Monday, 25 February 2019

Canadian Government funding of Homeopathy in Honduras #1

This story looks bad. The reality is somewhat worse. For the homeopaths involved, it could lead to the end of their activities in Honduras and increased Provincial regulatory scrutiny.

This post is going to be somewhat different in format - it is expected that someone in Canada is going to pick it up and run with it. A lot of evidence is presented here because it may be the case that a lot of it is going to disappear. That evidence will shared with journalists, submitted to relevant authorities.

There's an awful lot of it, hence there will be more than one part. And the first part is relatively short and assumes less prior knowledge.

Homeoprophylaxis is the idea that homeopathic remedies can be used to immunise against diseases. Homeopaths will claim that homeoprophylaxis is not vaccination/immunisation but whatever mental gymnastics they engage in, most people would understand a claim that a homeopathy remedy can somehow modulate the immune system so that it resists infection by a pathogen as immunisation.

The homeopathic remedies used in homeoprophylaxis are generally nosodes - remedies made from tissues or exudates from diseased persons/animals. Most will react with disgust to this. Whilst the remedies themselves are sufficiently dilute that they are unlikely to contain any pathogen, the preparation of the remedies can pose risks of exposure.

It goes without saying that there is no evidence that homeoprophylaxis offers any protection against infection. There have been no trials that show homeoprophylaxis can create antibodies against a pathogen. There are cases of persons believing they or animals are protected against infection by homeoprophylaxis becoming infected. The belief that they are protected by homeoprophylaxis can encourage them not to take precautions against infection eg use of mosquito nets.

Some homeopathy organisations have banned their members from offering homeoprophylaxis. The regulatory position of the remedies vary but in many countries they are either banned for certain purposes or the marketing of them for homeoprohylaxis is illegal.

Chagas disease
Chagas diease is caused by the protozoan Trypanosoma cruzi. It is endemic to parts of Central and South America but it is spreading. It is transmitted by biting insects known as kissing bugs.

Most victims develop fairly minor symptoms after being infected and recover. Some show no symptoms at all. A significant minority, between 20% and 40%, will go on to to develop very serious heart and/or digestive system problems as long as 30 years later. Chagas can cross the placenta and can cause miscarriage/still birth. It can also be transmitted via breast feeding.

One estimate puts the global impact of Chagas disease at US$7 billion a year. To directly quote from Wikipedia -

Chagas disease affects 8 to 10 million people living in endemic Latin American countries, with an additional 300,000–400,000 living in nonendemic countries, including Spain and the United States. An estimated 41,200 new cases occur annually in endemic countries, and 14,400 infants are born with congenital Chagas disease annually. In 2010 it resulted in approximately 10,300 deaths up from 9,300 in 1990.
Prevention involves the use of insecticides. Treatment involves the use of anti-parasitics but they are not 100% effective and the longer the persons has been infected, the less effective they are. There are new treatments under development.

There are vaccines under development. It is hoped that human trials will begin in the near future.

The smoking gun
This web page states - 
One of the most widespread health problems in Honduras (and most of Latin America) is Chagas disease, affecting almost 80% of the Honduran population and for which no effective medical treatment exists. Chagas disease is caused by a parasite transmitted by an insect that commonly lives and breeds under the thatched roofs of houses in Central and South America. Through intense fundraising, HTSF and Martine Jourde managed to obtain sufficient funds to establish a small laboratory in Honduras to monitor the presence of Chagas disease and the efficacy of the homeopathic intervention and prevention proposed to the population. This important work is now being duplicated in other Latin American countries.
This web page reveals Canadian homeopaths spreading the practice of homeoprophylaxis. This web page reveals "opportunities" for "Homeopathic Research related to early detection, homeopathic treatment and prevention of Chagas disease (trypanosomiasis)."

The ethics of promoting the totally ineffective homeoprophylaxis in a developing nation are highly questionable. In the case of Chagas, because so many patients do not develop symptoms until decades later, there are unpleasant questions about liability when homeoprophylaxis does nothing to prevent them.

It is likely that the Chagas homeoprophylaxis remedies are being prepared in Honduras and are not being imported.

Canadian researchers conducting human medical research are expected to conform to Canadian research practices, especially ethics guidance. This is even more the case when the project is funded in part by Canadian government money.