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India needs evidence-based, ethics-driven medicine
Context:
The recent push to integrate ‘AYUSH’ medicinal systems into mainstream health care to achieve universal health coverage and ‘decolonise medicine’ is a pluralistic approach that would require every participating system to meet basic safety and e?cacy standards.
E?cacy and safety of homoeopathy:
- The Nuremberg Salt Test-The Nuremberg Salt Test noted that “the changes which the homeopaths claimed to observe as an e?ect of their medicines were the fruit of imagination, self-deception and preconceived opinion — if not fraud.
- Low evidence quality-homoeopathic treatments lack clinically signi?cant e?ects. Reviews that somewhat support homoeopathy’s e?cacy also caution over the low evidence quality.
- Trials not registered- Recently, researchers demonstrated that more than half of the 193 homoeopathic trials in the last two decades were not registered.
Debate over standards used in evidence based medicine:
- Standards set by the global community- RCTs and other methods for assessing evidence are collaboratively set by a global community pushing for evidence based medicine that includes epidemiologists and several others, beyond clinicians.
- Not suitable for homoeopathy- Homoeopathy’s supporters argue that the standards commonly used in evidence based medicine are not suitable for judging the “holistic e?ects” of homoeopathy.
- No conformity on standards used- Homoeopathy advocates have failed to invent valid alternative evidence synthesis frameworks suited for testing its e?cacy and safety, which are also acceptable to the critics.
Way Ahead:
- Evidence based medicines- India’s path to universal health care must be grounded in evidence based and ethics driven medicine.
- Reason for rejecting homoeopathy- The argument to reject homoeopathy is not just based on its coloniality, but chie?y on the lack of evidence for e?cacy
- Updation as per scientific discoveries- All medicine practices should update themselves based on growing scienti?c evidence.
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