Homeopathy and the APLF – What’s Wrong With This Picture?


It’s not so long ago that i2P asked me to investigate the NHRMC investigation into homeopathy, because of perceived bias.
Go to: Homeopathy – A Political Diversion Rather Than a Valid Issue
This was requested because i2P was receiving information regarding the manipulation of orchestrated attacks on some health modalities, in particular homeopathy and chiropractic.
Our information also inferred that pharmacy was included in the firing line, but only to the extent that control of policy was involved, not obliteration of the entire profession, which is the aim for homeopaths and chiropractics.

While i2P primary focus is obviously pharmacy, we are interested in basic democratic freedoms that enable all health modalities to practice without imposition of unnecessary regulations, or being undermined for more sinister reasons.
We have noted, in particular, one group of people we would simply call Medical Skeptics (all belonging to Australian Skeptics Inc or their affiliated groups) who make it a priority to dictate to all health practitioners of any modality, a version of clinical evidence they believe to be the only version to be followed.

As Sir Paul Nurse, president of the UK Royal Society, stated in his address to the Melbourne science community in January 2012:
“Good science must be free of pressure and influence by lobby groups; such groups … are ideologically driven or commercially motivated, and their hallmarks emerge in the use of highly intemperate and sometimes abusive language”.

Strangely, most of the clinical evidence surrounding drugs and their use, is so corrupted, that even major medical journals now admit that up to 50 percent of all published evidence is fraudulent and that the entire database is now beyond repair.
You only have to Google “pharma” and “fraud” to discover the $’s multi-million that have been incurred in fines through various courts throughout the world, including cases brought against vaccine manufacturers, for instances of academic fraud.
Yet the Medical Skeptics never attack “Big Pharma”, but they do attack the softer targets of chiropractic and homeopathy, and it is believed that the primary reason is the use of natural medicines that cannot be patented and both modalities do not use mainstream drugs.
All therefore, must be sacrificed on the altar of Big Pharma profit.

Medical Skeptics target the executive of major professional policy groups to initially influence decision-making but with the eventual aim of actually being part of the executive.
A major front group formed by Medical Skeptics is the Friends of Science in Medicine, which is a tightly controlled organisation relying on the influence of its Skeptic members to influence such organisations as the Australian Broadcasting Commission, the Consumer Health Forum and the NHMRC, also the consumer group Choice.

In regard to the NHRMC, through its Homeopathy Working Committee (HWC) report into homeopathy, the following was discovered:

1. In April 2011, twelve months prior to the announcement of the review of homoeopathy, a NHMRC Draft Position Paper on Homeopathy was leaked across national media platforms. This document asserted that it would be “unethical for medical practitioners to treat patients using homoeopathy” because homoeopathy “has been shown not to be efficacious”.
This prejudicial view adopted and promulgated in advance of any research being undertaken by the NHMRC generated considerable concern within the homoeopathic profession.

2. It was clear from the content of the bias displayed in the leaked NHMRC document that the Council had reprised in toto the negative findings of the 2010 UK House of Commons Science and Technology (STC) Committee ‘Evidence Check 2: Homeopathy’.
The NHMRC would have been aware that the recommendations of the UK Science and Technology Committee (STC), to restrict the availability of homoeopathy through the National Health Service, were not endorsed by the U.K. Parliament.
Parliament, which made forthright statements supporting the right to freedom of choice of the “informed patient” when it preserved funding for homoeopathy in the UK National Health Service.
Ten members of the committee refused to support the STC’s recommendations due to the bias perceived to be inherent in the STC’s process, protocols and findings; of the three who did support the STC findings, none had any knowledge of homoeopathy.

3. While favouring the STC’s fatally flawed report, the NHMRC ignored the publication in English in early 2011 of a comprehensive review of homoeopathy commissioned by the Swiss Government.
This five year-long, in-depth review was part of the Swiss Complementary Medicine Evaluation Programme.
This Health Technology Assessment (HTA) of homoeopathy engaged inter-disciplinary medical experts in conducting a formal analysis of the clinical evidence, cost-effectiveness and safety of homoeopathy and the quality of homoeopathic medicines.
From its close study of the research, the HTA report found highly favourable outcomes for patients across a broad spectrum of conditions and significant financial and other benefits for that country’s healthcare system from the practice of homoeopathy.
One of the results of the Swiss report was the re-instatement of health-care rebates for homoeopathic treatment in Switzerland.

4. In April 2012 the proposed commencement of the NRHMC homoeopathy review was announced with high profile media coverage, re-stating the same negative claims in relation to homoeopathy asserted in 2011.
This announcement was a second robustly promoted indication of the NHMRC’s prejudicial stance regarding homoeopathy.
Of great concern was that these statements of opinion were pronounced as manifest ‘findings’ – again in advance of the research which was simultaneously being announced.
Emerging as it did from Australia’s peak medical science research body, this was both confounding and deeply troubling to the homoeopathic community, as indeed it should have been to all in the science research arena.
It is far from controversial to anticipate that such a position would compromise the processes of the anticipated review.

5. The Australian Homeopathic Association (AHA) submission to the NHMRC had objected to the Council’s pre-formed views: these alerts as to manifest prejudice and its potential consequences were not addressed.
No response was forthcoming from the NHMRC to the AHA’s 2011 submission, despite the AHA’s offer of consultative co-operation in the inquiry.

Homoeopathy groups had no evidence of an intention by the NHMRC to establish the requisite protective measures in the review protocols so clearly necessary to protect against the potential contamination of both the processes and conduct of the review.

6. The most telling point in the entire saga concerned the absence of experts in the field to be studied.
Homoeopathy groups urged the NHMRC to follow accepted research protocols by including homoeopathy experts in its research panel; the AHA submission explicitly offered its resources to the Council.
Consultation with experts is standard practice in science research, indeed in any research arena.
This reasonable request to so do was ignored by the NHMRC: this neglect of best-practice alone calls the validity of the review into question.
As one of the NHMRC (external) expert reviewers stated in relation to the HWC review into homoeopathy, “I am concerned that no homeopathic expert was appointed to the NHMRC Review Panel.
I cannot imagine this being agreed in oncology, orthopaedics, or other disciplines.” [Obtained through a FOI request]

That this neglect prevailed at the same time that the HWC included a member of Friends of Science in Medicine (with its explicit anti-homoeopathy agenda) is a further indictment of the Council’s partiality and its co-operation with the agenda set by FSM.
The FSM member, Professor Peter Brooks, resigned from FSM only after his appointment to the HWC, to avoid an on paper conflict of interest.
That such an in vivo conflict of interest continued to prevail appears very likely.
Good science protocols would have ensured homoeopathy experts a place on the HWC, just as a concern for the independence of the Council may have avoided the appointment of a member of an anti-homoeopathy lobby group.

7. Research contractor(s) were engaged for the HWC Review.
It has been widely alleged that an initial contractor was engaged by the NHMRC/HWC to conduct the review (April 2012 – August 2012).
This study employed a different methodology to that ultimately adopted and these initial researchers found positively for homoeopathy in certain areas.
It has been alleged that two members of the original review panel resigned in protest, perhaps when their findings were challenged by the HWC, or perhaps this initial contractor challenged the methodologies requested by the HWC.
This review process was abandoned and the contractor dismissed.
It is also alleged that the review criteria was narrowed and a new contractor, OPTUM/INSIGHT, was employed.

8. The NHMRC has refused multiple FOI requests seeking details of this initial review process and its findings, indicating its reluctance to allow this material to be made public.
Other accessed FOI material indicates that budgetary restraints may have been employed as a means of narrowing the review and thereby limiting the range and therefore the comprehensiveness of the review.
Restraints on the scope of a review such as this flies in the face of objectivity, ethical conduct and good science, aspirations to which the NHMRC is otherwise committed. These serious considerations are consistent with the view, reluctantly reached by the homoeopathic profession, that the NHMRC appears to have been driven by a particular agenda, perhaps initiated and fostered by FSM lobbyists outside the organisation, or by personnel with affiliations with both organisations.
Mutual goals seem manifest in a manipulation of public opinion regarding homoeopathy, based on inadequate research, which may ultimately result in directives restricting public access to homoeopathy via the removal of health rebates.

9. The Review methodology was seriously restricted.
The NHMRC Review of Homeopathy (ultimately conducted by OPTUM/INSIGHT on behalf of the HWC) chose to limit its range of data analysis to Level 1 evidence in the hierarchy of evidence, and further limited the reach of adequate data collection by employing a systematic review of existing systematic reviews (effectively an over-view), rather than undertaking its own systematic review.
(In this, the HWC has also departed from international standards in failing to search all available Level 1 evidence, and no justification for this departure has been provided.)

10. The Australian Homeopathic Association stated that in the absence of direct participation in the review, the homoeopathic profession was forced to rely on a presumed commitment to excellence by the NHMRC to properly address the characteristics of the research field under their scrutiny: the profession has been dismayed at the abject absence of such values in the carriage of the homoeopathy review.

11. Data excluded from the Review:
RCT’s: Factors pertaining to the above discussion revolve around the challenges to research in a ‘whole person/whole-medicine’ modality such as homoeopathy. Conventional medical research tools, where one single active agent is tested on a single pathology, cannot adequately encompass the field requirements of a holistic intervention such as homoeopathy, where highly individualised, complex strategies are employed.
However, in spite of the limitations of testing a holistic approach through the restrictive prism of Randomised Controlled Trials (RCT’s), it is notable that positive outcomes for homoeopathy have been established in a number of quality human RCTs.
The NHMRC excluded an examination and evaluation of RCTs from the scope of its review and from its assessment of the efficacy of homoeopathy: in this way, the NHMRC was able to disregard positive outcomes in homoeopathy research which are evident in many RCTs.

12. Non-human studies: The HWC review further excluded plant, animal and laboratory cell model research in homoeopathy, where successful outcomes in a range of quality studies challenge the presumption of ‘placebo-only’ effects in homoeopathy when applied to human subjects. The strategy of excluding these studies avoids a challenge to the highly presumptive statement published on the NHMRC’s website (that homoeopathy is “scientifically implausible”) and further supports the NHMRC/HWC’s pre-ordained outcome of negative ‘findings’ for homoeopathy.

Prophylactic homoeopathy: Similarly the scope of the Review specifically excluded research into the use of homoeopathy in preventative health care. There are numerous studies in this area reflecting successful global experience of the use of these medicines, which are publically administered by the health departments of several countries using homoeopathy in disease prevention at population levels.
Indian regional governments for example control epidemics of malaria, Japanese encephalitis, dengue fever, and epidemic fever with homoeopathy.

13. The Cuban government now relies on homoeopathy to manage its regular leptospirosis epidemics, which had typically high mortality and morbidity rates prior to this innovation: both morbidity and mortality levels have been dramatically reduced by this intervention.

14. Given outbreaks of highly infectious diseases in our own region in recent years, and the likelihood that climate change effects will further escalate this hazard to community health, greater interest by the medical science research community into these effective and highly economical approaches to prevention would be timely. Several studies supplied to the NHMRC in the use of homoeopathy in epidemics show good results: the NHMRC excluded this area of population-level prophylactic use of homoeopathy.

Perhaps this is just one issue that clashes with Big Pharma and its unsafe vaccination agenda.
i2P investigations show a complete lack of evidence to support the efficacy of any vaccine and a whole lot of vaccine damage that has been the cause of heartbreak to many families.

That government irrationally supports this activity and does little to protect the community in general, means that something is drastically wrong.

i2P has no confidence in any NHMRC report because clearly our investigation shows that there is something horribly wrong with this picture.

And now it has reached into pharmacy through the APLF – an organisation that i2P had hoped would help to resolve infrastructure and inter-professional difficulties experienced by the profession for well over a decade.

Instead of attacking the obvious major issues it has adopted the NHRMC report as policy for all of pharmacy and wants to change its name to replace “Liaison” with the word “Leaders”.
It is obvious that the APLF has simply adopted the faulty report of the NHRMC without any independent investigation of its own and converted it to official pharmacy policy.
That, it would seem, will condemn pharmacy to at least another decade of disruption because it is based on an immoral investigation. This is not leadership.
Here is their recent communiqué dated September 2015.

The Australian Pharmacy Liaison Forum (APLF) represents the peak professional bodies for pharmacy.
The Forum most recently met on 14 September 2015 in Sydney.
The Forum agreed on the following: Position Statement on Homeopathy In response to the National Health and Medical Research Council (NHMRC) report on homeopathy, published in March 2015, the members of the APLF unanimously agreed to prepare a position statement to establish a firm position in this area.

At the September meeting of the Forum, all members agreed to the Position Statement on Homeopathy which states that the pharmacy professional organisations support the NHMRC findings of the lack of effectiveness of homeopathy in treating health conditions.

It also states that pharmacists should not recommend, sell or support the use of homeopathic treatments.
The Position Statement is attached. Strategic Directions for the Forum for 2016 Members of the Forum reflected on the recent Workforce Summit held in June 2015 in Melbourne, and agreed that ongoing work was required by the sector to identify the supply and demand trends of the workforce.

This work will be further progressed by the Forum as part of its 2016 strategic work plan, along with work on prescribing and expanded roles for pharmacists.

Revision of the APLF Charter and new name – ‘Leaders’ Forum
Members of the Forum reviewed the charter and from the next meeting agreed the Forum should be called the Australian Pharmacy Leaders Forum, a change from the current Australian Pharmacy Liaison Forum.

Professor Iqbal Ramzan Chair Australian Pharmacy Liaison Forum
References NHRMC Statement and Advice on Homeopathy
http://www.nhmrc.gov.au/_files_nhmrc/media_releases/nhmrc_releases_statement_and_advice_on_homeopathy140311.pdf

The next step in the above faulty process is to add the NHRMC recommendation to the PSA Code of Conduct (and other pharmacy organisation codes) making it binding on all pharmacists and enforceable by the Pharmacy Board of Australia, whether you are a member of the PSA or not.
This is an undemocratic process!

In terms of freedom to practice what you think is in the best interests of your patient, your own freedom as a qualified health professional capable of being able to work out the science yourself, why is pharmacy even involved with a lack of ethics in destroying another health modality?
We shouldn’t even be there!
Once upon a time it was considered unethical to advertise a “fast dispensing service” or an “accurate dispensing service”. This was considered unethical and prosecuted by the Pharmacy Board.
Now our peak organisations can condemn an entire health modality on the basis of a deliberately biased report from the NHRMC.

And before the PSA alters its Code of Conduct without a majority of all pharmacists voting on the issue (not just PSA members) a referendum should be conducted because it affects all pharmacists.
Easy enough as pharmacists complete their registration each year.

And this is before we get to the “freedom of choice” for the informed patient and the restraint on trade issues when needs are requested by the “informed patient”. Seems there are a number of legal issues that can be brought on  by patients or Homeopaths.
Is this really necessary or even good policy, or just a method of subjective collaboration with the medical profession?

So we are still without quality leaders.
We only have substitutes that take their orders from questionable sources without checking the evidence.
What a farce!


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