WILL A CUP OF COW'S WHEY KEEP THE DOCTOR AWAY?
Senator Barbara A. Mikulski, a feisty Maryland Democrat, says acupuncture helps keep her spirited. Retired Iowa Representative Berkley W. Bedell claims a strange concoction of cow's whey cured his Lyme disease. His buddy, Senator Tom Harkin (D-Iowa), says bee-pollen pills are nothing to sneeze at: He popped as many as 250 to control his allergies. These endorsements--and Harkin's post as chairman of the Senate Appropriations health subcommittee--help explain why the government has pumped millions into research on what is politely called alternative medicine, from massage to prayer intervention.
But now the program that Harkin created--the National Institutes of Health's Office of Alternative Medicine (OAM)--is in a shambles. Its frustrated head, Dr. Joseph Jacobs, quit in September, charging that meddlesome members of Congress were more interested in getting unproven therapies shoveled out to the public than in putting the treatments through rigorous scientific review. On Dec. 7, the OAM's advisory board, which is filled with alternative-medicine advocates, will meet to chart a course for the office and narrow the list of 50 applicants for Jacobs' $125,000-a-year job.
"QUACKERY." With the GOP in control of Congress, Harkin's future clout will be reduced. But that doesn't mean alternative-medicine pork--$13 million for the OAM so far over two years--will be pared. Advocates are searching for new champions for prayer intervention to cure drug abuse and other treatments smirked at by the medical establishment. They are hoping these nostrums may appeal to some of the bedrock conservatives who are about to assume power. They support prayer in school, why not in drug treatment centers? What's more, alternative-medicine supporters want to cut the red tape for drug approval, which also would appeal to GOP leaders.
The key question, though, isn't whether the research should be funded, but whether unconventional remedies should meet traditional review standards. So far, critics say, the OAM has become a haven for crackpot ideas that don't pass muster for funding elsewhere at the NIH. Take the office's plans to help researchers investigate two risky cancer therapies that have been subject to federal probes or million-dollar malpractice awards (table). "It's so sad," says Grace Powers Monaco, founder of the Candlelighters Childhood Cancer Foundation, a nonprofit group in Washington. "They've veered into validating quackery."
Jacobs, who admirers say tried to make the office medically respectable, insisted that therapies be run through double-blind experiments and independently verified by other researchers. He encountered enough flack to force him out--and to prompt him to call for the office's abolition. "They wanted us to send staffers out and just say whether therapies worked or not," he says.
Harkin defends the office's mission. He notes that Americans shell out $10.8 billion annually on alternative medicine, so the NIH can devote a fraction of its $11.3 billion budget to see if the therapies work. "We're not trying to fleece the public," says one aide. "These therapies need to be investigated."
Alternative-medicine advocates dispute the idea that traditional testing requirements are necessary to show the remedies are valid. "The problem is [scientists] want you to do it the same way, with double-blind studies," says Bruce R. Brown, president of Phoenix-based CC Pollen Co. "That takes a heap of money and a lot of time. What you need to know is whether [the patient's] congestion clears up." CC Pollen, which made the pills Harkin used, was fined $200,000 last year by the Federal Trade Commission for making false claims about the effects of its bee pollen. Brown says that underscores the problem with marketing alternative therapies. "They want you to get a drug license," he says. "Who can afford to do that?"
CRONIES WITH CLOUT. So far, politics, not science, seems to have won this debate. Jacobs says Harkin's cronies used their clout with the senator to run the office. Last year, the Iowa Democrat hauled Jacobs before a hearing and threatened to use "the power of the purse" if the OAM chief didn't step up field investigations. Harkin says he was safeguarding taxpayers' dollars because Jacobs had yet to hire even one investigator. "More than two years after the office has been in existence, there is still no long-term plan," the senator gripes.
One potential compromise would be to continue to fund the research, but through other NIH units. In fact, the NIH has already spent about $13 million to look at nonconventional treatments. The NIH's National Cancer Institute, for instance, could expand its ongoing work and investigate whether a macrobiotic diet might help cure cancer. This approach would subject such treatments to normal standards of scientific scrutiny. If the new congressional leadership keeps the OAM open instead, it could be a sign that in Washington, it's still business as usual.
TWO RISKY THERAPIES IN REVIEW
ANTINEOPLASTON Houston physician Stanislaw Burzynski, who has been investigated by regulators for selling unapproved drugs, uses man-made amino acids mimicking those found in human urine to treat cancer. Critics say no independent studies have confirmed his findings.
THE REVICI METHOD Emanuel Revici, a 98-year-old New York doctor, administers mineral compounds to treat cancerous tumors. Critics say he does little more than monitor urine output to evaluate his treatment. The doctor has been slapped with two medical malpractice awards totaling nearly $2 million. Both have been overturned on appeal because of improper jury instructions.
DATA: NATIONAL INSTITUTES OF HEALTHMary Beth Regan in Washington