Is Ona not acting on critical health issues?

There’s a reorganization of staff as well as a re-orientation of priorities ongoing at the Department of Health. Not all are happy, and that’s to be expected. The big push, it seems, comes from the need to meet the Millennium Development Goals or MDGs by 2015.

Particularly, maternal health and child nutrition – both under the jurisdiction of the health department – seem to be two of the goals that are in danger of not being met. Even if grading time is still three years ahead, the gaps apparently justify radical measures.

We all know that change is not something that is welcomed by many people. But if this is something that the boss wants, subordinates may be critical and vocal about the new directives, but in the end, they need to be supportive. It is the boss’s neck, after all, that in on the line.

‘Shot-gun’ approach

The DOH is now busy mobilizing its resources to create an army of workers that will promote stronger relationships with local health unit workers particularly in the delivery of universal health care.

Those critical to the approach in the overall health management strategy liken the move as akin to a “shot-gun” solution, with DOH health executives and workers “downloading” a whole gamut of principles and practices to the local health executives and personnel.

They say that the risk lies in putting too much responsibility on the shoulders of the local health unit that may not be readily assimilated, or worse, may be rejected in a case of being asked to do more than they can handle.

But as mentioned earlier, this is the CEO’s call. In the end, it will be Sec. Ona who will be answerable to his bosing. And this is not just P-Noy, but all the 90 million plus Filipinos who pay for his salary.

Ambivalence on anti-smoking

More than the issue of management style and prerogative, there is the bigger problem that comes with a growing perception that our secretary of health is not all that supportive to critical health issues.

When Ona was chosen to head the department last year, he had issued a statement that he was supportive of the anti-tobacco campaign, but only to certain limits. I think his statement was something like: “There’s no question that smoking is dangerous but there is such a thing as moderation.”

This had raised quite a few eyebrows. The statement after all was almost like shifting the motor’s gears so as to throttle fuel and slow down the vehicle. To anti-tobacco advocates, this was a monumental threat to the campaign, and one that could reverse any gains made in the past.

At risk also is the government’s tobacco control program, as well as the country’s international commitments to the World Health Organization-Framework Convention on Tobacco Control treaty.

Could his position have considered his immediate supervisor’s inclination towards cigarette smoking? The President, after all, has declared in many occasions his preference to continue with the habit regardless of consequences to his own health or the negative example it demonstrated on the nation’s youth.

Or is the Secretary inherently less interested in the anti-smoking campaign? In the case filed against the Metro Manila Development Authority for the apprehension of two commuters caught smoking in a public place, Ona reportedly chided MMDA for giving too much weight on smoking rather than on the pollution from factories and motor vehicles.

This incident supposedly confirmed suspicions of anti-smoking advocacy groups as well as activist doctors that the health secretary was not wholly supportive of a number of public health issues, particularly those that run counter to the interest of powerful business groups.

Ambiguous on breastfeeding

In the same breath, supporters of the breastfeeding campaign had been concerned that the Secretary lacked an enthusiasm that his predecessor had displayed regarding the importance of keeping newborns and babies on breast milk.

If the anti-smoking advocates were wary of the tobacco industry’s lobby, breastfeeding champions were concerned of the formula industry’s wily maneuverings when interpreting the Milk Code. To date, they say that formula companies keep circumventing advertising rules to mislead mothers about breastfeeding.

Recent scientific evidence has shown that Filipino mothers have lost the culture of breastfeeding, which has been directly been linked to the declining quality of the health of children as well as unnecessary deaths of newborns.

Local studies have shown that babies that did not immediately suckle to their mothers after birth were more susceptible to infections like sepsis or those affecting the pulmonary system.

Unconditional support

Perhaps, in response to the severe criticisms particularly by anti-tobacco advocates, the DOH recently issued a statement that it was fully supportive of the MMDA’s campaign against pedestrian smokers and in fully enforcing anti-smoking laws.

We had best remember that anti-smoking efforts are supported by a May 2011 United Nations report that specifically cites non-communicable diseases as reaching epidemic proportions: In 2008 alone, the report stated, 36 million people died from NCDs, representing 63 percent of the 57 million global deaths that year.

The four main life-threatening conditions listed were cardiovascular diseases, diabetes, cancers and chronic respiratory diseases. All have been linked to or aggravated by tobacco use.

Critical health issues

A top health official who is seen as “ambivalent” and “ambiguous” in his views about critical health issues is like “a fly in the ointment” in P-Noy’s dream of healthier Filipinos.

The health secretary needs to throw in his unconditional support to both the anti-smoking and breastfeeding campaigns, with as much fervor as he had shown when he was the head honcho at the Kidney Center. After all, every life is worth saving. –Rey Gamboa (The Philippine Star)