Thursday, July 16, 2009

Consumers' Action for Empowerment: Make prices of medicine affordable now!

Consumers' Action for Empowerment: Make prices of medicine affordable now!

The government should compel multinational pharmaceutical corporations to make their prices affordable for Filipinos instead of giving them the option of voluntary compliance, says consumer group, Consumers' Action for Empowerment.

Launched in February 20, 2009, the group is composed of over a hundred members from different Metro Manila-based religious institutions, health professional organizations, community-based health programs, and people's organizations.

Eleanor Nolasco, RN, one of Consumers' Action for Empowerment conveners said that Mrs. Arroyo's obvious hesitance in giving relief to millions of poor and ailing Filipinos only goes to show her utter subservience to the interests of transnational corporations.

Last July 8, 2009, pharma industry giants Pfizer, Wyeth, Roche, and Sanofi sought an audience with Mrs. Arroyo in Malacanang. Others present were representatives from Pharmaceutical and Healthcare Association of the Philippines (PHAP), Philippine International Trading Corporation (PITC), Department of Trade and Industry (DTI), and Department of Health (DOH). The meeting tackled concerns of the industry's big players on the imposition of a Maximum Drug Retail Price (MDRP). Their basic position is to allow market forces and competition to decide drug prices, instead of the government setting a ceiling.

“For decades, many poor people have suffered and died because they cannot buy exorbitantly-priced medicine. The billions of profit that they have amassed after decades of control on medicine prices should be enough for them to consider the poor's sake this time,” said Nolasco.

She also assailed Mrs. Arroyo's indecisiveness in standing behind the people's right to low-cost and effective medicine by exercising her executive prerogative to impose MDRP on essential medicines. “Why should she provide a 10-day window period for these profit-driven companies to decide on voluntary compliance? If the president of the Republic of the Philippines is genuinely sincere in lowering medicine retail prices, she should demand and not appeal to these companies to substantially slash their prices to even lower than 50%.”

Furthermore, the convener said, for every single day that Mrs. Arroyo hesitates to put her foot down on making essential medicine accessible, the thousands of Filipinos, barely on survival income, are further deprived of money they could have used to buy food and other necessities.

Meanwhile, Nolasco bashed Pfizer's discount card offer to DOH amounting to P100 million saying the attempt is tantamount to bribery. She challenged Pfizer's recent open letter addressed to the Filipino people, “if Pfizer indeed has 'absolute commitment to the people of the Philippines to do what's right legally and ethically', why don't they just slash their prices and let all patients benefit from their medicines at a lower cost instead of just limiting the discounts to 1.8 million Sulit Card holders.”

Nolasco stressed that the public should not be misled into believing that the pending executive order on Maximum Drug Retail Price will be the end to decades of stranglehold by multinational companies of the local drug industry. “While the MDRP is a welcome step towards regulating medicine prices, a short-term Drug Price Regulatory Board represented by different stakeholders should be in place.”

She added that a crucial element in making essential medicines accessible to the people is the development of a self-reliant national drug industry that is responsive to the health needs of the Filipinos. “The government should provide incentives to the industry's small local players such as tax holidays and exemptions as well as lower fees on different BFAD requirements,” she said.

“One year has passed but RA 9502 failed to keep its promise of making essential medicines accessible to the people. The law failed primarily because it does not have any provision which removes the control and influence of foreign pharmaceutical companies on all aspects of the industry. These giant companies are not expected to just give up their control over the market from where they rake in huge profits. Hence, the Filipino people should remain ever vigilant and expose possible illicit relationships and sweetheart deals struck between these pharmaceutical companies and willing locals.”

“The need of Filipinos for efficacious and affordable essential medicines can only be met when a strong national healthcare system is in place and under a government whose policies are in the best interest of its people,” she concluded.

Reference:

CONSUMERS' ACTION FOR EMPOWERMENT

#35 Examiner Street, West Triangle, Quezon City, Philippines 1104
Telefax: 929-8109

Eleanor Nolasco, RN
Convener, Consumers' Action for Empowerment
0905 325 5223

Sunday, July 5, 2009

CHD to DOH: reach out to the grassroots

On July 1, 2009, the Department of Health (DOH) posted in its website that it is “further bolstering its mitigation efforts against Influenza A(H1N1) in light of the anticipated rise of cases in the country.” Moreover,the posting said that “This is in accordance with the directives of President Gloria-Macapagal Arroyo last week to prepare well-equipped isolation wards in all state-run hospitals throughout the country.”

Sadly, this pronouncement on the so-called bolstering of efforts against the disease was done 1,709 cases later.

Influenza A(H1N1) has already caused panic and hysteria among the general public. In fact, via constant media exposure and cases countdowns, DOH Secretary Francisco Duque III fueled more the public panic.

It can be remembered that during the first weeks of the disease in the country, the DOH poured a considerable amount of taxpayers' money on paid advertisements instead of using its resources on exhausting all means to educate people in the communities and taking first steps in preventing the outbreak. At that point, A(H1N1) was infective but not severe.

How the DOH and the government as a whole act now is not very surprising though. It has always been reactive in dealing with disease outbreaks while existing communicable but preventable diseases continue to cause fatality all over the country.

For instance, the number of dengue fever cases reaches thousands and its death toll reach hundreds yearly including those among very young children. From January to May this year, DOH reported 6, 537 cases of dengue.

In the National Capital Region, there have been 463 cases recorded in Manila and Quezon City alone. In the cities of Cebu and Santiago, there were 296 and 200 cases respectively. Meanwhile, 62 persons have already died of dengue in the country this year.

According to the World Health Organization’s (WHO’s) Global TB Report 2008, the Philippines ranks ninth on the list of 22 high-burden tuberculosis (TB) countries in the world. TB is the sixth greatest cause of morbidity and mortality in the country, the report stipulated. The country’s current ranking translates to some 250,000 Filipinos being infected with TB annually and 75 patients dying everyday from the disease.

As an agency existing to care for the health of the people, it should go beyond press conferences and media advertisements that are rather superficial. It should directly go to the communities and launch conduct massive health education drives in which people would know and understand A(H1N1) comprehensively alongside other health issues existing.

However, this is not a question that DOH must answer alone but a responsibility of the entire government.

But most importantly, the socio-economic needs of the people must first be met to ensure that families and individuals have the capacity to provide for their basic needs. Specifically, workers need jobs that will provide a liveable income and peasants need land which they can cultivate and get enough produce to meet their basic needs.

How can one prevent A(H1N1) disease through proper nutrition at these situations? While the best way to prevent acquiring the flu is by building up body resistance, how can poor Filipino families, who hardly have anything to eat, go by that DOH prescription?

It has been long overdue for the Arroyo administration to rethink the policies and programs it has implemented. The government should focus its attention in creating policies and programs that will prevent, manage and control diseases instead of merely implementing knee-jerk responses and stop-gap measures. Instead of reinventing the wheel in responding to outbreaks, why not come up with a sustainable and comprehensive plan that will truly address people's vulnerability to diseases?

The state should come up with a program that will genuinely address people's health. It is only through a sound health care system that the people can be armed with resistance and proper nutrition against whatever disease outbreaks that may come along.###

Thursday, July 2, 2009

Consumers' Action for Empowerment stage protest “people's verdict: cheaper med law is a failure”

Different organizations under Consumers' Action for Empowerment (Consumers' Action) staged “Hatol ng Bayan: Bigo ang Cheaper Medicine Law” (People's Verdict: Cheaper Medicine Law is a Failure), a street protest in Mendiola, Manila last June 5, 2008.

It was the eve of the first year of enactment of “The Universally Accessible Cheaper and Quality Medicines Act of 2008,” or Republic Act 9502 more popularly known as the cheaper medicine law, one of Mrs. Gloria Macapagal-Arroyo's centerpiece programs, which promised to bring prices of medicine down.

The protest aimed to deliver to Malacanang palace the people's verdict on the law. For Consumers' Action, RA 9502, enacted on June 6, 2008 failed because it does not have provisions that address the very reasons why the prices of medicine in the country are high.

Continuing monopoly

According to Dr. Julie Caguiat, one of the conveners of Consumers' Action, the law does not remove monopoly control of transnational corporations (TNCs) in the drug industry and neither does it contain provision for the development of a local drug industry.

Estimates put the share of TNCs in the Philippines from 68 to 72 percent in sales of medicines and pharmaceuticals alone. Last year, pharmaceutical sales in the country amounted to P116 billion.

Caguiat added that although between 80 and 90 percent of essential drugs being sold in the Philippines are no longer patented, the law did not provide for the development of a sound local drug industry that could have taken advantage of the fact that previously patented medicines can now be developed by local manufacturers.

Consumers' Action also criticized the policy of dependence being fostered by RA 9502, which gave particular focus on drug importation, including parallel importation. A parallel import is a non-counterfeit product imported from another country without securing the permission of the intellectual property owner. Parallel importation can eventually kill what remains of the local drug industry in the Philippines.

Moreover, Caguiat said that RA 9502 did not create a price regulatory board that could usher the democratic representation of consumers and other sectors in the market.

Eleanor Nolasco of the Health Action Information Network (HAIN) briefly presented the result of their study on the implementation of the law. Sadly, the study found no significant decrease on the prices of essential medicine in the country after one year.

Subservience to WTO

Dr. Gene Nisperos of Health Alliance for Democracy (HEAD) on the other hand, denounced the role of World Trade Organization (WTO) and its policies on health in the current health system of the country.

Under the WTO-Trade Related Aspects of Intellectual Property Rights Agreement (WTO-TRIPS), patent holders have the right to exclusively manufacture, use and dictate the selling price of a patented medicine. In the Philippine drug market, more than 70% of the manufacturers are TNCs.

Nisperos also pointed out Macapagal-Arroyo's regime as responsible for the worsening of the Philippine health situation, with her lack of genuine concern to the basic needs of the majority of the Filipinos.

On top of the government's subservience to WTO-influenced policies, it also failed to develop a self-reliant national drug industry that is responsive to the health needs of the people. There is also no government support for local drug manufacturers in terms of tax holidays and research and development subsidies.

Disappointed

Juanito Torres, a patient at the Tala Leprosarium in Manila and current president of Tala Hansenites Council, shared that leprosy patients including him, have experienced being given low-quality medicine for their ailments. Specifically, Torres pointed out that there was a time they were given antibiotics that was made of gaw-gaw, a local starch.

However, Torres said they did not have a choice because they could not afford to buy their own medicine because of its sky-rocketing prices. He added that they are disappointed with the cheaper medicine law because “isang taon na mula noong isabatas ang cheaper medicine law pero sobrang taas pa rin ang presyo ng mga gamot,” (a year have passed and prices of medicine remain very high). Torres spoke for thousands of patients who waited in vain for a substantive decrease in prices of life saving pills.

Creative protest

Amid rain showers, a dramatic presentation in a form of a street play in different frames was performed by the members of Kilos Bayan para sa Kalusugan (KBK / People's Action for Health).

The protest action was successfully and peacefully held.

Aside from HEAD, KBK, TALA Hansenites and HAIN, the Alliance for Health Workers (AHW), Community Medicine Development Foundation (COMMED), Health Alliance for Human Rights (HAHR), Health Students' Action (HSA), Bayan Muna Partylist and Council for Health and Development (CHD) joined the protest action.

Launched on February 20, 2009 the Consumers' Action also aims to monitor the prices, efficacy and quality of essential medicines in the market, launch educational discussions on the issue of high cost of medicines and push for the implementation of the Generics Law and National Drugs Policy.

For the group, access to essential medicines is part of a people’s inherent right to health. The need of Filipinos for efficacious and affordable medicines can only be met when a strong national health care system is in place and under a government whose policies are for the best interest of its people.#

Wednesday, June 10, 2009

Poor and Sick Filipinos Pay Dearly for Failure of Cheaper-Medicines Law

By MARYA SALAMAT
Bulatlat


MANILA — A law that was supposed to provide cheaper and quality medicines to Filipinos has failed to deliver on its promise — a promise that was hamstrung by the law’s own defects and the seeming inability of the government to muster the political will to go against transnational drug companies, according to health and consumer advocates.

Called “The Universally Accessible Cheaper and Quality Medicines Act of 2008,” or Republic Act 9502, the law sought to correct what many called a scandalous anomaly in a poor country like the Philippines, where medicines and drugs are among the most expensive in Asia.

The law “proved to be irrelevant and useless,” said Dr. Gene Nisperos, vice-chairman of the Health Alliance for Democracy (HEAD) in a conference last week. “In hospitals, whether private or public, prices of medicine have not changed with this law,” he said.

Because of its many flaws, RA 9502 has failed to bring down the “inhumane” prices of drugs and medicines, said the Consumers’ Action for Empowerment (CAE).

Amid the usual finger-pointing and bickering, the CAE said that the Department of Health (DOH) isn’t the only party accountable for the failure. “Although we’re in agreement that the Senate and other government fora should take the DOH to task for its failure in implementing the law, we’ve been saying that the law itself has inherent flaws,” Nisperos said.

TNC Control

The consumer group traces the uselessness of the law largely to its failure to break “the control of transnational corporations on all aspects of the [drug] industry.” Estimates put the share of transnational companies in sales alone of medicines and pharmaceuticals in the Philippines from 68 to 72 percent. Last year, pharmaceutical sales in the country amounted to P116 billion.

Health and consumer advocates protesting the high price of medicine. (Photo by Marya Salamat / bulatlat.com)

According to the group, RA 9502, signed by President Arroyo on June 6, 2008, also failed because, although between 80 and 90 percent of essential drugs being sold in the Philippines are no longer patented, the law did not provide for the development of a sound local drug industry that could have taken advantage of the fact that previously patented medicines can now be developed by local manufacturers.

CAE criticized the policy of dependence being fostered by RA 9502, which gives particular focus on drug importation, including parallel importation.

While it would seem that consumers can benefit from parallel importation, it actually discourages the development of the local drug industry. In fact, RA 9502 has not shown any support to local manufacturers, said Eleanor Nolasco of Health Action Information Network (HAIN). Eventually, it will kill the Philippine pharmaceutical industry, she said.

Moreover, the law failed to make sure that parallel importation, such as it is, will redound to the benefit of poor Filipinos.

Parallel Importation

Under parallel importation, the same drug that is manufactured and priced high in the Philippines can be imported – with or without the consent of the patent owner — from another country and sold here for prices that are several times lower than the ones produced locally. This is a method that transnational drug companies like Pfizer oppose because it obviously cuts their profits in countries where drugs are expensive, like the Philippines.

At first glance, parallel importation seems beneficial to consumers. But, according to the health-advocacy group KilosBayan Para sa Kalusugan, this is not necessarily true.

According to the Philippine International Trading Corporation (PITC), the trading and importing arm of the government, drugs that can be imported from India or Pakistan can be sold at half the price in local pharmacies.

But KilosBayan, in a primer, said these imported drugs can be sold at a much lower price. It cited Ponstan (mefenamic acid), which can be bought in India for the equivalent of P2.58 and in Pakistan P1.29. And yet, the same pain killer is sold for P11.25 in the 10,000 or so Botika ng Barangay outlets set up by the Arroyo administration, which promised half-priced medicines. Ponstan is sold for P25 pesos in commercial pharmacies.

“Why set the reduction of prices at just half of commercial prices when this could be lowered even more?” KilosBayan asked in its primer, citing the prices in India and Pakistan.

KilosBayan said parallel importation has not been maximized to the advantage of consumers. In fact, according to the Council for Health and Development, a health NGO, “the provisions on parallel importation bear no significant impact on the prices of medicines because even before the passage of the law, parallel importation is utilized by the government in its Botika ng Barangay program.”

Besides, the government only allots P1 billion for parallel importation — in an industry that is worth P100 billion.

Drug Cartel

Another major factor why the cheaper-medicine law failed to make a dent on the high cost of drugs and medicines is the fact that, according to data from the PITC, 80 percent of drugs being manufactured for multinational corporations is done by one company. Moreover, as much as 70 percent of wholesale distribution is handled by a sister company.

In the end, according to CHD, “more than 60 percent of the retailing of finished products is sold through Mercury Drug, which has more than 600 outlets nationwide.”

In other words, there’s an existing cartel of drug manufacturers and distributors that continue to dominate the market despite RA 9502. Indeed, one of the law’s biggest defects is it did not provide for the creation of a regulatory board for drug prices – a board that could have broken the stranglehold of this cartel — despite the strong clamor and recommendation of health-sector representatives and people’s organizations during public hearings when the law was still being crafted.

As a result, the law squandered an opportunity to ensure the democratic representation of consumers and other stakeholders that could ensure that the law’s intent is followed.

Currently, the task of monitoring medicines being sold in the country is with the Bureau of Food and Drugs, an agency under the DOH that progressive health-sector representatives consider as weak.

And to think that RA 9502 gives President Arroyo the power to impose price caps on the retail prices of drugs and medicines. She never exercised that power.

In fact, on the first anniversary of RA 9052, leaders of the Pharmaceutical and Healthcare Association of the Philippines (PHAP) were personally thanking President Arroyo for the government’s support in ensuring that their business would remain “viable.”

PHAP executive director Reiner W. Gloor thanked President Arroyo for assuring them that “we religiously implement laws that uphold patent protection.” PHAP, an industry lobby group, is largely composed of multinational drug manufacturers and providers of most of the country’s patented medicines.

Generic Drugs

The domination of the local drug industry by TNCs also has an impact on the affordability of medicines and on the campaign to lower prices through the prescription of generic drugs. Because not all drugs and medicines have their respective generic counterpart, the situation becomes even dire.

According to CHD, there are some 600 drugs in the Philippines that are considered essential. But of this number, only 200 are made by Philippine companies. The other 400 off-patent drugs do not have local generic counterparts and are thus dependent on importation, CHD said.

This partly explains why the use of generic drugs is low in the Philippines. In 2006, for instance, generic drugs account for only five percent of medicines sold locally. Compare that to the 50 percent generic-drug use in the United States.

Token Legislation

Although the intent of RA 9502 is to address the problem of expensive medicines, it became an example of token legislation because it did not support the local drug industry and enable the health sector to monitor its own pharmaceutical policy. This much is clearer among the growing number of young health workers.

In a rally by nurses demanding an increased in their entry-level salary grade, the health workers criticized the government’s disproportionate response to the AH1N1 or swine flu epidemic. According to them, other diseases that are much more common and much deadlier – such as tuberculosis or diarrhea — have largely been ignored.

“Despite the so-called cheaper-medicines law, we haven’t brought down the incidences of poverty-related diseases. Instead, morbidity and mortality rates have even increased,” Nolasco, of HAIN, said. For one, there’s still widespread malnutrition. “It’s not only fatal, it can also cause learning difficulties and disabilities,” Nolasco pointed out.

To this day, Nolasco added, diarrhea still kills; cholera has returned; pneumonia, broncho-pneumonia, and other illnesses that were supposedly controlled years ago are manifesting again. There is also a resurgence of malaria and dengue cases, she said.

Apart from rising death rates due to poverty-related diseases, or diseases that sprung and became fatal because of lack of proper nutrition and sanitation, among others, Nisperos of HEAD also cited the impact of the law on the second biggest health problem of Filipinos — chronic diseases such as hypertension. “If you are stricken with it, you’re forced to be under medication for the rest of your life.”

Without discounting the number of the dying, Nisperos called attention to the growing number of people who can’t function well because of their failure to acquire medicines for their chronic illnesses. “We’ve been saying for a long time — our peoples’ inability to access their needed medicines don’t just result in many untimely deaths, it also results in many suffering pain instead of becoming healthy, productive citizens.” There are more people, Nisperos said, “whose illnesses get worse because they can’t buy the medication they regularly need.”

And being a member of PhilHealth won’t help either, Nisperos said. “Further illustrating the inutility of the cheaper-medicine law, it didn’t even get PhilHealth’s cooperation, as PhilHealth doesn’t cover medicines for chronic diseases such as hypertension, diabetes, and heart ailments.

RA 9502, in other words, “has absolutely no impact on health services,” Nisperos said. (Bulatlat.com) [1]

Article printed from Bulatlat: http://www.bulatlat.com/main

Monday, May 4, 2009

CHD to Dep-ed noodle scam: shameful project

The Council for Health and Development (CHD) tagged DepEd’s noodle scam as “deceitful and scandalous” in a statement today.

CHD, a national consortium of more than 50 community-based health programs in the Philippines, scored the Department of Education’s recent distribution of 19,418,880 packs of instant noodles to more than 19 million public school children in the country.

In a statement, CHD Executive Director Eleanor A. Jara, M.D. said that “the millions of pesos spent by the government through DepEd to buy overpriced noodles for its so-called Food for the School program that aims to give proper nutrition to school children is an artificial and stop-gap measure to mask the problem behind a starving nation.

She further stated that many people question the true nutritional value of instant noodles including those that were distributed to public school children.

“Despite their companies’ aggressive marketing of instant noodles, the product is believed to contain far less nutrition than it actually claims. Natural food with high nutritional value remains to be the best source of proper nutrition. Sadly though, millions of Filipinos do not earn enough to buy adequate food,” she added.

Dr. Jara expressed that instead of nutrition, DepEd’s noodles gave those children and their families false hopes that the government is actually doing something for the children. She tagged the instant-noodle-program as “a deceitful and shameful show.”

“On hindsight, the more than P400 million spent to purchase a single measly meal will never give more than 19 million public school children brighter minds but will probably fatten the pockets of corrupt officials involved in the transaction,” she explained.

In their statement, CHD contends that if the government has sincere intentions of helping impoverished school children achieve better nutrition for better minds, it should look into the real circumstances that deprive these children of a balanced and healthful diet.

Moreover, they said that it is very likely that these children come from families who live on a hand-to-mouth existence and whose parents are jobless or underemployed. Hence, the only means to address undernourishment in schoolchildren is to provide their families jobs with livable income and access to basic social services.

Dr. Jara said that DepEd should rethink their feeding program. Instead of spending hundreds of millions for what appears now to be a shameful crime, it should focus on addressing the root causes of nutrition deficiency among public school children.

Lastly, CHD challenges this land’s lawmakers to seriously look into this scandalous project that is a threat to our children’s future.

Sunday, May 3, 2009

CHD says Dep-ed scam shameful

Council for Health and Development (CHD) tagged DepEd’s noodle scam as “deceitful and scandalous” in a statement today.

CHD, a national consortium of more than 50 community-based health programs in the Philippines, scored the Department of Education’s recent distribution of 19,418,880 packs of instant noodles to more than 19 million public school children in the country.

In a statement, CHD Executive Director Eleanor A. Jara, M.D. said that “the millions of pesos spent by the government through DepEd to buy overpriced noodles for its so-called Food for the School program that aims to give proper nutrition to school children is an artificial and stop-gap measure to mask the problem behind a starving nation.

She further stated that many people question the true nutritional value of instant noodles including those that were distributed to public school children. “Despite their companies’ aggressive marketing of instant noodles, the product is believed to contain far less nutrition than it actually claims. Natural food with high nutritional value remains to be the best source of proper nutrition. Sadly though, millions of Filipinos do not earn enough to buy adequate food,” she added.

Dr. Jara expressed that instead of nutrition, DepEd’s noodles gave those children and their families false hopes that the government is actually doing something for the children. She tagged the instant-noodle-program as “a deceitful and shameful show.”

“On hindsight, the more than P400 million spent to purchase a single measly meal will never give more than 19 million public school children brighter minds but will probably fatten the pockets of corrupt officials involved in the transaction,” she explained.

In their statement, CHD contends that if the government has sincere intentions of helping impoverished school children achieve better nutrition for better minds, it should look into the real circumstances that deprive these children of a balanced and healthful diet.

Moreover, they said that it is very likely that these children come from families who live on a hand-to-mouth existence and whose parents are jobless or underemployed. Hence, the only means to address undernourishment in schoolchildren is to provide their families jobs with livable income and access to basic social services.

Dr. Jara said that DepEd should rethink their feeding program. Instead of spending hundreds of millions for what appears now to be a shameful crime, it should focus on addressing the root causes of nutrition deficiency among public school children.

Lastly, CHD challenges this land’s lawmakers to seriously look into this scandalous project that is a threat to our children’s future.

The deteriorating health care system in the Philippines

Tambalan December 2008. click here, for the stories.

Tuesday, March 31, 2009

Tambalan special issue

CBHP celebrates 35 years. click here for the stories.

Monday, March 30, 2009

RH bill misses the nail's head

Various arguments regarding House Bill 5043 otherwise known as the Reproductive Health Bill center on whether population control will actually alleviate poverty or whether the bill is moral or immoral. But community-based health programs say the proposed law missed the nail’s head.

Over population?

According to the National Statistics Office (NSO), there are three babies born every minute, almost two thousand in an hour, and almost four-thousand every day. This year, the NSO projects the population to balloon at 92.23-million making it one of the most populous countries in Asia. On the other hand, population density is 277 per square kilometer while the gross domestic product per capita is $3,400

In an online article by Emil Jurado, a columnist in the Manila Standard Today, he cited fifty other countries which have a much lower density whose per capita is also much lower. There are also thirty-six countries which are more densely populated, yet their GDP per capital is also much higher. He argued that all these simply mean that the few are not at all richer, and the many are not always poorer.

If over population is not the root cause of poverty in a country like the Philippines, what then is the source of the problem?

Wrong priorities

Recently, the P1.414-trillion 2009 national budget was approved by MalacaƱang. Simply put, the government has allotted each of the more than 90-million Filipinos with a P15,331 budget for year 2009 or a meager P42 per day. Instead of beefing up funds for social services, the government allotted P252-billion for debt service. Originally, the amount for debt servicing was cut by Congress from P 252 billion to P 202 billion, but Mrs. Arroyo’s veto restored the original amount for debt servicing. The Department of National Defense (DND) on the other hand will receive P56.5-billion, as funding for highly questionable wars and military spending. In contrast, government agencies who are expected to provide basic social services like the Department of Health (DoH) received a measly P27.9-billion. Meanwhile, the Department of Social Welfare and Development (DSWD) was allotted P10.5-billion (177% increase from last year’s allocation of P4.8-billion). However, bulk of the budget will be given away to dole-out programs such as donations and subsidies.

Beyond numbers

In a statement, Council for Health and Development (CHD) expressed that the issue of poverty should be viewed beyond the issue of an oversized population. Although the Reproductive Health Bill is “anchored on the rationale that sustainable human development is better assured with a manageable population of healthy, educated, and productive citizens,” CHD argued that managing the population through population control is not an assurance of genuine human or people’s development. They further stated that the worsening poverty is not caused by over population but by farmers’ problems of landlessness, workers’ lack of jobs and low wages, and government policies that favor big business interests over people’s welfare.

Accessible health care system

Reproductive health must be viewed and not separated from the overall context of people’s health. As the economy worsens, the state of the public health system also deteriorates. And with it, women’s health, especially those belonging to the marginalized sectors become all the more at stake. Year in and year out, the government continues to fail in its efforts to address people’s health problems. Consequently, many women’s and children’s lives are endangered. Moreover, the government’s hell-bent efforts to push for the privatization of public health facilities have made matters worse (e.g. collection of out-of-pocket fees in public hospitals) for poor women’s access to a comprehensive health care including reproductive health.

The debate on reproductive health vis a vis population can go on and on. But at the end of the day, it is the government’s responsibility to ensure accessible health services including reproductive health services. In particular, women should be provided with necessary information regarding reproductive health including all types of family planning methods to guide them in their decisions.#

please click here for the story in pdf.

Tambalan December 2008

click here to read the whole issue.

The burden of renal diseases

About 1.2 million Filipinos today are suffering from kidney diseases, requiring either dialysis or a kidney transplant for them to live. Among the leading causes of kidney failure in the country are diabetes (41%), inflammation of the kidney (24%) and high blood pressure (22%).

According to the Department of Health, kidney disease is now one of the top ten causes of death among Filipinos wherein 7,000 die annually due to kidney malfunction. Because of the increasing number of Filipinos with kidney disease, it is now considered among the top seven health problems in the country.

Worldwide, there is also an alarming level of kidney disease with more than 500 million persons suffering from some form of kidney damage. Over 1.5 million of them are kept alive either through dialysis or transplantation. Every year, over 12 million individuals die prematurely of cardiovascular diseases linked to chronic kidney disease.

Costly treatment

In the Philippines, the treatment of kidney diseases is very costly and unaffordable.

Dialysis treatment uses artificial devices to perform the function of the kidney at about 15%, which is enough to sustain life but needs to be performed adequately on a regular basis (2-3 times a week) for life. Patients without sufficient dialysis are weak and show many of the symptoms that led to their diagnosis. Malnourished and unable to work, they tend to survive only until the next dialysis treatment. A patient has to spend P25,000 to P46,000 a month or P300,000 to P552,000 a year for his or her dialysis. Maintenance medication costs about P20,000 a month.

Kidney transplantation offers the best option for patients with kidney failure as shown by foreign and local studies, according to Romina Angangco Danguilan, chair of the NKTI’s Department of Adult Nephrology. In her study, she noted that the quality of life of a transplant patient is superior to one on dialysis. Kidney transplantation cost ranges from P500,000 to a million. Post-operation medication costs about P12,000 a month.

Because treatment is very expensive and draining to the pocket, it was reported that in 2007, only 73% of Filipino patients with kidney failure were able to afford necessary treatment.

No government support

Patients with PhilHealth coverage can only claim half of the cost of their treatment and cash out for the remaining cost. According to National Kidney Transplant Institute, only 15% of the partially-subsidized patients are PhilHealth members.

Poor kidney patients survive through assistance and borrowings from relatives and friends. Many of them had to beg around for funds from politicians and charitable organizations to pay for their treatment. Even patients who can afford admit that the burden of their treatment cost is heavily draining their families’ resources.

Dr. Lyn Almazan-Gomez, former president of the Philippine Society of Nephrologists said that there is no “free treatment” for kidney diseases. “It would be very draining for the government to shoulder treatment costs for renal patients considering the amount involved,” said Dr. Remedios De Belen-Uriarte, Department Manager of the Renal Disease Control Program of the National Kidney Transplant Institute (NKTI). She said that with limited income and resources, even NKTI can hardly afford to expand its services.

The NKTI is the government’s specialty health facility for kidney transplant and kidney-related diseases. In its out-patient hemodialysis unit, about two-thirds of the patients are pay patients who are able to afford the full amount of treatment costs and are given priority in the dialysis treatments. Only one-third of the patients are relatively poor service patients who avail of the discounts on hospital fees and charges given by the social services section but would have to wait for days to acquire a slot in the dialysis treatment. Regularity of dialysis treatment is very crucial for kidney patients because delay in such treatments would mean danger and may call for more expensive emergency procedures if not attended to immediately.

In 2007, NKTI records showed that of the 336 patients who were given transplantation procedures, 231 or 69% were pay patients and only 105 or 31% were service patients.

Prevention is best move

Prevention is the best move to counter the worsening problem on kidney disease in the country.

Kidney diseases are preventable, according to Dr. Uriarte. She emphasized the importance of early recognition of the causes to prevent or delay the development of kidney problems that usually end to kidney failure. That is why the REDCOP or Renal Disease Control Program under the NKTI, gives emphasis to the prevention aspect of controlling the spread of kidney diseases, according to Dr. Uriarte.

Playing a major role in the prevention of renal diseases, of course, is having a healthy lifestyle, which includes proper nutrition, regular exercise and timely physical check up.

The government appears to be giving less attention to combat the kidney disease problem. The Department of Health has no specific program to address this. Dr. Uriarte pointed out that no single centavo is given by the government in the campaign against renal diseases. She said that REDCOP depends on the funds that NKTI allocates to the program from the institution’s income.

Dr. Eleanor A. Jara, Executive Director of Council for Health and Development (CHD) said that it is the responsibility of the government to decisively exert the effort to address the worsening problem on renal diseases in the country given the prevailing economic difficulties confronting poor Filipinos these days.

Much more with the prevailing economic difficulties, the government must prioritize people’s health. This means increasing the share of health in the national budget from the less than one percent at present to as much as five percent of the country’s total production following the World Health Organization’s prescription. It also means unburdening the people in paying onerous debts incurred by the government and decreasing the budget for huge military spending.

Sources:
info@worldkidneyday.org
www.sunstar.com.ph/static/dav/2003/12/13;
sree1010.wordpress.com/2009/02/04;
abs-cbnnews.com/07/29/2008;
www.positivenewsmedia.net/.../Gov;
PIA Press Release, 12-04-2008; REDCOP/NKTI

The Dengue Chronicles

Dengue fever, an infectious tropical fever contracted through mosquito bites used to occur only during rainy season.

In the Philippines though, it has become an all-year round threat. In the first six months of the year 2008, there were 15,061 people afflicted by dengue with 172 deaths. Manila has the highest incidence rate, followed by Quezon City, Caloocan and Pasig.

Even at the start of the 2008, records at the San Lazaro Hospital in Manila have shown that there has been 152 percent increase in the number of dengue cases compared to the same period in 2007.

Dengue also hit the provinces of Batangas, Laguna, Rizal, Negros Occidental, Cagayan de Oro and Misamis Oriental. Again, compared with 2007, in Negros Occidental, dengue cases have increased by 50 percent while in Northern Mindanao, there was a 69 percent increase.

A disease of poverty

Dengue fever is a disease attributable to poverty. The National Center for National Disease Prevention and Control said that there was a direct proportion between population density and dengue.

People from congested communities, where mosquitoes can easily find breeding place on worn-out tires, stagnant drainage and dirty surroundings, are more prone to this disease.

Sadly, detection of dengue usually comes late due to financial constraints of the people affected especially with the very expensive cost of health care even in the government hospitals. These contribute to the increase in the mortality of dengue victims yearly.

Sound public health care system

Even with the few existing laws that mandate the Local Government Units and other government agencies to involve themselves in disease control programs such as the Code on Sanitation (1975), Local Government Code (1993), Ecological Solid Waste Management (2000), and the Clean Water Act (2004) and the National Dengue Control Program, communicable diseases remain to be the top leading causes of mortality and morbidity in the country.

The worsening threat of dengue fever is but a manifestation of government neglect of the public health care system.

Fighting dengue fever requires more than stopgap solutions. It requires a government that prioritizes the health of its people - meaning a public health care that is comprehensive and responsive to our needs and with adequate budget allocation.

First and foremost, dengue is a preventable illness.

Moreover, the steps to prevent cointracting dengue are very simple and easy to follow. With a sound and pro-active public health care system, Dengue will be easier to combat. On the other hand, it also requires mobilization and active participation of the people in the communities.

Launching campaigns that include awareness raising and education is also an effective solution. Organizations within communities should actively cooperate with other local agencies to form measures in prevention and management of dengue.

Again, dengue is a preventable disease and as we all know, as in every disease, prevention is better than cure.#
There was an error in this gadget