Get real
Philippine Daily Inquirer, 6 December 2014

 

Consider the following: The chief of the Philippine National Police, Alan Purisima, was placed under preventive six-month suspension by the Ombudsman two days ago, on the basis of an anomalous multimillion-peso contract that the PNP awarded to a courier service sometime in 2011. The transaction has been under investigation by the Ombudsman since July, and she cited the reasons and the facts that led to the conclusion that it was anomalous.

Health Secretary Enrique Ona has been “on leave” from the Department of Health since Oct. 27 for one month, supposedly for health reasons but also to prepare a report to the President regarding an P800-million contract. The one-month leave is over, the report to the President is done, his health issues are resolved—but he has not reported back to the DOH.

Here’s a comparison of the two cases: Purisima was suspended after four or five months of investigation leading to the Ombudsman’s decision to suspend him. Ona was effectively suspended (well, he’s out of his office) even if there were no charges against him from the Ombudsman, Department of Justice, or National Bureau of Investigation. I am given to understand that the President himself had Ona investigated by the NBI, but its inquiry was finished last June with no charges made.

The point is, Ona was unceremoniously removed from his office, without cause. The only comfort, cold as it is, is that the President reportedly won’t fire him without first reading the NBI report. It seems to me, therefore, that someone or some group poisoned P-Noy’s mind against his health secretary (who has no political backing), but he is loath to let the latter go without just cause, and there is now a scrambling around to provide him with this just cause.

And scrambling they have been. I think Ona has been doing a good job (confession: My candidate for the job was Espie Cabral). And this is an assertion that has good basis.

For example, the President’s main health campaign platform was to provide universal healthcare. Ona has delivered on this: From 54-57 percent coverage in 2011 (which covered about 55 percent of the poor), his people have brought it up to 86 percent in 2014 (which covers practically 100 percent of the poor). Ona apparently convinced the President and Congress that the poor should be wholly subsidized by the government instead of the local government units, and that simple act removed healthcare from the grasp of politics. (Remember the previous election campaigns where health insurance cards embossed with the names of candidates were distributed to the poor, only for them to find out that the entry was a one-shot deal, because subsequent premiums were not paid.)

With that kind of increased coverage, there was a need for health facilities to be increased and improved, which is one of the reasons the DOH budget increased from something like P20 billion in 2011 to P85 billion in 2014. That’s a large increase to absorb, and Ona has worked to increase the absorptive capacity of his department.

One of the things he did in this regard was to form more bids and awards committees (which got him into trouble, because there was suspicion of hanky-panky going on). But these committees were made up of DOH people also; it was just that there was too much work (with quadruple the budget), and therefore more people were needed. In any case, except for the vaccine controversy (PCV-10 as against PCV-13), there doesn’t seem to be any bad results from this practice, particularly because the DOH was able to save a lot from contracting in bulk—like CT scanners, which started at P30 million each and now costs the DOH P16-20 million each. The DOH has made this standard equipment in all its health facilities.

Now let’s talk about this PCV (pneumococcal conjugate vaccine). As it turns out, it’s all a tempest in (an P800-million) teapot, because the choosing between PCV 10 and PCV 13 is like six of one and half-a-dozen of the other. Except that PCV 10 is supplied by GlaxoSmithKline (a UK pharma) and PCV-13 is marketed by Pfizer (a US pharma). If the pharmas were from one country, there would have been no problem. But from two countries? You can expect double the lobbying, pressuring, visits from ambassadors—and, yes, even dirty dealing, and press campaigns.

Add to all that the fact that the DOH has become a very juicy financial plum, attractive to politicians especially this close to 2016. It makes for a fantastic jump-off point to higher political office (Ona is not, and will never be, a politician).

Thus all the sound and fury. Let me disabuse the Reader of any media-created doubt about the PCVs. Pneumococcal disease is the leading cause of serious illness in children and adults worldwide.

First, the World Health Organization (WHO), the Asian Strategic Alliance for Pneumococcal Disease Prevention (Asap), and the UP Econ-Health Policy Development Program (HPDP), are agreed: Neither PCV 10 nor PCV 13 can be considered superior or dominant over the other (this is UP HPDP’s language). WHO says it would be a value judgment, Asap says no WHO document recommends one over the other.

And the second surprise: The procurement of PCV 10 (in 2012?) was not even done by the DOH. It was done by Unicef, so no one in the DOH could have made money on it. The 2013 procurement was done by the DOH (which did not specify either PCV 13 or PCV 10, but merely the generic PCV), because Ona found out that he could save more money by forcing the giants to compete with each other.

And dare I say it? PCV 10 was $0.96 cheaper, per dose, than PCV 13.

Ona should be commended, not crucified.