Field of Science

Save NIH $$$: eliminate “alternative” medicine

This past week, President Obama called on all federal agencies to voluntarily propose budget cuts of 5%. What, cut the science budget? Well, Mr. President, you might be surprised to learn that there's a way for you that cut the NIH budget without hurting biomedical research. In fact, it will help.

Here's my proposal: save over $240 million per year in the NIH budget by cutting all funding for NCCAM and OCCAM, the two centers that fund alternative medicine. NCCAM is the National Center for Complementary and Alternative Medicine, and OCCAM is the Office of Cancer Complementary and Alternative Medicine, and both of them exist primarily to promote pseudoscience. For the current year, NCCAM’s budget is $128.8 million, an amount that has rapidly grown from $2 million in 1992, despite the fact that not a single “alternative” therapy supported by NCCAM has proven beneficial to health. OCCAM’s budget was $121 million in 2008 (the latest I could find) and presumably higher in 2010. That’s over $240M, not counting money these programs got from the stimulus package (and yes, they did get some stimulus funding).

These two organizations use our tax dollars – and take money away from real biomedical research – to support some of the most laughably pseudoscientific claims that you can find. To take just one example, NCCAM has spent $3.1 million supporting studies of Reiki, an “energy healing” method. Energy healing is based on the unsupported claim that the human body is surrounded by an energy field, and that Reiki practitioners can manipulate this field to improve someone's health. Not surprisingly, the $3.1 million has so far failed to produce any evidence that Reiki works. But because there was never any evidence in the first place, we should never have spent precious research dollars looking into it.


In addition to funding pseudoscience, NCCAM also “educates” the public about alternative medicine. I put “educate” in quotes because much of what NCCAM has on its website is misinformation, which serves to mis-educate rather than to inform. For one example (and there are many), under homeopathy the website states that
“homeopathy is used for wellness and prevention and to treat many diseases and conditions.”
Note how carefully this is worded: homeopathy is "used for prevention", from which one might easily infer that homeopathy is effective. It is not.

NCCAM’s homeopathy page goes on to state that
“most analyses have concluded that there is little evidence to support homeopathy as an effective treatment for any specific condition; although, some studies have reported positive findings.”
Again, note the careful wording of that last phrase: strictly speaking, it is true, but let me state it a bit more accurately: “some poorly designed, poorly controlled studies with small patient groups, published in low-quality journals, have reported positive findings.”

Homeopathy is based on principals that scientists know to be false: for example, homeopaths believe that an active ingredient is stronger if there is less of it in a solution. In fact, the opposite is true. They also believe that solutions can be diluted infinitely and still retain their effectiveness. Even NCCAM admits that “its [homeopathy's] key concepts are not consistent with the current understanding of science, particularly chemistry and physics.” So why does NCCAM insist on maintaining misleading information on its website?

Getting rid of NCCAM and OCCAM won’t be easy. These “alt.med” agencies have grown at the direct behest of the U.S. Congress, particularly Sen. Tom Harkin, who is woefully misguided where science is concerned. Back in 1998, when previous NIH Director Harold Varmus tried to impose more scientific standards on the Office of Alternative Medicine, Harkin retaliated by elevating it to a Center (thus creating NCCAM) and dramatically increasing its budget. And just a year ago he scolded NCCAM because too many of the studies it funded were “disproving things rather than seeking out and approving” them. As Kimball Atwood pointed out, this comment illustrates rather starkly how that Sen. Harkin doesn't care what the science shows. Sen. Harkin, if the evidence says it doesn’t work, then it doesn’t.

I proposed eliminating NCCAM in Obama’s “Citizen’s Briefing Book” in early 2009, and it received thousands of positive votes, thanks in part to a boost from fellow blogger P.Z. Myers. My proposal was reported by the Washington Post too. But it was also subject to a broad attack by proponents of the supplement industry, who sent out a web alert to their minions and did their best to vote it down. Despite their efforts, the net vote was strongly positive. But like most (or all) of the suggestions in the Briefing Book, my proposal went nowhere.

For more details, see one of my previous blog posts on this proposal, or take a look at Steven Novella’s comments, or at David Gorski’s excellent argument against NCCAM here and here. I also liked the recent blog post by Barbara Drescher.

So, to Francis Collins (Director of NIH) and Kathleen Sibelius (Secretary of Health and Human Services, in which NIH resides), there you have it: an easy way to cut $250 million from the NIH budget. I know the total NIH budget is $30 billion, and this is only about 1%, but if you need suggestions for the other 4%, let me know.

5 comments:

  1. I think part of the problem is that the public doesn't get that science isn't just empirical studies of phenomena. Empirical results are of course important, but a solid theoretical basis is as well. If the supposed results can only be explained by what amounts to magic (as is the case for homeopathy and Reiki), this is an excellent reason to study something more plausible instead.

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  2. I'm wondering if Varmus is going to quietly champion -- if one can quietly champion something -- getting rid of NCCAM and OCCAM now that he's back working for the gov't.

    Also, how come I never noticed that the cancer alt med agency is called OCCAM? Ha!

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  3. I wory that if you get rid of it all together there will be less oversight over alternative medicine. The case I'm familiar with is St. Johns Wort(which is a proven herbal treatment for depression). St. Johns Wort is a powerful drug, yet it is sold over the counter. It has the same dangers as a normal antidepressant(people with bipolar dissorder, psychosis, or sleep disturbances may become manic, anxious, suicidal or psychotic well taking the drug). AKA, it's EXTREMELY dangerous. There needs to be research and oversight given to these alternative substances because they are potentially just as harmfull as their perscription counterparts.

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  4. Tim: you are right to be concerned about oversight, but NIH does not do oversight of drugs. That is the FDA's mandate. But unfortunately, supplements such as St. John's wort are treated differently from drugs, and are almost completely unregulated, even by the FDA, thanks to a federal law (DSHEA) that was passed years ago and that is fiercely protected by the supplements industry.

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  5. Steven:

    When there is a study with no statistical significance performed with Ebola, you publicize the study with the title:

    A breakthrough cure for Ebola.

    Now here's my question: if an alternative medical treatment were conducted and yielded results of effectiveness with NO statistical significance, would you say the following:

    Alternative Medicine Yields Breakthrough Cure.

    Isn't this a double standard?

    By the way, the general idea of homeopathy is not without support in conventional medicine.

    Vaccines use small doses of the infectious agent in order to prevent the full blown disease from occurring.

    I believe the same idea is used in some treatment of hyperactivity (ie the treatment of hyperactivity with a dose of a stimulant drug that would cause unnatural stimulation in a normal person).

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