an autodidact meets a dilettante…

aka quackology monthly

Well, having just completed the onerous task of ‘debating’ William Lane Craig, it’s time to refresh with something new, and local – or at least national. Or perhaps local, because one of the leading writers behind this story is Tory Shepherd, who writes for Adelaide’s Advertiser and The Punch, and who is always excellent on pseudo-science, religion and many other issues, as well as being a far more entertaining writer than myself, as for example in this enjoyable but thought-provoking article on alcohol and anti-social behaviour (but don’t bother reading the comments, they’re mostly depressing, and give me the distinct impression that most people who comment on news articles are rather sad, angry souls who nobody else would want to talk to after five minutes).

Shepherd has recently written this piece on proposed new federal laws to deregister bogus medical treatments with the Australian Register of Therapeutic Goods. The opposition has provided in-principle support, which is great, as it might allow a smooth path to legislation in late June. However, if the opposition sniffs a vote in opposing it, there could be trouble. I’d like to keep an eye on this one.  She also wrote this interesting piece in early February, about setting up a quackometer-style website to expose medical frauds, though I felt a bit confused about how it might work, funding-wise, and I can’t quite believe that quack peddlers would fall into the trap of getting listed on such a site. They’re pretty canny operators.

Let’s look, though, at the proposed legislation and why the government’s trying to act. Shepherd quotes Dr Ken Harvey, of LaTrobe Uni, a public health advocate and campaigner against bogus treatments, as welcoming the move, but with warnings about loopholes and various ways and means for the companies pedalling these products to dodge regulators (and there’s considerable concern about the rise of ‘fatblaster’ products, where big money can be made, and where the claims made are pretty extraordinary). I haven’t kept up with these issues, but a bit of research into Dr Harvey reveals these treatment peddlars to be more than just sneaky. The director of a company called Sensaslim Australia Pty Ltd, manufacturers of a completely bogus ‘slimming spray’, tried to bring a lawsuit against Harvey for defamation, citing a ridiculous amount of money. The whole thing eventually collapsed as more of the company’s shonkiness was revealed, but not before having caused much distress to the doctor. Shades of the Simon Singh case. But this case and others have highlighted weaknesses in the way the Therapeutic Goods Administration deals with the ever-increasing number of dodgy cures in the market-place.

The Australian Register of Therapeutic Goods (ARTG), which comes under the Therapeutic Goods Administration (TGA), which in turn comes under the federal government’s Department of Health and Ageing, is a compulsory register for anyone wanting to sell therapeutic goods (defined on the TGA website) within Australia or for export. A click on the website tells me that some 25 products were registered yesterday (March 28), and if that’s an average day, that’s an awful lot of products – thousands per year. There’s a lot of info on the TGA website relating to counterfeit medicines and complementary medicines, a lot to get my little head around, but I note they have a two-tiered system in which a medicine or device has to be either registered or listed. Heavy-hitting stuff, including all prescription medicine, has to be registered, which means going through an assessment process for quality, safety and efficacy. Most OTC medicines have to be registered, as well as some complementary medicines, but within the registration process is another two-tiered system, ‘high risk’ and ‘low risk’. Clearly the more low-risk the treatment, the less it will be scrutinised, but this means that treatments which are ineffectual but without evident risk, such as homeopathy, irridology, reflexology and the like, get through the system with minimum if any scrutiny largely due to their inefficacy. They do no harm, so they’re ‘okay’. What needs to be strengthened is the scrutiny of goods that just don’t do what they claim to do. There also needs to be an active recognition that dodgy products are harmful precisely because of their false claims, so that unsuspecting consumers buy them instead of more genuine products. The new legislation will provide stiff penalties for false and misleading information, as well as deregistration, which in effect would be an official ban on sale. Does this mean homeopathy might be banned in Australia soon? Don’t hold your breath on that one. One way that the homeopathy industry flies under the radar is by avoiding claims on its labels, and relying on word-of-mouth and its reputation, especially among the ‘new age’ and generally disaffected-with-mainstream-medicine crowd, to maintain sales. My (minimal) research suggests that this ‘medicin douce’ is listed rather than registered, and the TGA probably doesn’t have the resources or teeth to verify low-risk listed products for efficacy.

However, there are other government agencies such as the ACCC (Australian Competition and Consumer Commission) and the NHMRC (National Health and Medical Research Council) ready to do their bit in protecting consumers. The NHMRC is currently reviewing the effectiveness of homeopathy in a systematic ‘review of reviews’, and will be asking for public feedback in mid 2013. This will be part of an overview of various CAM modalities, with a view to possible changes to the government rebate on private health insurance for natural therapies. Interesting, but with the slowness of this process, and the likely demise of this government come September, we can’t expect too much.