A bunch of people into homeopathy protesting outside the Advertising Standards Agency.
I’ve always envied reporters who cover big protests. The protests I end up at never seem quite in the same league, be they a group of environmentalists baking bread under a tree in Rothamsted, or, as I witnessed last week, a contingent of miffed homeopaths demonstrating outside the Advertising Standards Authority (ASA). While you couldn't question the zeal of the 20 or so polite men and women who turned up with their banners, it's difficult to imagine the state being overturned by people who are convinced that putting water in a tube, banging it against something repeatedly, then pouring it over little sugary pills can cure diseases like malaria and typhoid.
Most reasonable people dismissed the idea that homeopathy might be able to benefit anyone years ago. It's been around since the 18th century, so it's not quite as old as trepanning, but it's roughly as illogical as drilling a hole in your head to cure a headache. For some reason, the practice has been allowed to continue. Treating what are essentially placebos as legitimate medicine may be harmless if you're buying them from an upscale pharmacy like the Boots in Hampstead because your millionaire husband snores too loudly, but it's more dangerous if you're a refugee in Nairobi being told that homeopathy can cure your daughter's life-threatening illness.
But somewhere along the line, homeopaths may have shot themselves in the foot. A few years ago, critics of homeopathy examined the Code of Ethics published by the Society of Homeopaths (SoH), a professional body with ambitions of becoming the statutory regulator of the industry. They spotted an interesting clause in it, in which SoH members were told that they must comply with the British Code of Advertising Practice, as enforced by the ASA, and avoid claiming that their pills could cure specific diseases. As it happens, the SoH aren’t the most enthusiastic enforcers of their own code, but given the ASA’s strong record on tackling bogus remedies, skeptics fresh from battling the British Chiropractic Association sensed an opportunity to take down another foe. Mass complaints were organized, supported by the Nightingale Collaboration, a consumer group set up by the science writer Simon Singh.
A number of punitive rulings later and homeopaths were getting seriously pissed off. William Alderson left his position as director at the Society of Homeopaths to co-found the group Homeopathy: Medicine for the 21st Century (HMC21), an ironically name given the quackery that never really left the 1700s it was founded in. Alderson and HMC21 had organized the protest that I’d now managed to infiltrate using the "dark arts" of journalism: not giving anyone my last name and hoping I was too obscure for anyone to recognize me. Which, it turned out, I was.
Office workers looking happy with the protest outside their building.
Back in High Holborn, things were not kicking off. Instead of being kettled like a real journalist, I was busy explaining what VICE was to a group of people in their 50s and 60s. William Alderson was leading the protest and displaying plenty of the energy and commitment that had earned him the nickname "homeopathic Duracell Bunny" from the antiquack blogger Andy Lewis. (Alderson was wearing bunny ears in a reference to this at one point, but wouldn't let me photograph him wearing them.) Every so often, two charming ladies would lead a cheer—“Homeopathy WORKS! Homeopathy WORKS!”—blissfully unaware of the dagger eyes being thrown their way by workers exiting the office buildings nearby.
I spoke to Jennifer, a homeopath who had seen her own ad rejected by the ASA on the grounds that she had failed to provide enough supporting evidence for her claims. To her, it seemed terribly unfair. “What I find a joke is… I was watching TV with my grandson and a Lucozade advert came on, and it says, 'Lucozade hydrates better than water!’ So my grandson’s like, ‘Get us some Lucozade, it’s really good!’ and it’s got bright colors and it’s on children’s television. I went into the supermarket and I looked at the ingredients—first ingredient is water, all the other ingredients are chemicals. Nothing that helps the body hydrate. They got away with advertising that—where’s their proof? Where’s their evidence?”
I asked her why she felt there were different standards. “Money!” she replied. Capitalism came up with almost everyone I spoke to in one form or another, with protesters variously criticizing Monsanto, Nestle, and, of course, the pharmaceutical industry. Some of their arguments had merit, and I found myself nodding along in agreement on more than one occasion. It was easy to see why alternative medicine has been so welcome in the anti-big-business Green Party over the years.
Alderson was particularly eloquent. Most of what he said seemed to me to be wrong, but he said it well. His basic argument revolved around the worth of patient testimony. The ASA will not let you advertize medicine as being effective if those claims are based purely on feedback from those who've been treated with it. This is critical to the marketing of homeopathic remedies, because most tests that rely on actual science rather than conjecture suggest that homeopathic medicines are as effective as placebos. Alderson's objection is that mainstream medicine also takes patient testimony into account—although this is in the form of regulators collecting reports of negative side effects. And of course academics and pharmaceutical companies do conduct empirical research before this stage.
Other arguments seemed confused or lost in sophistry. “Randomized controlled trials [also known as RCTs, the tests used by mainstream medicine companies] only produce results in about 50 percent of cases. Half of them are inconclusive,” he told me. But even if that's true, it's not really very surprising—plenty of potential new drugs may have a marginal or unclear effect. In another gambit against medicine’s gold standard, he suggested: “Every drug that is withdrawn is withdrawn because the RCTs that proved they were safe and effective turned out to be wrong.”
Again, he seemed to struggle to understand what trials are and what they do. An RCT can’t "prove" that a medicine is safe. It can suggest it with a degree of probability, and then patient surveillance is used over time to look for any issues that may have been missed. In any case, the fact that RCTs aren’t flawless doesn’t mean that anecdotes from homeopaths are any better.
Alderson loved science, but seemed to have missed some lessons along the way. “When they say the explanation for homeopathy is the placebo effect, there is no scientific explanation for the placebo effect. You can’t explain one inexplicable thing by another inexplicable thing.“ Perhaps not, but you don’t need to know how something works to observe that is—scientifically—working.
Paul Burnett, a homeopathy supporter.
Underlying all the cheerfulness were some worrying subtexts. The people I spoke to seemed very much in favor of science and the NHS, but had to square that with the seemingly inexplicable rejection of their medicine by the world around them. Conspiracy theories offered an attractive way out of their intellectual cul de sac. Alderson connected spurious dots between a Swiss government report that he believes upset "Big Pharma," the medical journal the Lancet's rejection of homeopathy in the mid-00s, the creation of Sense About Science and individual skeptics and campaigners. “You can see a whole pattern of using different organizations and individuals to push this attack [on homeopathy] in the public arena. The ASA is just the latest in this line of attacks."
It’s all very plausible, except that it falls into the skeptic’s fallacy: assuming that beliefs you don’t understand can’t be sincerely held. People campaign against homeopathy because it’s quack medicine, because belief in it can be dangerous and because treatments that don’t work shouldn’t be funded with tax payers' money. Many of the most prominent critics of homeopathy have also attacked practices in the pharmaceutical industry.
Another subtext was the threat of "poison"—a word I heard so many times that it felt like subliminal messaging. Almost every person I spoke to used the word "poison" in reference to real medicine. Alderson himself described Sense About Science’s campaigns on vaccination as "propaganda." Coupled with the proud boasts of parents who treated their own children with homeopathy (one man asked me to photograph his four children "All raised on homeopathy!"), a disturbing picture began to emerge: a community of people, suspicious of corporations, believing that modern medicine is poison and treating patients and their own families with an array of homebrew "remedies" that are actually nothing but water.
Before I left the small crowd in the sunshine on High Holborn, I asked Jennifer about the future of homeopathy. “We’ll always be here,” she replied. “I’ll defend homeopathy until I die.”
Follow Martin on Twitter: @mjrobbins
Previously - The Weird Science of North Korea