The ongoing problem with the National Center for Complementary and Alternative Medicine: in spite of statements to the contrary by its director, the NCCAM continues to fund and promote pseudoscience. Political pressures and the Center's charter would seem to make this inevitable. Ethics and the public interest are compromised

The National Center for Complementary and Alternative Medicine (NCCAM) was established in 1998, seven years after the creation of its predecessor, the Office of Alternative Medicine (OAM). The OAM had been formed not because of any medical or scientific need, but because Iowa senator Tom Harkin and former Iowa representative Berkeley Bedell believed in implausible health claims as a result of their own experiences. Bedell thought that "Naessens Serum" had cured his prostate cancer and that cow colostrum had cured his Lyme disease (Jarvis 1996). He recommended "alternative medicine" to his friend Harkin, who subsequently came to believe that bee pollen had cured his hay fever (Marshall 1994).

Political wrangling, but little science, marked the history of the organization throughout the 1990s (Gorski 2001). Although the OAM was officially a part of the National Institutes of Health (NIH), it was managed more by "Harkinites" than by scientists (Marshall 1994; Satel and Taranto 1996). Science magazine recounted a 1993 congressional hearing held by Harkin, with Bedell as a witness:

   NIH, Bedell said, should hire staffers to locate anyone who
   claims to have a successful therapy, search the files, and "just
   simply find out whether what he claims is correct."

   [Subsequent to the heating] Bedell brushed aside questions about
   how his field studies could be designed to avoid bias. This is a
   technical detail, Bedell said, and "I'm not a scientist." But he
   insisted at the hearing--and still insists that field studies can be
   done quickly and easily, without fancy statistics or double-blinded
   controls (Marshall 1994).

The creation of the NCCAM as an "NIH Center" in 1998, followed by the appointment of Stephen Straus as its director in 1999, marked a noticeable change. Straus is the first director of the OAM/NCCAM to have legitimate qualifications as a biomedical scientist. He promised "to explore CAM healing practices in the context of rigorous science, to educate and train CAM researchers and to disseminate authoritative information about CAM to the public" (Straus 1999). Three years later he felt confident enough to tell The Scientist, regarding scientific opinions of the NCCAM, "I think there's very little skepticism left" (Russo and Maher 2002).

This article argues that in spite of Dr. Straus's convictions, the NCCAM continues to be committed more to pseudoscience and CAM advocacy than to rigorous science.

Pointless Research and Dangerous Promotions

Director Straus, referring to NCCAM-sponsored research, recently wrote, "Some people believe that any such undertaking is a pointless exercise" (Straus 2002). That is correct, and some of the reasons for this were evident in his short article. He noted that the herbal mixture PC-SPES was recently found to be adulterated by prescription drugs. He did not mention that when this adulteration was discovered, the NCCAM had been sponsoring four studies of PC-SPES. The studies had been justified by preliminary data suggesting that PC-SPES may be effective for the treatment of prostate cancer. That effect, however, has now been explained by the presence of diethylstilbestrol and indomethacin (Sovak et al. 2002). Nevertheless, after a brief pause the NCCAM intends to resume three of the studies "because of the promising data from the early studies of PC SPES" (NCCAM Web site 2002a).

Straus warned of "some herbal medicines ... that interfere with the metabolism of drugs used to treat cancer or AIDS" (Straus 2002). By this he meant, mainly, St. John's wort. But St. John's wort has for years been recommended as a treatment for the HIV by the naturopathic Bastyr University AIDS Research Center, funded by the OAM/NCCAM since 1994 (BUARC Web site 2002). The Bastyr Web site does not mention the danger of mixing St. John's wort with HIV protease inhibitors, although that fact had been known since 2000 (Piscitelli et al. 2000). How many people carrying the HIV may have developed AIDS or relapses because of such promotion is a mystery, but there is no indication that anyone at Bastyr or the NCCAM is wondering.

The director of the Bastyr University AIDS Research Center is naturopath Leanna Standish. She was a member of the NCCAM advisory council from 1999-2001. She is the Principal Investigator of an NCCAM-sponsored clinical trial to study "Garlic in hyperlipidemia caused by HAART [highly active anti-retroviral therapy]." But garlic is another substance that reduces blood levels of lifesaving HAART agents (Piscitelli et al. 2002), a fact that is mentioned in neither the NCCAM nor the Bastyr descriptions of the trial.

Standish is the lead author of a chapter in the major textbook of naturopathy that recommends more than 100 "therapeutic suggestions" for HIV infection and its complications (Standish et al. 1999). The authors state that these treatments constitute "comprehensive care that is concordant with several naturopathic principles" and that the program is being studied "through a three-year cooperative agreement grant with the NIH's Office of Alternative Medicine" (now the NCCAM). In addition to St. John's wort and garlic, some of the recommended treatments are "acupuncture detoxification auricular program," whole-body hyperthermia, "adrenal glandular," homeopathy, "cranioelectrical stimulation," digestive enzymes, and colloidal silver, a toxic heavy metal that the FDA has declared useless for any medicinal purpose.