CFI and its affiliate, the Committee for Skeptical Inquiry (CSI), issued a statement last week criticizing Walmart for its marketing of a homeopathic “medicine” called oscillococcinum, manufactured by a French company, Boiron. Walmart markets this product as a flu remedy. The statement, which was endorsed by a number of experts (scientists and physicians), pointed out that there is no credible scientific evidence to support the claims Walmart makes for this product. Oscillococcinum is ineffective against flu and flu symptoms—apart from what may be expected from the placebo effect.
After we issued our statement, we received a couple dozen e-mails. Many individuals thanked us for taking a stand. Others, however, questioned whether this issue was beyond CFI’s purview. Also, some argued we should let market forces prevail and not interfere with Walmart’s marketing of this product. Finally, a few vouched for the effectiveness of oscilloccinum.
I thought it would be worthwhile to address some of these objections briefly. This may also give our supporters a better idea of what we are trying to accomplish with the statement.
CFI and Critical Thinking
CFI promotes critical thinking and evidence-based reasoning. Although we are perhaps best known for our work in the area of critical examination of religion, we also examine claims made in other areas, in particular, claims that may be classified as fringe science. These are claims that are not accepted by most scientists, principally because the claims have not been subjected to scientific testing or testing has not substantiated the claims. This includes claims in the area of alternative medicine.
In fact, CSI—the CFI affiliate focusing on fringe science—has a well-earned reputation for careful investigation and analysis of fringe science claims. To many of us at CFI, this work is as important as our work on the examination of religious claims. Mysticism and fallacious reasoning should be rejected for all issues, whether the claim relates to a communion wafer that has a body that isn’t there or a drug that has an active ingredient that isn’t there. .
Many are familiar with the “theory” behind homeopathic medicine, but some may not be, so here is a quick summary: Homeopathy originated in the 18th century with the notion that small doses of substances that cause disease can actually help to remedy the disease in a sick person. This core notion is on its face problematic, to put it mildly, although the notion of “like cures like” is reflected in folk remedies, such as hangover cures. But homeopathy goes further by maintaining that the smaller the dose, the more powerful and effective the medicine. The so-called active ingredient in homeopathic medicine has actually been diluted many times over so that there is rarely ever a physically detectable trace of the ingredient remaining in the finished product. Although duck liver and heart are listed on Boiron’s box of oscillococcinum as the medicine’s active ingredients, they are in a “200CK” preparation, which effectively means the active ingredients have been diluted to the point of extinction (1/100 of a part diluted 200 times over, or .01 to the 200th power). As a result, leaving aside the fact that duck heart and liver have no apparent connection to relief of flu symptoms, no trace of these substances remains in the box of oscillococcinum you purchase. What Hobbes said about the Catholic doctrine of the Eucharist can be applied to homeopathy: it combines both magic and lying. The communion wafer is supposed to be magically transformed into the body of Jesus, but it has no molecule of the body of Jesus in it; similarly, homeopathy promises some magical formula, but then provides you with a box without the magic ingredient.
Homeopathy has an “explanation,” however. The diluted substances leave behind a spirit-like trace that brings about the desired effect. Of course, this trace cannot be detected by the senses or standard scientific equipment.
No homeopathic treatment has ever been shown to be effective in standard, placebo-controlled clinical trials. So there are no scientific studies to support its claims. Moreover, if homeopathy were to be true, it would work a revolution in biochemistry, causing us to discard mountains of evidence and basic scientific notions. There is not a single verified example of a substance that causes effect X becoming more effective in causing X the more diluted it becomes. Yet, to accept homeopathy, this is what we have to believe.
And what of the people who claim they feel better after they have taken a dose of a homeopathic product? Some of them undoubtedly do feel better. The placebo effect can account for this. It has nothing to do with the effectiveness of the product. Similarly, for any disease, there are people at either end of the spectrum who do much better (or much worse) than others. A case of the flu typically results in 3-4 days of fever and 2-3 weeks of recovery. But some people take much less time and may be bouncing back in a couple of days, regardless of what they take. This is why anecdotal evidence is scientifically unreliable. The only way to determine the effectiveness of drugs is through controlled clinical trials and, as indicated, homeopathic remedies fail miserably in such trials.
So Why Doesn’t the FDA Do Something?
The Food and Drug Administration has the authority to regulate homeopathic products, but it hardly ever does so. Pursuant to its own enforcement guidance, it has decided that because homoeopathic products contain nothing active, they can do no direct harm, so the agency concentrates its resources on other problems. In other words, precisely because homeopathic products have nothing in them (other than simple additives, such as sucrose), from a toxicity control standpoint they have low priority.
Nonetheless, the FDA has from time-to-time has issued warnings to some retailers to stop marketing homeopathic products that claim to remedy specific diseases, such as the flu. Indeed, during the 2009 H1N1 (swine flu) scare, the FDA issued a warning letter to one web-based retailer that directed the retailer to stop marketing oscillococcinum as a flu remedy. The rationale was that a public health emergency existed, and ineffective flu remedies should not be marketed under those conditions
CFI believes ineffective flu remedies should not be marketed at any time. An ineffective product often does cause harm by being taken in place of an effective remedy. Moreover, the fact is that millions of people are getting defrauded out of their money.
Can’t the Market Take Care of This?
No. For a market to work properly, buyers must have access to accurate, relevant information. But, as indicated, oscillococcinum is not sold as “Sugar water that probably doesn’t contain a physical trace of the listed active ingredient, and has not been shown to be effective to alleviate symptoms of any disease in controlled clinical trials.” It is marketed as flu remedy, and the FDA is unwilling, most of the time, to exercise its authority to protect consumers from this fraud.
Just because the FDA does not always exercise its authority to keep oscillococcinum and other homeopathic junk from being marketed as effective remedies, does not imply that retailers do not have an obligation to act responsibly—especially as they are aware that the FDA has found oscillococcinum is not effect
ive against the flu.
Of course, other retailers besides Walmart sell homeopathic hokum, including “natural” food stores such as Whole Foods. But Walmart is the leading retailer in the world, with over $400 billion annually in sales. We believe with greater power comes greater responsibility. Walmart is not some corner drugstore that depends for its existence on the sale of homeopathic products to the gullible. Walmart could easily stop selling homeopathic products without even causing a ripple (or a homoeopathic “trace”) in its sales figures. Furthermore, Walmart boasts about its corporate ethics and its concern for its customers. Those boasts seem misplaced when Walmart uses misleading advertising to persuade ailing customers who need real help to buy useless junk instead. Walmart is treating its loyal customers as marks, who can be exploited when they are most vulnerable. We call upon Walmart to set an example for other retailers: Stop marketing oscillococcinum as a flu remedy.
To help Walmart discern the proper course of action, we will begin gathering other signatories to the statement issued by CFI/CSI, and we will make us of other persuasive techniques. Stay tuned.