‘Take control of your health’, and we’ll take control of your wallet!

‘Take control of your health’, and we’ll take control of your wallet!

“Take charge of your health by being an informed consumer” or “….empowering patients to take control of their health and wellbeing” etc.

These are very common statements made by proponents of complementary, alternative and integrative medicine (CAIM), and it conveys a very clear message; you should take control of your health! But the question is; what do they really want to achieve with this message? If we look at this superficially, we might think that they refer to a healthy diet, physical exercise and other positive lifestyle changes, but then again, any medical doctor will give you this advice as well.  One might think that being an ‘informed’ consumer is clearly good advice, but then again, why do they continue to provide the public with misleading and false information regarding their CAIM products and therapies? So, it cannot be this either. So, what is it that these people really want to achieve with statements like this?

Well it’s simple, they want more people to buy their disproven and unproven products, and hence they aim to manipulate us, with using statements like this, in doing just that. One of their techniques is what I call, a soup kitchen approach, where they provide some good information for free, in order to lure us into their web of deceit. Because they do not make much money with their ‘good advice’ (e.g. lifestyle changes), they are thus hoping that we will also fall for their false and misleading information regarding the benefits and safety of a huge range of products, that they happen to sell.  To give you a rough idea of the sheer number of ‘products/services’ in their arsenal, please have a look at this table.

So, allow me to translate what they actually want to achieve with their ‘take control’ statement. There are two important aspects; creating distrust in conventional healthcare, and masterfully exploit a very common innate cognitive bias that we all suffer from, in order to increase their sales.

Let’s first look at creating distrust in conventional healthcare. With this message, they are implying that our health is currently in the hands of someone else, and that we should now take it back – it is our right. This is quite misleading. Lifestyle choices is indeed in our hands, but even people with the healthiest lifestyles, still get sick. And when you do get sick, you should go to a qualified medical doctor, get a proper diagnosis and a conventional medicine prescription – if needed (most people do not have the medical knowledge to do this themselves). In this conventional approach, we do not have much control and we put our trust in the hands of trained professionals.  According to the CAIM proponents this is not a good system because you need to be in full control.

So, with their ‘take control’ message they are actually creating distrust in conventional healthcare  with some even going as far as stating that very little of conventional healthcare has been proven to work, or that medicine just treats the symptoms and not the cause, or medicine doesn’t work at all, it is just toxic etc. Clearly, the real message here is that we should not really trust our doctor or conventional medicine, but we should trust ourselves and we should make our own healthcare decisions. The CAIM proponents only provide the ‘options’ that we can choose from, but unfortunately, they are notorious for making false and misleading claims about these ‘options’. And don’t they provide a massive range of products to choose from (and importantly, many pharmacies also benefit from this situation). In Australia, you have a choice of roughly 20 000 CAIM products. In South Africa, it is estimated that there are more than 155 000 products, and I have been informed that none of these products have had their quality, efficacy or safety verified!  But who cares, they want you to trust yourself and to decide which of these products will work for you.

The second aspect is exploiting an innate cognitive bias that we all struggle with. All of us are continuously performing risk-benefit analysis, usually, without us even knowing it.  Everything we do; getting out of bed, driving to work, going for a walk in the park etc. carries a risk and hence we will continuously perform a risk-benefit analysis. The CAIM proponents are skilfully exploiting the fact that we sometimes struggle to get this right, and in some cases, we just get it completely wrong. For example: we are far more likely (up to a thousand times) to downplay or ignore a risk if we perceive to be in control of a situation. A good example: we are far more likely to get into a car (we are in control) than getting into a plane (a trained professional is in control), even though the former is much riskier than the latter. Using false and misleading claims for their products and making their ‘take control’ statements, we are hoodwinked into perceiving that we can be in full control of our health, and hence we are far more likely to ignore the (in)direct risks associated with CAIM products.  And this is where they are really making a killing with their ‘take control’ message. Add to this the distrust that they are creating in trained professionals and conventional medicine, then it is no wonder that more and more people are consulting Dr Google and buying OTC CAIM products.

The CAIM proponents are quite happy with this situation because they can now use the explosive growth in sales figures as ‘evidence’ that their products work – the typical appeal to popularity fallacy (another weapon in their arsenal). So, what is the take home message? With their statement, they are trying to take healthcare out of the hands of professionals and they want to place it in your hands (and you don’t have the medical knowledge), knowing fully well that in such a situation we are much more prone to take a risk by dipping our toes into their disproven and unproven CAIM therapies and products – it is all about money!

But is there anything we can do about this? We are irrational beings, so trying to change or influence human nature is highly unlikely to succeed. The only thing we can do, is to continue to expose how the CAIM industry misleads the public, and hopefully, one day, politicians and regulators will start to impose very tight restrictions on this industry, which frankly speaking, should not have existed in the first place.

“Swallowing It!” The ABC’s ‘Four Corners’ takes a look at the Australian vitamin and supplement industry. And the NICM’s role in all of this?  

“Swallowing It!” The ABC’s ‘Four Corners’ takes a look at the Australian vitamin and supplement industry. And the NICM’s role in all of this?  

Swallowing it: How Australians are spending billions on unproven vitamins and supplements.” A catchy title and a very important subject to investigate. It is however unfortunate that the term ‘unproven’ is used, instead of ‘disproven’. There is a major difference between these two terms.  The former means that vitamins and (mineral) supplements has not been tested, and therefore it is unknown if it is beneficial or not, whilst the latter indicate that it has been tested, to infinity and beyond, and it was shown not to be beneficial for most people, but for a select small group of people and for very specific conditions (e.g. vegans, pregnant women etc.). In reality, it has been tested, over and over – very little benefit and it might even carry a risk. It is therefore mainly disproven.

Herbal supplements are somewhat different. Many, such as St Johns Wort and Gingko biloba, have been tested thoroughly, whilst many haven’t. Therefore, we have a combination of unproven and disproven herbal supplements and very few that might actually be beneficial. Having said that: this does not matter one iota for the Complementary Medicine (CM) Empire – they just couldn’t care less. Why do I call them an Empire? Because of the remarkable similarities between their modus operandi and that of the well-known gangster, Al Capone. You can read about it here and here.

To say that a specific CM does not work, and that the public should stop taking it, is for these people totally unacceptable.  Here is a simple example of how it works:

A large clinical trial, called SELECT, (involving more than 35 000 men) was conducted to test if Vitamin E and Selenium prevents prostate cancer. It was stopped prematurely because not only did it not prevent prostate cancer (no benefit), there were, although not significant, “….more cases of prostate cancer in men taking only vitamin E” (indicating that it might actually be harmful). Based on this information, any responsible scientist will now conclude that the benefit of taking this supplement for the prevention of prostate cancer has now been disproven (no benefit and it might even be dangerous). Simple stuff.

Therefore the ‘National Cancer Institute’ in the US provides this information on their website; “Should men take vitamin E or selenium supplements for cancer prevention?  No. Scientists do not understand how these supplements really work and more importantly, the interactions that these supplements have together or with foods, drugs, or other supplements. There are no clinical trials that show a benefit from taking vitamin E or selenium to reduce the risk of prostate cancer or any other cancer or heart disease.”

Although the National Institute of Complementary Medicine (NICM), in Australia, did not take part in the SELECT trial, they felt compelled to release a press statement regarding the trial outcome. Whenever a negative (no benefit) result is published that might influence the sales figure of their main sponsors, they will react. In a long, and somewhat confusing, statement the NICM reaches the following conclusion and recommendation “….the precautionary principle would suggest that men over 50 and any man over 40 with a family history of prostate cancer should avoid selenium and vitamin E supplementation at doses that exceed recommended dietary intakes if not prescribed by a health professional.”

In other words; continue to buy the stuff that our sponsors sell. The well-known Australian supplement company, Blackmores, who has given the NICM more than $5 million in 2016, happily continues to sell these supplements to the Australian public. Asking Blackmores online Naturopath about the products for men with prostate issues, this is what they recommended “Blackmores has a product called Prostate Health Formula which contains both vitamin E and selenium along with a few other ingredients. Here is the product link for your information:  https://www.blackmores.com.au/products/prostate-health-formula. Frank, if you require any further information please contact the Naturopathic Advisory Service at advice@blackmores.com.au

So, is the naturopathic advisory service the ‘health professional’ that the NICM refers to in their statement?

This is a simple example of how it works. These people (and I have to exclude those very few that are conducting unbiased research into CAM’s) cannot accept that most CAM’s doesn’t have any benefit, some are dangerous and very few might be beneficial. If they do, and advise the public accordingly, their whole empire will collapse. And as usual; it is all about money and therefore it might be a good idea to keep an eye on the share price, before and after the Four Corners program airs, of the main producer of these products in Australia, Blackmores. It just might give us an indication if this program will have any sort of impact.

The Four Corners program airs tonight (13/02/2017) at 8:30 pm (AEST) but will also be archived on their website, that you can find here.

“All I do is satisfy a public demand”- Al Capone and the Complementary Medicine Empire. Part 2: The profitable political and regulatory connections.  

“All I do is satisfy a public demand”- Al Capone and the Complementary Medicine Empire. Part 2: The profitable political and regulatory connections.  

Al Capone’s “…mutually profitable relationships with mayor William Hale Thompson and the city’s police meant that Capone seemed safe from law enforcement.” If you want to build, maintain and expand a dubious empire, then this is the way to do it. Popularity and a positive public image alone won’t do it, you need strong ties, with mutual benefits, with politicians and regulators.

In Part 1 of the Capone series of articles, the well-known ‘appeal to popularity’ was discussed with Capone’s famous quote “All I do is satisfy a public demand”. Capone was very popular and improved his already positive public image by opening up soup kitchens during the great depression. This is strikingly similar to what the Complementary, Alternative and Integrative Medicine (CAIM) Empire is doing by ‘only satisfying a public demand’ while their proverbial soup kitchen is to provide some very good advice such as a balanced diet, exercise etc.  To understand the context of the current article Part 1 should first be read.

Political and regulatory connections

Capone was big buddies with the mayor, as well as with key figures in the police force (the regulators). To such a degree that he basically got away with murder. The CAIM empire achieve the same feat via organisations such as Complementary Medicines Australia (CMA), Australasian Integrative Medicine Association (AIMA), the National Institute of Complementary Medicine (NICM) etc. Every country has similar organisations, which again link up on an international level. These organisations lobby endlessly to achieve further legitimisation of disproven therapies, for example, through mandatory registration of disproven CAIM practices and therapists (TCM, Osteopathy, Chiropractic etc.). They aggressively defend against any negative scientific evidence and advertise their proverbial soup kitchens via ‘friendly’ journalists – to name but a few things.

But let’s focus on Australia; the deputy mayor of Sydney, Kerryn Phelps, has very strong ties with the NICM and is currently listed as an adjunct, she was the former president of the AIMA and, of course, she operates two integrative medicine clinics in Sydney. The NICM provides the ‘scientific evidence’ and she puts it in practice via her clinics. So, what type of political protection will she wield over the Sydney branch of the Empire, including the NICM? How will they further legitimise disproven therapies? But this is only the deputy mayor of Sydney, here is list of other Australian politicians that have been approached. Here is one senator that has clearly fallen for it – resulting in gems such as genital acupuncture that cures infertility.

What they want is protection, they want to be safe from prosecution, while continuing with their dubious activities. So who better to ask than the big champion of the CAIM Empire, HRH Prince Charles, to join the Sydney club.  Who will dare to touch you when you have the big guns on your side. But we have to be fair. Some politicians and other high profile people will reject the advances of the Empire, problem is, many might not. Be as it may, political connections are of utmost importance making them pretty much untouchable – same as with Capone.

As for the regulators; they have a very strong presence and even chaired the ‘Advisory Committee on Complementary Medicine’ advising and influencing the Australian regulator on CAIM issues. Currently a tremendous effort goes towards further relaxing the already extremely lax regulations governing CAIMs in Australia; “….excessive regulatory burden from the Therapeutic Goods Administration (TGA) as the biggest challenge affecting their business” They want to be able to make it easier and cheaper to sell the public whatever they fancy.

As for their global aspirations. There is one document that seems to have had a major impact on their credibility and expansion drift more than any other, and it is used to defend against any scientific evidence that a specific CAIM does not work. A respected global authority clearly gave them the thumbs up and a green light to go.

“….on the stance that Australia’s peak medical science authority takes towards the aspirations and commitment of the WHO 2014-2023 Traditional Medicines Strategy” (letter from the Australian Homeopathic Society in response to the negative NHMRC Homeopathy report).

The recent release of the World Health Organisation (WHO) Traditional Medicine Strategy 2014-2023 provides an important message to all world Governments that TM is an important and underestimated part of health care found in almost every country in the world, and community demand for it is increasing.”

“…will be in line with the World Health Organization’s strategy of increasing public awareness and strengthening the role traditional (indigenous) and complementary medicine plays in keeping populations healthy.”

The WHO Traditional Medicine Strategy 2014-2023 recommends member states, in effect, to integrate disproven and unproven CAIM therapies with conventional healthcare. This is, surprise surprise, exactly what the CAIM Empire wants and now they use this document as an ‘order’ from the WHO to aggressively expand their operations – because who can argue with the well-respected WHO? Does this report say anything regarding the horrific trade and use of human body parts, ‘harvested’ from children while alive, or the use of endangered animals in their products? (apparently, donkeys are being skinned alive nowadays for their purported ‘medicinal’ value). The NICM approved a thesis in 2008 where the lifesaving properties of Rhino horn was being promoted and currently they direct consumers on their website under the ‘CM resources’ tap, to a site where Rhino horn is listed as a ‘herb’ for when ‘your blood feels hot’! Just 1-2 grams will do the job.

What is their strategy to root out these horrific practices? You would expect at least a chapter on this issue, but no, it is completely ignored and instead a lovely ‘soup kitchen’ strategy is presented. This WHO strategy clearly has the fingerprints of the CAIM Empire all over it, and lo and behold, it was indeed compiled by another adjunct (a naturopath) of the NICM. Anyone that raises serious concerns? Well, it is not us that want to integrate CAIM, the command comes straight from the WHO (they just fail to tell you that they have written it) – and they just continue as before.

Politicians and regulators; it worked wonders for Capone, but the CAIM empire makes him look like a boy scout. They are indeed a very clever, although unethical, bunch of people. Part 3 will deal with breaking the law –  another similarity between the Capone and CAIM Empires.

“All I do is satisfy a public demand”-Al Capone. Part 1: A quote perfected by the Complementary Medicine Empire.

“All I do is satisfy a public demand”-Al Capone. Part 1: A quote perfected by the Complementary Medicine Empire.

“I am just a businessman, giving the people what they want”. “All I do is satisfy a public demand”. Two quotes made by the (in)famous American gangster, Al Capone. Little did Capone know that his quotes will be fully exploited and perfected by another business empire, almost a hundred years later. Nowhere is this sort of argument more prominent than in the world of complementary, alternative and integrative medicine (CAIM). ‘There is a growing demand for it, so surely our products work and are safe to use’ (this Capone approach is currently being used in a relatively new development, to integrate their ‘goods’ with conventional healthcare).  For people with the skill of critical thought, this is the well-known fallacy of “appeal to popularity”. Undeniably, this approach is quite effective and therefore also employed as one of their main vehicles to expand their empire.

Here you can find some recent examples where these statements were made in the public domain. There is, however, one example that I want to give here. “…given the number of people using these therapies, it was unethical for doctors not to practise in an integrative way.” This statement was made by Prof Kerryn Phelps, founder of Sydney Integrative Medicine and Cooper Street Clinic and consequently also a former winner of the Bent Spoon award for the promotion of pseudoscience. It comes as no surprise that she is also a conjoint professor at the National Institute of Complementary Medicine (NICM), but it is somewhat surprising that she is deputy mayor of Sydney who will; “…call out BS when she sees it…”.

So, they do not only supply the growing demand, but they claim it is also unethical not to do so. Said differently, they are trying to legitimise disproven ‘health’ products, because the public demands it – they are the good guys! In effect, they take it one step further than Capone, who at least admitted that he was a criminal. The CAIM empire expressly state that they only integrate evidence-based CAIM’s and reject disproven or ineffective CAIM’s. Problem is; they almost never specify which those latter ones are, let alone removing ineffective therapies – and this is the big problem. If they actually go and do what they claim they do, their empire will contract by 95% or more, which will result in only one thing, and that is total collapse. But this also means that there are many more parallels that can be drawn between the Capone and CAIM Empires.

Populism and a positive public image

Capone rose to power during the great depression of the 1920-30’s, and it stands to reason that public sentiment during these hard times was firmly anti-establishment. Much like today, any populist with anti-establishment sentiments seems to be able to garner the support of many. Such was Capone’s popularity that the crowds would cheer for him at ball-games, as they saw him as some sort of modern-day Robin Hood. He was also a master in polishing his public image by donating to various charities and even running soup kitchens for the unemployed during the depression years. Although commendable, this was only done to build and maintain a positive public image in order to expand his highly profitable criminal empire.

Similarly, CAIM proponents have created, over a very long time, a firm anti-healthcare sentiment under the general public. The anti-vaccination movement is a case in point. They focus solely, and of course publicly, on existing problems within the healthcare establishment. Yes, there are many problems within conventional healthcare, but those problems needs to be identified and addressed – this is also known as progress. But unfortunately, their motives are not all that pure. They want to replace conventional healthcare with mainly disproven and unproven CAIMs, and again, the anti-vaccination movement is a case in point. They thrive on the anti-healthcare sentiment and while they work towards achieving their goals, the crowds are cheering them on. The fact that most of their treatments by and large fail to have any effect, and some might even be quite dangerous, seems to be of minor importance.

The CAIM empire specialises in public relations by providing the public with a proverbial soup kitchen. Commendable, but unfortunately these soup kitchens are being used to hide a more sinister world – very similar to Capone.  You be the judge! Here is a list compiled from the websites of ten organisations in six different countries, advertising the wholesome goodness of their soup kitchens, using phrases such as “wellness”, “patient centred”, “holistic”, “evidence-based”, “safe”, “cost effective” etc. It is more than enough to satiate the appetites of the hungry masses – and it might even convince some scientists.

But, if we look behind the soup kitchen we find a completely different world, which, I might add, is much more sinister. Here is a list compiled from the websites of the same ten organisations, detailing what they’re actually selling – and it is much more than just soup.  A quick scan of the list will tell you that although it contains some good medical advice, it basically contains everything that has ever been invented as a complementary or alternative medicine. A very large number of disproven and unproven therapies are listed -therapies that are known to have no benefit and to have caused harm to patients. They continue to advertise, use, defend, and importantly, refuse to publicly criticise those that sell these disproven therapies. This list reflects what their empire really stands for, and it has rightfully been called “…….one of the most colossal deceptions in healthcare today”.

Although a lot can be said about this list, I only want to focus on one aspect. When one or more of these treatments are shown, with scientific evidence, not to work (and hence it becomes dangerous to use) the Empire reacts by simply hiding their involvement and full support for those treatments from public scrutiny, and they continue as before.  For example: The AIMA currently do not list a single specific “medicine” (although their NZ counterparts still do).  This wasn’t always the case, as can be seen in the table, they simply decided to remove this (incriminatory) information and currently, they only provide the soup kitchen. The NICM do exactly the same thing, but once authorities were notified that their main funders, the Jacka Foundation (with links to anti-vaccination proponents), lists some shocking disproven “treatments”, this information was simply removed – and they continue as before. And what about the Royal London Homeopathic Hospital – they simply changed their name not to reflect what they are actually doing and they basically continue as before.

The Empire get rid of incriminating paper trials, they refuse to acknowledge that a specific CAIM doesn’t work and they become better and better at drawing the public’s attention away from what they really do and to deflect the attention towards their soup kitchens – this is called, deception!

Part 2 will deal with some other striking similarities between these two empires and, of course, the eventual fall of ‘Good Guy’ Capone.

‘Officer I am not drunk, I am alternative sober!’ Skeptics stand by Bent Spoon nomination.

‘Officer I am not drunk, I am alternative sober!’ Skeptics stand by Bent Spoon nomination.

‘I reject your reality and substitute my own’ – a quote made semi-famous by Adam Savage from the TV series, Mythbusters, and obviously meant as a joke at the time. But it seems that this one-liner has caught on with some of the world’s most powerful. Donald Trump, working tirelessly to solve the world’s biggest problems, decided during his first few days in office to release a statement, via his team, that they will provide the ‘alternative facts’ regarding the number of attendees at his inauguration. Truly important stuff, resulting in a deluge of twitter comments including the hilarious ‘Officer I am not drunk, I am alternative sober’.

This article is, however, about his front-runners who has perfected the art of conjuring, disseminating and defending ‘alternative facts’ and because they were mainly allowed to do so, unchecked or unchallenged, for many years or decades they arguably assisted in paving the way for creating the current situation we find ourselves in. For example: scientists are now holding their breaths due to Trump’s plan to review current vaccination policies and for whatever might follow once this review is completed.  What kind of ‘alternative facts’ will this review reveal? Allowing ‘alternative facts’ to go by unchallenged, even the tiniest of deviations that may seemingly not have any measurable impact, creates societies that accepts ‘alternative facts’ and hence for it to become the norm.  It is about accepting it and not necessarily about the fact itself – e.g. nobody really cares about the inauguration numbers (correction; there might actually be one person who truly cares).

Nowhere is ‘alternative facts’ or ‘alternative truths’ more common than in the world of alternative medicine, in all of its different shapes and sizes. But as Edmund Burke apparently said sometime in the 1700’s “the only thing necessary for the triumph of evil, is for good men to do nothing”. It is therefore important that men and women, specialising in different areas of science, to at least try and present the real facts when confronted with the unchallenged dissemination of ‘alternative facts’. Yes, it can get you in hot water, but it needs to be done.  In the world of alternative medicine this also seems to be a full-time job, but luckily there are a number of brave souls, and a number of organisations, who expose these ‘alternative facts’ with the real facts, as and when presented by the alternative, complimentary and integrative medicine fraternity.

One such organisation is the Australian Skeptics who annually reward the ‘best performing’ Australian with the coveted Bent Spoon award for “the perpetrator of the most preposterous piece of paranormal or pseudo-scientific piffle, and it serves to highlight particularly egregious instances of anti-science”.   A number of ‘alternative fact’ proponents were nominated in 2016, including Prof Alan Bensoussan, Director of the National Institute of Complementary Medicine (NICM), Western Sydney University, Australia.  Obviously, you cannot just nominate anyone; that would be just wrong and therefore the provided incriminatory information has to be double-checked and authenticated.

In a recent newsletter of the Australian Skeptics an article appeared about the efforts by Prof Bensoussan to get his nomination removed (without providing a shred of scientific evidence!). You can read the full text of this riveting article here and below is mainly the e-mail exchange between the Skeptics and the NICM (republished with permission):

“On 22 November 2016, a few days before our National Convention where we present our annual awards, Australian Skeptics Inc President Eran Segev received an email from Professor Alan Bensoussan. It had a letter attached, and requested “that this letter is treated with strict confidence and only used for the purpose of removing the nomination”.

As will become clear shortly, we rejected this request as being unreasonable and unjustified both substantively and as the email was copied to two other parties not directly linked to Australian Skeptics Inc. However, there were parts of the letter that we accept should appropriately remain confidential, and we have chosen to redact those.

You can read Prof Bensoussan’s letter here.

On 3 December, a few days after the Convention, Eran Segev sent the following email to Prof Bensoussan:

Dear Prof Bensoussan,

Thanks for your email and letter. At the convention this weekend we have announced the “winner” of the Bent Spoon for this year, and I’m sure you’d be pleased to know that NICM was spared. The nominations for 2016 have now been removed from our website.

I wish to use this opportunity to express my ongoing concern over the uncritical way NICM presents information that is, at a minimum, dubious. The easiest example is the definition provided under “Energy Medicine”. Simply using the biologically meaningless terms “energy fields” and “biofields” puts you in the same category as some of the worst cranks in alternative medicine. As a minimum, I would have expected something like “it is claimed” followed by other qualifications that make it clear that NICM does not subscribe to these unscientific definitions. Unfortunately, a review of your site suggest that your claim that you “…do not defend the use of any complementary medicine unsupported by evidence” is false.

While you did not win the Bent Spoon this year, I reject your suggestion that the nomination was undeserved. Investigating complementary medicine in a scientifically rigorous manner is a credible scientific pursuit. Promoting it with weak or non-scientific evidence, as NICM often does, is not. I wouldn’t be surprised to see more Bent Spoon nominations for your organisation as you continue your uncritical support for implausible and evidence-free treatment modalities.

In your response to the NH&MRC review you ignored the magical pre-scientific notions that underpin homeopathy and its complete lack of plausibility, producing a statement which makes it look very much like you think this modality has some credibility, yet to be proven. The same approach permeates your site – no criticism of any alternatives to medicine in sight.

Even your warnings are mealy-mouthed: Saying “Serious forms of disease, conditions and disorders should not be diagnosed or treated without first consulting a suitably qualified healthcare professional” is not nearly good enough, when what any responsible organisation would say is “Go see your doctor” to make sure no-one sees a naturopath for a serious condition.

I also note that NICM is being sponsored by the Jacka Foundation, an organisation so uncritical of alternatives to medicine that it links to notorious anti-vaccination activists as sources of information.

I hope this will serve as a bit of a reminder of the need for scientific thinking to replace the unwavering support of complementary medicine in all its forms, which seems to inflict NICM.

Sincerely,

Eran Segev

President – Australian Skeptics Inc

Prof Bensoussan’s response on 5 December:

Dear Eran

Thank you for your update note and thoughts. We are intending to revise our website over the summer and hope to address some of the issues you have raised. However, I don’t agree with everything you say and your language is in places unnecessarily offensive.

Kind regards

Alan

And finally, Eran’s message on 5 December:

Dear Prof Bensoussan,

We at Australian Skeptics are encouraged by the news that you intend to revise the website and look forward to seeing a more measured attitude to the evidence – or lack thereof – for various CM modalities. However, until such time as NICM has clearly made a shift in its approach, we will continue to keep a sceptical eye over the Institute and its publications, and make public our criticism of the Institute when we feel it’s appropriate.

Specifically, we refer to your letter dated 22 November 2016, which we note was headed “Strictly confidential”. We suggest that this was inappropriate and that we are entitled to republish your letter if we wish.

Your letter requested us to remove text from our publicly available website. There was no confidential information in the letter which you are entitled to protect from public disclosure.

As part of our ongoing investigation of CAM, we consider that it is in the public interest to republish the nomination, your letter and our response dated 3 December 2016.

We also give you the opportunity to respond and we will publish that, assuming it is in appropriate terms and not of excessive length. If you wish to take advantage of our offer, please respond by 5 pm Friday 9 December 2016.

Sincerely,

Eran Segev

President – Australian Skeptics Inc

To date, no response has been received to this last message.

We sincerely hope that NICM will change its ways; but if past behaviour is the best predictor of future behaviour, we remain sceptical.

Complementary medicine and the NICM. What do we want to achieve with this blog site?

This blog site is not about complementary medicine as such but rather about a specific Institute, the National Institute of Complementary Medicine (NICM), Australia. There are a number of valuable blog sites and resources that deals with complementary medicine in general, of which the blog site of Prof Edzard Ernst is highly recommended. You can find it here. Friends of Science in Medicine also provides valuable information and insight into the world of complementary medicine. You can find it here.

The reason that we focus on the NICM is not only because one of us has worked there for a number of years but rather that we have first-hand knowledge of what happens when a university allow pseudo-sciences to get a foot in the door. The NICM is therefore not the real problem but rather a result of a much deeper underlying issue. When the gatekeepers of science let their guard down for the sake of external income and international rankings then we are in serious trouble – the NICM, using complementary medicine as their vehicle to achieve their dubious objectives, is a prime example of this.

We therefore aim to address both these issues.

  1. It is too late to prevent society from being flooded with unproven and disproven complementary, alternative and integrative medicines (due to the efforts of the NICM and the like) under the guise of ‘evidence-based’, but we should aim to reverse this trend. The only way to do this is to continue to publicly expose how the NICM mislead the public, regulators, lawmakers and all other stakeholders. The public should, with the information provided on this blog site and others, start to put pressure on all these stakeholders for true reform. This is obviously easier said than done. We can, unfortunately, only provide information on how this truly shocking game is being played at the NICM and what the (future) impact on society will be if it goes unchecked.
  2. To address the second issue is much more complicated. Very few university’s will ignore millions of dollars from the complementary medicine industry for the sake of protecting the integrity of science, scientific education and the well-being of society – which is alarming because most universities are funded mainly by the public. Unfortunately, and even after repeatedly being warned about these dangers, this is exactly what has happened at Western Sydney University (WSU). We therefore aim to publicly expose how WSU play the game and what the (future) impact of this is on science, education and on society.

As a secondary aim, we request anonymous information about any verifiable information exposing any wrongdoing at the NICM or WSU (we already have enough data to keep us busy for a very long time but you never know what might turn up). This is preferable although we do welcome information from other fields of science and also from other universities (let’s call this “academic-leaks”). Information regarding how to send anonymous emails or documents can be found here. We do not care about who you are, as long as the information provided can be verified and that it clearly contains information about any wrongdoing e.g. data falsification, fabrication, cover ups, bullying etc.  If the information can be verified, it will be published on this blog site as is. This is needed to put pressure on universities, especially WSU, to make a true effort to return to unbiased scientific research and student training as their main objectives. Yes, it will take a long time but it can, and should, be done!!

Information can be send to: charlademia@gmail.com

Promoting Rhino horn as medicine at Western Sydney University: Has this contributed to the exponential rise in Rhino poaching?

Promoting Rhino horn as medicine at Western Sydney University: Has this contributed to the exponential rise in Rhino poaching?

Something happened in 2008. Something, or a number of things, triggered an exponential rise in the number of rhinos being killed in South Africa. Poaching numbers remained quite low and was stable for a decade with only 13 being killed in 2007. But then suddenly the number jumped to 83 in 2008, followed by an exponential increase every year, reaching a staggering total of 1 175 in 2015 – one Rhino poached every six hours. To explain this will be difficult and, in all likelihood, will be due to a number of factors or events coinciding in 2008. Maybe the global financial crises had something to do with it – people tend to turn to ‘commodities’ in times of financial uncertainty (rhino horn is apparently worth around $60 000/kg). Maybe there was a sudden increase in the popularity of rhino horn as a traditional Chinese medicine (TCM) in Asian countries. Or maybe effective conservation/anti-poaching efforts of the Indian Rhino in Nepal and India started to pay off and this led to a shift in focus to the African Rhino which inadvertently took its place in TCM – or all of the above factors and much more.

Another possible contributing factor, which I will discuss here, is the growing acceptance of TCM in western countries! For example: Phynova recently advertised a new product as the first traditional Chinese medicine (TCM) being registered in the UK. By directing customers to a separate site for more information regarding their product they ‘accidentally’ linked to a site which ‘advertised’ rhino horn (this link has since been removed). Another example is Western Sydney University, Australia who accepted and published a thesis in 2008, in which they described the current use of Rhino horn as a highly effective medicine, just like you would describe any real medicine. Surely this will have an impact!

But first a bit of background, so please bear with me. There are two ‘opposing’ aspects regarding TCM that most members of the public do not seem to understand well. Not their fault, because the TCM lobby groups are spending a huge amount of effort to keep the lines between these two aspects as blurred as possible. The first aspect is the underlying pseudoscientific TCM principles; the yin and yang and the vitalistic “energy” flow through “meridians” and much more. Scientists have relegated this to the pseudosciences, just like bloodletting, which was seen as a cure-all hundreds of years ago. Unfortunately, the pseudoscientific TCM principles are still with us and based on these principles almost every single TCM modality works! From acupuncture to herbs to animal matter (including rhino horn) – everything is efficacious, safe and cost effective. Evidence for this is that close to a 100% of clinical trials done on TCM in China give positive results. Strange isn’t it! People in China should thus no die of any disease – they have ‘effective’ medicine for everything! This is the world of TCM in a nutshell.

The second aspect of TCM is the application of the modern scientific method to test which of the thousands of TCM modalities are really active, which ones are useless and which ones are dangerous. Decades of investigation have come up empty-handed with one or two exceptions. One notable exception is Artemisia annua which contain a single compound that is highly effective for the treatment of malaria, and once identified and intensely studied, it was taken up into conventional medicine – not the herb, but the compound. If you investigate all the plants in the world you are bound to find some compounds that can be used as medicine – it has nothing to do with TCM principles and it can most definitely not be used as evidence that the TCM principles are correct or that it based on science.

These two aspects are therefore quite different.

In the TCM world just about everything works, but it is not backed up by science. It is huge market ($170 billion) and it creates employment for many – something that make politicians smile. In the modern scientific world, almost nothing in TCM works, but it is based on science. It is however not profitable at all – you have to investigate thousands of plants in order to find one useful compound.

Many TCM practitioners and researchers are avidly trying to combine the positives of these two worlds. They focus mainly on the money and employment aspect of the TCM world and try and combine this with the modern scientific approach. They tend to focus on the one example where modern science discovered a useful compound (artemisinin) in the medicinal plant Artemisia annua, which was also coincidently used as an herb in TCM – as evidence that TCM works! Here are some examples:

“To stigmatise all traditional medicine would be unfair. After all, a Chinese medicine practitioner last year won a Nobel prize.” No, a Chinese scientist using the modern scientific method identified artemisinin after testing hundreds or even thousands of different plants.

This year, Chinese medicine practitioners will be registered in Australia. ….. Chinese herbal medicine is administered routinely in hospitals for many chronic diseases. …… This has led to recognising herbs such as Artemisia as a proven anti-malarial ……” No, the compound artemisinin is a proven anti-malarial!

There has been enormous progress in the last 20 years or so. I am sure you are familiar with the use of one of the Chinese herbs in managing resistant malaria.” No, very little progress and no, the compound artemisinin!

So this is a game that is being played with the simple intention to blur the lines between these two aspects regarding TCM – but the real reason might simply be “A new research-led Chinese medicine clinic in Sydney, better patient outcomes and the potential for Australia to tap into the $170 billion global traditional Chinese medicine market”

Prof Alan Bensoussan the director of the National Institute of Complementary Medicine (NICM) and registered in Australia as a TCM and acupuncture practitioner is a champion in blurring this line. Alan has been instrumental in lobbying the Australian regulatory agency that a long tradition of use is all you need to be able to register new products. He was also influential in establishing the Chinese medicine practitioner registry in Australia, in 2012, and thereby legitimising TCM in Australia. He has been actively chipping away at the resistance that the Australian public have against these pseudoscientific healthcare systems such as TCM – one can argue that he has done so quite successfully because they are expanding their operations into the Westmead precinct of Sydney with a new TCM clinic/hospital.

Enough background; so what does all of this have to do with Rhino horn? (and for that matter other endangered species). We have to remember that in the TCM world just about everything works and that includes rhino horn! Searching Western Sydney University’s theses portal for Xijiao (Chinese for Rhino horn) I found a thesis published in 2008 from the NICM and co-supervised by Alan; “Development of an evidence-based Chinese herbal medicine for the management of vascular dementia”

On page 45-46: “Recently, with fast developing science and technologies being applied in the pharmaceutical manufacturing area, more and more herbs or herbal mixtures have been extracted or made into medicinal injections. These have not only largely facilitated improved application to patients, but also increased the therapeutic effectiveness and accordingly reduced the therapeutic courses …… lists the most common Chinese herbal medicine injections used for the treatment of VaD. “

“Xing Nao Jing Injection (for clearing heat toxin and opening brain, removing phlegm) contains ….. Rhinoceros unicornis (Xijiao), …… Moschus berezovskii (Shexiang), …..”

“…. Xing Nao Jing injection has been widely applied in China for stroke and vascular dementia. …. After 1-month treatment intervention, they found the scores in the treatment group increased remarkably, as compared with the control group …… “

They list two endangered species; the Rhino and the Chinese forest musk deer (Moschus berezovskii). But what is truly worrying is that they don’t even mention the endangered status or at least recommend that the non-endangered substitutes, which do exist in the TCM world, should be used instead – or maybe use fingernails as a substitute? It is not discussed at all. Clearly they are stating that using these endangered animals are way more effective than western medicine (the control group) for the treatment of vascular dementia!  This is deplorable to say the least. Statements like this fuels the decimation of this species.  But this shows that they truly believe and support the underlying pseudoscientific principles of TCM – they have to, their ability to tap into the TCM market depends on it!

But is this now really promoting Rhino horn as medicine? Well, the definition of promoting something is; “support or actively encourage (a cause, venture, etc.); further the progress of.” – so I would say, yes. As a scientist you are entitled to discuss historic believes, such as that most people once believed that the earth was flat. But make sure to also state that modern science has now shown beyond any doubt that the earth is round. If it is stated that the earth is flat without saying that this is incorrect then you would be promoting that idea – and believe it or not, even in 2016, you can find a flat earth society! The same goes for Rhino horn and this is exactly what they have done here. But then again they live in a world where all TCM modalities are active!

How to solve this problem of growing acceptance of TCM in western countries?  A simple step could be that people like Alan publicly denounce the underlying pseudoscientific TCM principles and make the ‘difficult’ switch to real science! Admittedly, he will have to part with lots of money from the CM industry and his Chinese partners, and maybe not built his new TCM hospital! But for some reason I strongly doubt that this will happen. The NICM have successfully applied a very thin, but beautiful, veneer of political correctness and modernity over the surface of complementary medicine. Anyone who cares to look underneath this veneer will find a rotten ancient pseudoscientific TCM world – in this case the promotion and the use of endangered animals.

After reading chapter two of this thesis one cannot believe that this is from an Australian University and paid for by the Australian taxpayer! The main question though: Can I directly link this thesis with the increase in rhino poaching? This will be very difficult if not impossible to do. But that is not the problem. Promoting the pseudoscientific principles of TCM in Australia expands the export market for TCM, and hence will lead to an increased need for raw materials, including the banned Rhino horn. That Rhino horn has been a banned substance since the 1980’s clearly does not seem to have any impact looking at the poaching statistics. In an unrelated paper published in 2010 the ingredients in the Xingnaojing injection is listed as “…. consisting of Chinese herbs such as Moschus, Borneol, Radix Curcumae, Fructus Gardeniae, ….” No full list is given in the paper – dare I say because it contains Rhino horn as well?

The drug Ice is also banned, but if you are going to promote it at a ‘trusted’ university, then you shouldn’t be surprised that Ice production increases and more of it flows into Australia – even if it is illegal.  The same goes for Rhino horn!