MANILA - The House Appropriations Committee on Tuesday approved a bill authorizing the Department of Health (DOH) to use a revised budget for medical aid for recipients of anti-dengue vaccine Dengvaxia.
The DOH proposal, as approved by the panel, would be funded from the over P1.16 billion in refunds from French drug maker Sanofi Pasteur to the government for the procurement of Dengvaxia.
Government had stopped its dengue immunization program in December after Sanofi Pasteur released an advisory warning that Dengvaxia may cause more severe symptoms of dengue on those given the drug who had never contracted the mosquito-borne disease.
The revised budget allots P945 million for a medical assistance program, which will cover those admitted in hospitals and outpatients.
Broken down, assistance for admitted patients in hospitals will be P726.87 million while assistance for outpatients will be at P218.95 million.
Some P148.29 million was supposed to go to public health management, but the panel amended this portion to cover assessment and monitoring of those vaccinated with the drug (P25 million) as well as the purchase of supplies and medicine (P45 million).
Some P67.58 million will go to human resource for health development, which will cover followup checkups of those immunized who have complaints.
For 900,000 individuals vaccinated, some 1,250 nurses aim to tackle 12 patients a day over 3 months. About 382 nurses will also be deployed for 5 months in 4 regions to provide counselling, lectures on disease prevention and health promotion, and regular submission of reports.
Health Secretary Francisco Duque III was not present at the committee hearing because he was at the World Health Assembly in Geneva, Switzerland, according to Health Undersecretary Erik Domingo, who briefed lawmakers on the department's plans.
"This is a lot bigger than what we originally forecast for 2018 and 2019. Ang tingin po kasi namin (We think) 10,000 cases might be enough for admission; even if you double, 20,000, sosobra pa rin ito (that will be too many)," he said.
The department then asked the panel permission to use the additional fund beyond 2019.
"We want to take care of them (Dengvaxia recipients) for at least the next 5 years and we think this will actually be enough for 4-5 years," said Domingo.
He said the DOH has allocated an average of P13,000 to P14,000 for admitted patients. The mildest of infections may cost P6,000 to P13,000 while those with catastrophic cases like leukemia may cost P500,000.
PLEAS FOR HELP CONTINUE
Girlie Samonte, whose children were vaccinated with Dengvaxia, tearfully reiterated her plea for help during the hearing.
“Ang anak ko po after 6 months ng mass vaccination, unti-unti po siya pumayat and then bigla bumagsak, pumutok na po ugat sa utak...Dalawang anak ko na-admit, ang cost ng hospital sa Maynila, sabay 'yun ang cost ng hospital sa Maynila is free pero for basic angiogram is P55,000 di pa po kasama ang laboratory (fees),” she said.
(My child lost weight about 6 months after the vaccination, then a nerve burst in the brain. Two of my children were admitted to the hospital, and while the basic cost of treatment in the Manila hospital was free, an angiogram costs P55,000, not including laboratory fees.)
“Bilang isang mahirap na mamamayan, paano ko po 'yun matutugunan kung wala pong tulong? Ito pong nangyayari sa mga anak namin, hindi po namin ito gusto. Noon pong nag-mass vaccination, ang ganda ng sinabi ng DOH: magpa-vaccine kayo kasi P5,000 'yan, para maging maligtas sa dengue ang anak niyo. Realidad po pinag-uusapan dito, buhay ng mga anak namin," she said.
(As an indigent, how was I supposed to pay for that without assistance? We did not want what happened to our children. When the mass vaccination was initiated, the DOH said something good: get vaccinated because it's worth P5,000 and it will save your child from dengue. We're talking about reality here, the lives of our children.)
She appealed for help, saying "biktima kami rito (we are victims here)."
Domingo assured families of those vaccinated that in giving aid, the government would not discriminate if the patients fall sick with ailments that are not related to dengue.
"Walang tanong tanong if its connected to the illness but all 900,000 nabakunahan basta nagkasakit po sila at may card, whether in-patient or outpatient, sasagutin natin ang kanilang pangangailangan,” he said.
(There would be no questions asked if it's connected to the illness, but all the 900,000 inoculated, so long as they have their cards, when they get sick, whether in-patient or outpatient, we will pay for their needs.)
Samonte said while she was trying to get assistance from government, she could not get through the dedicated hotline. She was only able to get assistance from Public Attorney’s Office Chief Persida Acosta and Special Assistant to the President Bong Go.
Samonte also recalled the lack of sensitivity her family experienced when her son was brought to a government hospital.
“Noong araw po na nilabas ang anak ko, mahinang mahina pa po ang anak ko. Palakad-lakad kami, pinapila pa rin po kami," she said.
(My son was very weak when he was discharged. We walked around and were asked to line up.)
“'Pag sinabi namin Dengvaxia, sasabihin walang kinalaman ang dengue diyan. Sana po 'wag na sana kuwestiyonin at maging makatao po kasi nung dinala ko po 'yung anak ko pinagtawanan kapatid ko. Paano nalaman positive sa NH1 'yan, sinabihan pa kapatid ko na 'Wow ano kayo presidente?' Sana po makatao ang pagtanggap, sana hospital staff maging makatao rin po," she recalled.
(When we said Dengvaxia, we were told dengue did not have anything to do with my son's condition. I wish they didn't have to question it and be humane because when I brought my son, they laughed at my sibling. They asked, 'how did you know [the patient] was NH1 positive?' They added, 'Wow, are you the president?' I wish they were humane, the hospital staff could also hopefully be humane.)
Raising concern, Gabriela party-list Rep. Arlene Brosas said 81 percent of the proposed budget, or around P940 million, will go to DOH's Medical Assistance Program (MAP), which could be subject to a politician's endorsement and are discretionary in nature.
This will be on top of the P22 million MAP funds already spent by the DOH for children inoculated with the controversial vaccine.
"Addressing the needs of Dengvaxia patients should take the form of increased budget for direct health services and for plantilla health workers, not for discretionary lump sum funds such as the MAP," said Brosas.
"It seems that the Dengvaxia fiasco is now being used to supplement the pork barrel funds lodged in DOH instead of funding target-specific health interventions for Dengvaxia victims. Hindi MAP ang tutugon sa pangamba at suliranin ng mga biktima (MAP won't address the worries and problems of victims)," she added.
Gabriela said the congressional infusion for MAP, which will remain valid for up to two years, is suspicious especially as the midterm elections will be held next year.
House Bill No. 7449, House Resolution No. 1724 and House Joint Resolution No. 20 all seek to allocate a budget for those inoculated with Dengvaxia who may experience health problems.
Sanofi Pasteur, whose officials have faced legislative hearings, has repeatedly said no death has been attributed to the drug and that it remains safe and effective.