Wazzup PIlipinas!
"The majority of the people are not really aware on how Dengue really attacks the body. I do believe if we can educate them the chances of surviving will increase dramatically and we may even reach a point that dengue deaths will be zero. Thus, this advocacy." - Dr. Richard Mata
Sanofi Pasteur, a French multinational pharmaceutical company, led by Dr. Bouckenooghe, Mr. Joshua_Nealon, and Dr. Ruby Dizon, recently conducted a media conference about the dengue vaccine.
The event was held at the Dusit Thani hotel in Makati city on October 20, 2016. It allowed us the opportunity to ask them several questions about the dengue vaccine, including the many issues that has made it very controversial.
While the Department of Health (DOH) Secretary Paulyn Jean Ubial assured that the newly registered vaccine was safe for use, there has been an awful lot of questions about this sudden, undue haste in providing the dengue vaccine. The vaccine is the first ever approved for use to prevent dengue, a mosquito-borne disease endemic in the Philippines. Should we express concern that children in the Philippines are being used as “guinea pigs” since the country was the first in Asia to implement the vaccination?
The government purchased the dengue vaccine in March this year and was delivered in the same month. The vaccine was just registered by the Food and Drug Authority on Dec. 22, 2015. The Department of Health (DOH) started to give the first of three doses of the vaccine from April to July this year to almost 500,000 children in Metro Manila, Southern Luzon and Central Luzon.
The question that people ask is "What was the “undue haste” in providing a dengue vaccine worth P3.5 billion to almost half-a-million children during the administration of former President Benigno Aquino III?"
Here is the punch line, and Mexico didn't do this. And why we are now the big joke in the international health policy world.
Our government funded this vaccine with 3.5 billion pesos of people's tax money sans WHO Strategic Advisory Group of Experts (SAGE) and cost benefit analysis research not funded by the pharmaceutical industry."
Our government funded this vaccine with 3.5 billion pesos of people's tax money sans WHO Strategic Advisory Group of Experts (SAGE) and cost benefit analysis research not funded by the pharmaceutical industry."
Not that we are saying that the facts about the vaccine are true or false, but we can't help to be concerned with all these doubts since the overwhelming truth to all of these is the lack of trust we have with our government. Why are we doubting our government? Because there has been so many occurrences of corruption. Also, the pharmaceutical industry is likewise filled with controversial issues even to the point of being accused of keeping the people sick so they could continue selling their supposedly cures at prices too high to fathom. This is why generic medicines have emerged as popular, but lately they have also invested on the generics game as more and more of these pharmaceutical companies are already competing with each other with their corresponding generic medicines.
But how do we go on with our lives if we continue to distrust everyone else? That is the question whose answer is too elusive.
Below are some facts about Dengue in the Philippines:
DENGUE
IN THE PHILIPPINES
Dengue
cases rose to epidemic levels in 2015 with an average of 220 reported cases per
day
Dengue
is a high-profile and ongoing public health concern in the Philippines. The
first known epidemic of severe dengue or dengue hemorrhagic fever anywhere in
the world was recorded in Manila in 1953.[i]
By the mid-1970s, severe dengue had become a leading cause of hospitalization
and death among children in the region.[ii]
Between 2004 and 2010, the Philippines experienced the seventh highest number
of dengue cases in the world according to the World Health Organization (WHO).[iii]
2016 data suggests an
increasing trend in reported dengue cases
In
2013, DOH reported 204,906 cases of dengue, the highest number recorded since
the establishment of the National Dengue Prevention and Control Program in
1993. More than 200,000 dengue cases were reported in the Philippines in 2015, 80,000
more than were reported in 2014.[iv]
In both September and October 2015, the number of reported cases rose above the
epidemic threshold.[v]
Although
the number of reported dengue cases slightly decreased in 2014, the 2015 data
suggest an increasing trend in cases in the coming years.[vi]
Recent data gathered by the Department of Health from January to 24 September
this year shows an increase of 11.5 percent year on year across the country,
with total dengue infections at 142,247 compared to 127,525 last year and 604
recorded fatalities[vii]
Based
on Philippine surveillance data collected between 2011 and 2015, an average of
220 dengue cases were reported in the country every day.[viii]
In 2015, almost 50% of reported cases came from three most urbanized regions:
Region 3 (17.6%), Region 4 (17.3%), and the National Capital Region (12.6%).[ix]
Cases stemming from all four serotypes of dengue were reported in 2015.[x]
Disease burden: US$345
million per year
The
economic burden of dengue in the Philippines is substantial. A study published
in 2015 estimated that between 2008 and 2012, clinically diagnosed dengue cases
in the Philippines were associated with a direct medical cost (in 2012 US
dollars) of $345 million annually. The study calculated the average cost of
treatment per case to be $409, representing 16% of the Philippines’ 2012 per
capita GDP. Sixty-five percent of cases were treated in inpatient hospitals,
representing 90% of direct costs.[xi]
In
addition to dengue’s burden on a household, the illness can adversely impact a country’s
economy through a loss of productivity caused by the illness and pre-mature
death, increased healthcare costs and a possible reduction in tourism.[xii]
Seasonality and global
climate change
Dengue
has become a year-round threat in the Philippines. However, data suggests that
the number of dengue cases increases one to two months after the onset of the
rainy season, resulting in a peak of dengue cases between July and November
each year.[xiii]
The
Philippines is severely affected by extreme weather events and is vulnerable to
the effects of climate change. Vector-borne diseases like dengue may be
particularly sensitive to both periodic fluctuations and sustained changes in
global and local climates.[xiv]
Additionally, a study examining data from eight Asian countries including the
Philippines over 18 years revealed a strong correlation between regional dengue
epidemics and elevated temperatures associated with El Niño.[xv]
DoH implements a
step-wise public vaccination program in 2016
The
Department of Health announced on 4 January 2016 that one million (1M)
nine-year-old Filipinos enrolled in government schools in Region 3, Region 4-A
and the National Capital Region will be the first beneficiaries of the
government-procured dengue vaccine.[xvi]
In
a recent dengue vaccine cost-effectiveness study performed by Professor Hilton
Lam of the UP-National Institutes of Health, a nationwide annual routine
vaccination of nine-year olds starting in 2016 would lead to an estimated 24.2%
reduction in dengue cases in the country over a five-year period. This would translate
to 775,053 avoided cases of dengue, 502,000 avoided hospitalizations, 22,010
avoided deaths and almost Php 21 billion in avoided cost to society.[xvii]
[i] Gubler, D. J.
(1998, July). Clinical Microbiology Reviews. Retrieved from American Society
for Microbiology. http://cmr.asm.org/content/11/3/480.long
[ii] Anonymous (1986)
Dengue hemorrhagic fever, diagnosis, treatment and control. (World Health
Organization, Geneva, Switzerland).
[iii] World Health Organization.
(2012) Global Strategy for Dengue Prevention Control. 2012-2020. http://apps.who.int/iris/bitstream/10665/75303/1/9789241504034_eng.pdf?ua=1
[iv] Philippines
dengue fever cases update and Dengvaxia plan, March 14, 2016. http://outbreaknewstoday.com/philippines-dengue-fever-cases-update-and-dengvaxia-plan-76200/
[v] WHO Western
Pacific Region Dengue Situation Updates. http://www.wpro.who.int/emerging_diseases/DengueSituationUpdates/en/
[vi] DOH to provide
dengue vaccine for poor Filipino children in NCR, Regions III and IV-A, Press
Release, January 4, 2016, http://www.doh.gov.ph/node/3784
[vii] Philippines data provided by
Epidemiology Bureau of DOH.
[viii] DOH to provide
dengue vaccine for poor Filipino children in NCR, Regions III and IV-A, Press
Release, January 4, 2016.
[ix] Ibid.
[x] WHO
Western Pacific Region Dengue Situation Updates.
[xi]
Economic Cost and Burden of Dengue in the Philippines. Am J Trop Med Hyg. 2015
Feb 4; 92(2): 360–366. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4347342/
[xii] Ibid.
[xiii]
Epidemiology of Dengue Disease in the Philippines (2000–2011): A Systematic
Literature Review. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4222740/
[xiv] Ibid.
[xv]
Region-wide synchrony and traveling waves of dengue across eight countries in
Southeast Asia, August 25, 2015, Proceedings of the National Academy of
Sciences of the United States of America. http://www.pnas.org/content/112/42/13069.abstract
[xvi] DOH
to provide dengue vaccine for poor Filipino children in NCR, Regions III and
IV-A, Press Release, January 4, 2016.
[xvii] Lam
H. et al. Cost effectiveness analysis of dengue vaccination in the Philippines.
Presented at ICID, Hyderabad, India, March 2016. Abstract number 43.160.
Ross is known as the Pambansang Blogger ng Pilipinas - An Information and Communication Technology (ICT) Professional by profession and a Social Media Evangelist by heart.
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