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Evidence-based medicine – treatments based on evidence of safety and efficacy from clinical trials – has been in the ascendant for decades now in Europe and around the world. So why is one system of treatment which has been dismissed as ineffective by clinical trials still in use?
History
Homeopathy, developed in the 18th century by physician Samuel Hahnemann in Germany, is based on the principles that 'like cures like' and that greater dilutions of treatments have the most beneficial effects. When mainstream treatments included blood-letting and purging, and surgery frequently led to fatal infection, these principles may have had the benefit of at least seeming benign. But now that modern medicine has a far greater understanding of the causes of disease and their treatments, homeopathy has been dismissed as – at best – a placebo.
There are signs that governments in Europe are hardening their attitudes to state funding of homeopathy, with the UK, France, and Spain all announcing an end to funding or support for homeopathic products or services in recent months. We took a look at the popularity of homeopathy across the continent, the different traditions of its use, and ask whether attitudes are changing.
Evidence
The biggest survey of studies of homeopathy was published in 2015, when Australia's National Health and Medical Research Council considered 57 systematic reviews that assessed the effectiveness of homeopathy compared to placebo or other treatment, for 68 health conditions. The systematic reviews included 176 individual studies.
The NHMRC concluded: "Based on all the evidence considered, there were no health conditions for which there was reliable evidence that homeopathy was effective. No good-quality, well-designed studies with enough participants for a meaningful result reported either that homeopathy caused greater health improvements than placebo, or caused health improvements equal to those of another treatment."
The landmark review has been cited by organisations and health services wanting to withdraw funding from homeopathy ever since.
In 2017, the UK's Specialist Pharmacy Service updated the NHMRC's review by searching for systematic reviews published since the search date. It concluded: "the quality of the trials included within most of the reviews are variable thus this new data does not change the conclusion of the NHMRC review conducted in 2015".