DOH budget not enough for vaccines

Special Report: Can RP cope with full-blown Novel A(H1N1) epidemic?

THE Philippines can ill-afford to have run-away cases of the Novel Influenza A(H1N1), said Dr. Lyndon Lee Suy, head of the Emerging and Re-emerging Infectious Diseases Program of the Department of Health (DOH).

There is no vaccine for A(H1N1) yet, but when it is expected to come out, hopefully this year, it is estimated to cost P1,000 per treatment of two doses.

Giving vaccines to the elderly, or those 60 years old and above, will cost P3.6 billion, an amount that is equivalent to about three years of the DOH budget, Lee Suy said.

The computation is based on the priority groups for vaccination to be given to those considered highly at risk: the very young (5 years old and below), the elderly and health workers.

There are about 3.6 million Filipinos considered elderly, and vaccinating each of them will cost a total of P3.6 billion, Lee Suy said during a forum on the Novel Influenza A(H1N1), or what has been wrongly called swine flu.

The problem is compounded when those 5 years old and below are included as they make up about 15 percent of the 90 million Filipinos.

As it is, he said, the country is experiencing “mild” cases of Influenza A(H1N1) of more than 1,700 cases as of yesterday but there are many issues that have yet to be addressed.

A national task force is in place but questions have been raised whether similar versions are in place at the provincial and municipal levels, he points out.

All secondary and tertiary hospitals should be prepared for more cases, Lee Suy said, but not all of them have isolation wards.

And the 1.5 million anti-viral medicines in the DOH stockpile may not be enough if panic buying starts, he said, pointing out that the P1,500 treatment course is given free to confirmed cases partly to discourage uncontrolled buying.

And while there are vaccines against seasonal influenza, there is none yet for the Novel Influenza A(H1N1).

The big question, Lee Suy said, is whether Philippine health facilities will be able to cope with a full-blown epidemic.

“This is the reason for our strong advocacy on personal hygiene and the protection of vulnerable groups,” he said. “This is because each potential infectious person shares households with the young, the elderly and those who have previous illnesses.”

Public awareness of the potential impact of the novel flu is at an all-time high, he said, so much so that all fevers are now considered suspect by the ordinary Filipino.

But in the past two weeks, he lamented, the public’s trust of the Health department has been tarnished because of allegations that its efforts are politically motivated.

“The DOH has shifted from containment to mitigation, or slowing down the rate of transmission,” Lee Suy said. “But it is site-specific and not country-wide.”

For example, in islands where there are very few cases, containment will still be the focus, he told The Manila Times. In Metro Manila, where there is low-level transmission, the mitigation mode is in place.

The country should prepare for a worst-case scenario, he said. “We will be expecting more cases, and we’ll never be able to contain it,” Lee Suy said. “These will be mild cases instead of severe ones.”

“There is no way to contain it anymore,” according to Dr. Davinio Catbagan, Director of the Bureau of Animal Industry. “We need to monitor the situation, to watch out for a second wave of infections.”

“We should not be apprehensive of a second wave, or even a third or fourth wave,” said Dr. Jaime Montoya, head of the Philippine Council for Health Research and Development. “The Novel Influenza A(H1N1) is already here. What is important is what to do about it, to focus on treatment and developing a vaccine which hopefully should be available this year.”

 “If you ask me, should we be scared? Definitely not,” said Dr. Veronica Chan, head of the Department of Microbiology and Parasitology, Emilio Aguinaldo College. “From laboratory experience, the H1N1 virus was here before. We should just take normal precautions.”

“Enjoy life,” she added.  –PAUL M. ICAMINA Special Reports Editor, Manila Times