine substitutes. Last year the advocacy group Bad Science Watch launched a public campaign against nosodes, and succeeded in getting Health Canada’s agreement to force commercial manufacturers to place a label on their products stating “This product is not intended to be an alternative to vaccination.” This was the warning CBC Marketplace was looking for on the packages sold on camera. The warning wasn’t there – because Health Canada apparently doesn’t require the warning when the remedy is produced by the homeopaths themselves, only when the products are commercially prepared. Rather than reflecting on CBC’s question and Health Canada’s intent, homeopaths are instead gloating about their supposed “victory” over a requirement to give consumers a fair warning. No regulator is going to stop Canada’s homeopaths from selling fake vaccines to Canadians, it seems.
This isn’t the first time CBC Marketplace has scrutinized homeopathy. A 2011 episode asked if homeopathy was a “Cure or Con” and came to the expected conclusion. This episode had a similar reaction, with homeopaths outraged over the “bias” from CBC. (For LOLs, check out the Homeopathy and CBC Marketplace Facebook page.) CBC notes that not one of the five homeopaths filmed on camera was willing to go back on camera to defend their actions. Nor was any homeopathy spokesperson from the various homeopathy organizations that exist in Canada. But now that the show has been broadcast, several homeopaths are defending themselves in print. Their own words are further evidence that homeopaths do not appear to comprehend the risks they are taking with the health of children. Beth Landau-Halpern was one of the homeopaths that the CBC filmed. Writing in The Straight, she notes:
In May of this year I received a call from a young mother expressing concerns about the safety of vaccines for her baby and asking if she and her husband could come in and talk to me about homeopathic alternatives (which, in the simplest terms include homeoprophylaxis for those choosing not to vaccinate, or immune support for those who choose to vaccinate). This is a common request from (especially educated) parents, aware of media stories of vaccine damage as well as the myopic perspective of mainstream medicine for whom there are no alternatives, no accommodations, and no individualizing of vaccination schedules.
Vaccination is perhaps the most fraught decision a family makes in the first years of their child’s life. I do not believe that there is one right answer for every child and every family. People who come to talk to me about vaccination concerns and seeking information about alternatives are presented with a nuanced discussion. The primary goals of this discussion are to encourage families to do their research, understand the choices, and make a decision that is most suitable to their child, their family’s lifestyle (e.g. daycare or home care), their family’s health history and susceptibility to disease, and the risks and concerns they are most able to live with.
Upon leaving, “Emma” asked me for a nosode remedy to protect her son against measles while she and her husband were making their decision about vaccination; she told me they would be travelling to an area where there had recently been a measles outbreak and they were concerned about exposure. Of course I helped her—this is what homeopaths do. It turns out that MARKETPLACE then made a formal complaint to Health Canada about my labelling of the remedy I had dispensed. Unfortunately, “Emma” and her team didn’t do their research and were unaware of the regulations that cover homeopathic practitioners. Needless to say, Health Canada found the complaint spurious and dismissed it, assuring me that I was practising well within regulatory norms. I might add, that Health Canada has conferred a DIN-HM number on many nosodes, giving them a “seal of approval” as it were. There is no salacious story here, no matter how MARKETPLACE frames it.
Not only does Landau-Hepburn appear oblivious to the science and is clearly anti-vaccine, she’s gloating about being exempted from Health Canada’s explicit expectation that nosodes should be labelled to indicate that they are not vaccine substitutes. She knows the warning is required on some products. But she’s not required to give it. So she doesn’t disclose it to her customers. You can’t get much more paternalistic than that.
Susan Drury, a homeopath, wrote the following in the comments section of Landau-Hepburn’s column:
I am another one of the homeopaths who was “visited” by a young mother and accompanying “friend” (ie CBC Marketplace agent) under false pretenses, secretly filmed and included in their episode without my permission. When CBC informed me they had come to see me “undercover,” I wrote them a letter explaining, as Beth has done so well above, that my role is to support parents in whatever decision they make regarding vaccines. If they choose to vaccinate, there are ways to do so more safely and protect their child against possible ill-effects. If they make the difficult decision not to vaccinate, there are ways to educate their immune system to lessen their susceptibility to specific diseases.
Sonya McLeod, a homeopath who touts homeopathy as an alternative to vaccines on her website, also complained about the program in the same comment thread:
What was not explained in the context of this poorly done piece is that we offer alternatives to parents who have done their research and have made a decision for their family about the vaccine issue. We do not decide for the parent and their family, they decide for themselves. We all have the right to decide what we put into our bodies and into our children’s bodies.
While these homeopaths may genuinely believe their homeopathic “remedies” are effective, their customers are not receiving full disclosure of the scientific facts. This is where homeopathy can harm. Choosing homeopathy over a vaccine is a decision to forsake immunization, something a homeopath’s customers may not even realize – and seemingly something homeopaths have no intention of disclosing, even when they know the product should be labelled this way. Frustratingly, regulation has given homeopaths an opportunity, and now they’re exploiting it, suggesting that homeopathy may offer something valuable. It does not. Regulating homeopathy and its providers makes as much sense as regulating magic carpets and their vendors.
Why is all this so important? Because vaccines work. And we need high vaccination rates to control or eradicate disease. Vaccines are one of the most remarkable health interventions ever developed. This fact has been written about countless times in this blog, so I won’t rehash that evidence. I will share some amazing facts that Bill Gates described this week:
I’ll start with polio. Cases are down more than 99 percent since 1988. Earlier this year, we celebrated a fantastic achievement: India was declared polio-free. And in Nigeria, the number of polio cases is at an all-time low, just 6 so far this year versus more than 50 by this time last year. It’s one of only three countries that have never been polio free (the others are Pakistan and Afghanistan).
Wherever we make progress on polio, it’s a testament to the amazing work of many people: political leaders who prioritize stopping the disease, donors who help fund the effort, and—most importantly—the health workers who doggedly go from house to house to deliver vaccines. Thanks to all this work (and with a little luck), 2015 could be the first time Nigeria goes a year without a case of wild poliovirus, and the first time all of Africa is polio-free. If we maintain this commitment, I’m quite optimistic that by 2018 we will get rid of this crippling disease, everywhere, forever.
There’s also fantastic progress in delivering basic immunizations for diseases like measles and pneumonia. The impact is phenomenal: By next year, the public-health group known as Gavi, the Vaccine Alliance will have helped prevent 3.9 million deaths. And expanding vaccine coverage over the next five years can save as many as 6 million lives and unlock more than $100 billion in economic benefit.
And the image he shared is astonishing:
Millions of lives saved by an inexpensive and safe medical intervention. The potential that we’ll be able to eradicate a disease from the earth, like we did with smallpox. That’s what vaccines are doing. And that’s why the actions of homeopaths are so frustrating. With vaccine rates dropping in some areas (some Toronto public schools have up to 40% of students with “exemptions” from the vaccination schedule), health professionals and public health advocates need to be prepared to recognize and address the antagonism against vaccines that’s fostered by homeopaths.
Another image that really hit home for me recently was this photo series from Anne Geddes, whom you probably associate with photos of cute children. She recently did a photo session with the victims of meningococcal disease, an illness that can steal limbs and even kill within 24 hours. The photos are beautiful but heartbreaking, and speak to the catastrophic harm that this infectious disease can cause. Amazingly, this infection is now vaccine preventable. But you need to be vaccinated with medicine – not sugar pills.
Anti-vaccine sentiment is ugly, and it’s even uglier when there’s a profit motive behind it. I commend CBC Marketplace for yet again taking a hard look at homeopathy from a consumer protection perspective, as it’s something that regulators like Health Canada seem to show little interest in. The evidence is unequivocal – homeopathy has nothing to contribute to immunization or public health issues. One thing that you can do to counter-balance the harms of Canadian homeopaths is to contribute to vaccine programs directly, like those coordinated by Bill Gates or by other organizations. I’ve just contributed to UNICEF’s program and bought vaccines which should prevent measles, tetanus and polio in 139 children. The costs are modest, the risks are low, and the vaccines will save lives. If only this type of health care was supported by homeopaths.