ON TARGET The Department of Health reports on its achievements in the fight against vaccine-preventable diseases
By Mabelle Aban, Contributing Writer
The picture Dr. Yolanda Oliveros of the Department of Health described was not a very happy one: "More than 10 million children die every year throughout the world. Two-thirds of the causes of death are preventable. The Philippines is one of the six countries that contribute to 75 percent of all deaths among under-five children in the Western Pacific region with 82,000 deaths per year." Speaking at the first Curing Poverty through Vaccination seminar organized by the University of the Philippines-National Institutes of Health at the Manila Hotel in January, Oliveros gave an update on the National Immunzation Program being implemented by the DOH. And while there are some things to be alarmed about, there have also been significant improvements in the country's fight against vaccine-preventable diseases.
How well did we fare? Oliveros said that there is a general decline in infant- and under-five-mortality rates in the country. This, she said, is an important result of the implementation of child-health programs that target not only newborns, but also slightly older children. There has also been improvement in immunization rates. The goal set in international agreements is 80-percent vaccine coverage. While the National Demographic and Health Survey pegged the national vaccine coverage rate at 69.8 percent in 1996, 2006 data from the DOH-Field Health Services Information System (FHSIS) showed a 93-percent coverage rate-a significant jump over 10 years. Oliveros also reviewed how well the country fared in vaccinating against certain diseases in comparison with existing international goals. First, as far as polio is concerned, she said: "The international goal of eradicating polio in 2000 has been achieved by the Philippines, because we were certified polio-free in 2000." Current activities are just focused on strengthening and intensifying the surveillance of acute flaccid paralysis to monitor any resurgence of the disease. The global target for the elimination of measles is 2012. In 1998, the Philippines committed itself to the elimination of measles by 2008. However, at the moment, very rigid surveillance is needed to be able to monitor not only the clinically confirmed cases but also the laboratory-confirmed cases of measles. Oliveros said: "Because of some outbreaks that the Philippines experienced last year, I really can't say if the Philippines has eliminated measles in 2008." On the brighter side, the Ligtas Tigdas campaign in 2004 proved to be highly successful, as it brought about a 96-percent drop in measles morbidity rate. Oliveros also proudly announced that "the Knock out Tigdas coverage of 2007 reached the target of 95 percent." Elimination of neonatal tetanus by 2005 is also a part of the international goals. Oliveros stated that if we are going to look at the national level, neonatal-tetanus elimination has already been achieved. "However, we are still looking at few priority provinces that still have cases of neonatal tetanus," she added. Thus, it also warrants improved surveillance. Even the inclusion of hepatitis-B vaccination at birth in the national immunization program NIP has started to show promise. Said Oliveros: "Hepatitis-B birth dose started in 2007 complemented with the 100-percent procurement of the hepatitis-B vaccines in 2006, and its inclusion in the newborn package provided by PHILHEALTH (Philippine Health Insurance Corporation)." With the increasing budget, they remain hopeful that the provision of 100-percent hepatitis-B supplies and as well as logistical support can be sustained.
Child survival, Oliveros said, is an important part of the national health agenda. She added: "Now we are one of the signatories [to] the [United Nations] Convention on the Rights of the Child. We have formulated our Philippine plan of action for children and we are one of the 189 other nation-signatories to make the elimination of poverty and fulfillment of human rights their highest priorities through the Millennium Development Goal agreement." She also reported that in September last year, President Gloria Macapagal-Arroyo signed Executive Order 663, which involves "implementing the national commitment for Bakuna ang Una sa Sanggol at Ina, and attaining the World Health Organization's goal to eliminate measles and neonatal tetanus, eradicate polio, control hepatitis B and other vaccine-preventable diseases." Accordingly, Health secretary Francisco Duque III issued the implementing rules and regulations for EO 663, which also offers protection to public-health professionals by way of "appropriate legal assistance" in case some acts are committed against them in the performance of their duty. Because of this, Oliveros said, the Philippines has become the 13th country and the first developing country with a policy of compensation of health workers and victims of adverse events following immunization. PHILHEALTH has also made improvements in its immunization package. Dr. Madeleine Valera, PHILHEALTH senior vice president for health-finance policy and services, said that the agency now supports the "vaccination program on hepatitis-B for newborns, tetanus toxoid, and the first dose of antirabies vaccine."
Vaccines to "cure" poverty? A group of doctors is calling the shots
Poverty is a highly complex issue that figuring out where to start in coming up with solutions has been more than challenging to many policy makers. Now a group of doctors has thought of a possible cure for poverty: vaccination. The University of the Philippines-National Institute of Health, in cooperation with the Philippine Foundation for Vaccination, International Society of Tropical Diseases, Meningo.Org Foundation, and the Rotary Club of Pasay, held the first ever Curing Poverty through Vaccination seminar at the Manila Hotel in January. The theme of the convention appeared to be too ambitious, but the daylong event sought to discuss relevant options to fight poverty, as well as to convince health workers and policy makers that vaccination can really be an effective antipoverty strategy. Dr. Ramon Arcadio, UP Manila chancellor, described how poor health and opportunity losses due to disability and death can eventually lead to poverty. One way to address the problem, he said, is to see vaccination as "a vital preventive health strategy that can significantly reduce health costs and lead to improved and healthier lives." This can be supported by looking closely at the Millennium Development Goals, a set of targets that United Nations member-states committed themselves to. Arcadio said that based on available data, the common factor among countries that have achieved or are close to the MDGs is the adoption of massive immunization programs. Dr. Jaime Galvez Tan, a health-financing expert and former health secretary, said that there is evidence that vaccination not only has a positive effect on the economy, but also leads to "great human-development outcomes." Studies done here or abroad all point to one thing-"vaccination is one of the most cost-effective public-health interventions," and it is a "wise investment." Dr. Eric Tayag, president of the Philippine Foundation for Vaccination (PFV) agreed, saying that "vaccination remains to be the best investment in public health." While economic benefits are measurable through existing economic tools, social benefits are not. However, Tayag said that when people talk about the social value of vaccination, "social justice and equality among others should be given the highest premium of consideration and perhaps eliminate poverty as an influence in attaining health and productivity." He added that vaccination truly "respects the dignity and worth of human beings." Considering the available evidence, the delegates to the seminar found that there are indeed health, economic, and benefits from vaccination. The results of these studies should be the basis for policies and decisions that are to be made, said Tan. While some may still believe that vaccination is not the one best solution to poverty, one thing is certain-it can make a big difference in the lives of many Filipinos. "This we believe will be our key towards better health, better productivity, better quality of life and of course, better wealth for the nation," said Dr. Lulu Bravo, executive director of the NIH and PFV. |
