ANNIE RUTH C. SABANGAN, GMANews.tv
07/01/2009 | 06:12 PM
MANILA, Philippines - Two legislators have urged the government to declare a state of national health emergency and ensure that poor people will have access to affordable medicine, even as the Department of Health (DOH) relaxed its guidelines despite a spike in the number of Influenza A(H1N1) cases in the Philippines.
The declaration would allow the government to re-align funds for the containment of the disease, impose price control over essential medicines, and require compulsory licensing of patented drugs through the Cheaper and Quality Medicines Act of 2008, according to Iloilo Representatives Ferjinel Biron and Janette Garin, who are both physicians.
"Nothing is preventing the DOH from declaring an epidemic. The phenomenon is global, it was declared a pandemic. It is timely for the DOH to declare a state of national health crisis," said Biron, principal author of the House version of R.A. 9502.
As of June 29, the DOH had reported 1,709 cases from various parts of the country. The Philippines has the 10th highest number of patients in the list of 101 countries that have reported A(H1N1) cases, based on the June 29 report of the World Health Organization.
Given its rapid spread, one-fourth of the country's population of 90 million could be hit with the infection, according to recent estimates made by Dr. Lyndon Lee Suy, head of the DOH's Emerging and Re-Emerging Infectious Disease Program.
The virus claimed its first fatality in the country and in Asia last June 19 with the death of a 49-year-old female employee of the House of Representatives who had been suffering from a heart ailment. Thailand, another Southeast Asian country, reported three A(H1N1)-related deaths in the past week of people who had been stricken with pneumonia.
Measures relaxed
However, DOH Secretary Francisco Duque III stood pat on the department's decision to shift its anti-A(H1N1) strategy from containment to mitigation. He said there was nothing to fear in the increase in number of cases, as more than 80 per cent of infected patients have recovered.
He also opposed the suggestion for a declaration of a state of national health emergency. "No, we're far from doing that," Duque said. He refused to answer further questions on the issue, saying the department's legal experts would have to study the matter.
Dr. Robert So, program officer of the DOH's pharmaceutical management unit, said the "criteria for declaring a national health emergency is not fixed" in the Cheaper Medicines Act. He maintained that there is no need for such a declaration because the government has enough stock of 1.2 million Tamiflu capsules, and the drug is not patented by its manufacturer Roche in the Philippines.
Instead, the DOH began relaxing control measures against the new flu strain through Interim Guideline No. 16 issued last June 24. The directive no longer requires travelers arriving from countries with A(H1N1) cases to observe home quarantine before they return to their work places or schools, advising "responsible self-monitoring" instead.
It also lifted mandatory hospital confinement of patients with suspected or confirmed infection. Instead, patients were advised to place themselves under home care.
The DOH limited hospital confinement to patients "manifesting respiratory difficulty, progressively acute illness and debility belonging to risk groups."
Free distribution of the anti-flu drug Oseltamivir has also been limited to individuals who had "close contact" with people having "existing medical conditions that may be aggravated by viral infection."
In previous weeks, the DOH had given Oseltamivir to all healthcare workers, household members, and individuals who had close contact with suspected or confirmed cases.
The new directive has also restricted treatment to A(H1N1) patients "with severe or progressive illness or pre-existing illness that compromises the immune and pulmonary system." Prior to the new guideline, the DOH had been providing treatment to all individuals confirmed to have been infected by the virus.
Also on June 24, the department issued another directive, Interim Guideline No. 18, disallowing the suspension of classes in areas with community level A(H1N1) transmission. The DOH said classes could only be suspended if the schools have patients with "unusually severe illness" or if there is a "large number of simultaneously ill" students or staff.
Secretary Duque said the DOH came out with the guidelines "in conjunction with WHO recommendation."
Duque said that according to the WHO, which declared a flu pandemic last month after receiving reports of A(H1N1) cases across the globe, the virus "is stable and is not undergoing changes so far."
Reactive approach?
But Garin said that even without a pandemic, the government could make the declaration and use it as a tool to lower the prices of essential medicines. She said the move could benefit thousands of chronically ill people who are the most vulnerable to the flu virus.
"As long as you include the medicines in the list of essential drugs, these could already be subject to price regulation that will be approved by the President through the recommendation of the DOH secretary," she said. According to Section 23 of the Cheaper Medicines Act, all medication for the treatment of chronic illnesses, life-threatening conditions and infectious diseases and prevention of diseases are subject to price regulation.
Garin said even paracetamol, Vitamin C supplements and other drugs used to prevent the spread of A(H1N1) should be subject to price control.
Biron and Garin have criticized the DOH's "reactive" approach to combating the new flu strain, saying the agency should have long taken preventive measures to arrest the fast spread of the virus.
"The DOH's approach is always curative, and not preventive. It only acts when the problem is already getting worse. Downplaying the illness could make the public lenient," said Garin.
Biron said the DOH should not underestimate the mild effects of the virus, as this could be just the tip of the iceberg.
"I'm sure there are thousands already affected (by the disease), but we do not have enough testing kits. We are not fully equipped to have people checked. Besides, we don't know whether the virus would stay in its mild state or become virulent," he said. - GMANews.TV
From GMANews.tv; see the source article here.
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