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Philippine health recovery not a priority for Duterte administration

by Maricar R. Piedad

Deliberations on the proposed Php4.5-trillion General Appropriations Act (GAA) for 2021 have begun. This budget will be crucial for the Philippines to fast track recovery from the worst health and economic crisis in its history because of COVID-19. But it is not at all about health recovery as the Duterte administration hypes.

In the National Expenditure Program (NEP) for 2021 submitted to Congress, the government actually defunds areas that are vital to boost the public health system in the time of a pandemic. These include those for disease surveillance, health infrastructure, and human resource capacity building. Despite the glaring health and economic needs exposed by the COVID-19 pandemic, the NEP for 2021 reflects how the government sticks to its old priorities such as transport infrastructure and defense, which are not what the situation urgently requires.

Making the health system weaker

The effect of COVID-19 on the health and livelihoods of the Filipino people is more severe compared to other nations. While countries around the world are starting to recover from the pandemic, the Philippines has the most total and new COVID-19 cases and the most deaths per million population in East Asia.

COVID-19 is stretching the health system’s capacity and the vaccine for the coronavirus is still far from the people’s reach. It is only rational and urgent to ensure that resources to further enhance and capacitate the country’s health system are made available. However, the government is not prioritizing this.

Bayanihan 2, a stimulus package aiming to cushion the effects of the pandemic, allots only Php30.5 billion for health-related responses to COVID such as tracing, treatment, support for health workers, health facilities, and pandemic research. There is also a Php10-billion standby fund for testing, which is paltry according to health advocates.

The proposed 2021 budget for the Department of Health meanwhile has been increased from Php104 billion in 2020 to Php131.7 billion in 2021 or a Php27.7-billion hike. But allotments for some of the most essential programs for health recovery have been slashed.

Selected Health Programs, 2017-2021

The budget for the Epidemiology and Surveillance program, which is important to control the spread of diseases through timely data and research, was halved in 2020 – from Php263 million in 2019 to Php116 million this year. A larger budget would clearly have helped strengthen preventive measures versus COVID-19 in the country at the beginning of the year when the first cases emerged. Yet despite the proven importance of this program, the government even proposes to reduce it further to Php113 million in 2021.

The proposed budget allocation for the Health Facilities Enhancement Program (HFEP), which ensures the maintenance and quality of public healthcare facilities, also decreases this year. HFEP is actually being allocated lower and lower budgets each year as hospitals are obliged to generate their own income to fund infrastructure-building and maintenance. From an Php8.4 billion budget for HFEP in 2020, the proposed budget for 2021 is only Php4.8 billion, or almost 50% less than its current budget.

The National Reference Laboratories are vital in detecting and testing COVID-19 cases and other emerging diseases. But the proposed budget for these decreases from the present Php326 million to Php289 million.

Even though one of the main issues during this pandemic is poor data management and reporting by the DOH, the proposed budget for Health Information Technology drops massively from Php1.2 billion in 2020 – which it failed to use properly – to Php97 million, or a 92% decrease.

The proposed budget allocation for Human Resource for Health (HRH) deployment increases, but the program that ensures that the health workforce is equipped with proper training and knowledge to deal with different medical situations is decreased. The budget for HRH Institutional and Capacity Management has been cut by Php15 million.

The DOH’s COVID-19 specific programs – the Php4.2 billion Health System Enhancement to Address and Limit COVID-19 and the Php1 billion Philippines COVID-19 Emergency Response Project – are mere drops in the country’s budget bucket.

What government cares for

The Duterte administration’s proposed budget for 2021 shows how little it cares for the health and socioeconomic recovery of the Filipino people. The biggest chunk of the proposed 2021 budget goes to the Php1.1 trillion “Build, Build, Build” program taking up 24% of the total budget. Only a tiny fraction of this goes to health infrastructure with the DOH getting just Php2.3 billion or barely one-fifth of one percent (0.2%) of total infrastructure spending.

Many of the infrastructure projects lined up – such as big-ticket railways and roads funded with China and Japan loans – are not as urgently needed as facilities for health and more direct measures to support the socioeconomic recovery of distressed households and small businesses.

The government is apparently only willing to spend Php203.1 billion on its so-called universal health care program including to respond to the pandemic – this is just 4.5% of the total proposed budget for 2021. As it is, the Php1.1 trillion infrastructure budget is almost 5 ½ times larger.

The proposed budget for the Department of Public Works and Highways (DPWH) is Php667.3 billion or over five times that of the DOH. The government will allocate Php7.6 billion for primary roads’ maintenance and repair alone which is almost three times the size of the DOH budget for the COVID-19 vaccine, at only Php2.4 billion.

The DOH’s proposed Php203.1 billion budget – even including the budget for PhilHealth – ranks only 5th among department budgets in 2021. This is because, amid the unprecedented public health emergency, the DOH’s proposed 2021 budget is only a Php25.4 billion increase from the GAA this year.

The DPWH gets a much bigger Php228.4 billion increase to Php667.3 billion, as does the Department of National Defense (DND) which gets a Php29.4 billion increase to Php209.1 billion. The military and police forces will still be receiving more funds than the health sector.

The Duterte administration’s proposed 2021 budget bares how it is not changing its priorities despite the marked worsening of the Philippine health situation. Even before the COVID-19 pandemic, infrastructure has been consistently a priority over the health sector which, if anything, is even being distorted and privatized. The people’s health and strengthening the public health system are among the most immediate areas needing attention which, apparently, the administration simply refuses to give. #

Heavy cost of coronavirus response drains local governments’ disaster budgets

Pandemic response is taking up bulk of resources, including funds meant for disaster management.

By Estrella Torres, Philippine Center for Investigative Journalism

The coastal towns of Dolores and Sulat in Eastern Samar constantly battle with the impact of extreme weather events such as storm surges, flash floods and typhoons.

Early this year, the leaders of the two towns were set to conduct training for emergency response teams, buy rescue equipment and early warning devices from their calamity funds, but the Covid-19 pandemic got in the way and wiped out their calamity funds to prevent the entry of the virus.

“The province was not ready to have a Covid-19 case,” said Manuel Catuday, head of Municipal Disaster Risk Resilience Management Office (MDRRMO) of Dolores. “We don’t have a government hospital, only a rural health center with one doctor.”

A community hospital in Dolores has been dilapidated since last year, and has not been repaired, he said. The next government hospital is in Tacloban City, which is at least a four-hour drive.

Covid-19 came at a time when the localities have not even completely recovered from the onslaught of Typhoons Yolanda and Ruby, which struck a year apart.

While the government was still on post-Yolanda operations, Ruby came in November 2014 and caused severe damage to homes, crops and farmlands that were still being rehabilitated. There was not enough public attention in the aftermath of Ruby as Yolanda was still fresh in the minds of government officials as well as the general public.

A piece of G.I. sheet is seen on top of an electrical post in Barangay Sagkahan, Tacloban City after Typhoon Yolanda made landfall and claimed around 6,000 lives. Photograph: Bernard Testa

Lahat ng hanapbuhay namin nawala (All our sources of livelihood were destroyed),” said Rio Caspe, 42, a fisherman from Barangay San Francisco in Sulat whose house was destroyed by Typhoon Ruby.

His three children and wife had to rely on the meager earnings of their small sari-sari store as massive flooding made fishing difficult.

Caspe said his neighbors were also cash-strapped because their crops such as banana, rice and copra were destroyed by the typhoon.

“We only relied on relief goods while staying in an evacuation center,” said Caspe.

Funds depleted

Dolores, a third-class municipality, earmarked P8 million in calamity funding for 2020 to prepare and protect its 42,000 people or 12,700 families from the impact of natural calamities.

However, the funds had to be realigned to buy personal protective equipment (PPE) for community volunteers as well as hygiene kits and food packs for residents during the lockdown, which was imposed to prevent the spread of Covid-19. The national government’s Bayanihan fund gave Dolores a P14-million subsidy to respond to the  Covid-19 pandemic.

“We are now sourcing from this (Bayanihan) fund for our response to Covid-19 pandemic,” said Catuday.

The town also has to spend for at least 900 LSIs or locally stranded individuals who arrived in Dolores from March to June.

Dolores, Sulat, and seven other towns in Samar were placed under state of calamity in May when Typhoon Ambo, the first typhoon to visit the country this year, pummeled the province. As usual, the storm destroyed crops and damaged houses, displacing more than 140,000 people.

Most houses in these towns are made of light materials.

Matagal bago kami makabangon, hirap kasi ang pagpapagawa (It takes a long time to recover because we don’t have enough money to repair our houses),” said Catuday.

Charlie Rosaroso, head of the Sulat MDRRMO, said at least P1.5 million or 30 percent of the P5.1 million calamity fund for 2020 was spent to provide emergency assistance to families affected by Typhoon Ambo. The remaining funds were depleted by the Covid-19 response.

He said he was only able to spare P300,000 to continue the training for volunteers on emergency response.

Provinces and cities get 5 percent of the Internal Revenue Allotment (IRA), the local governments’ share of national tax collections, for disaster risk resilience (DRR) under Republic Act 10121 or the Philippine Disaster Risk Reduction and Management Act of 2010.

Of the total calamity fund, 70 percent is allocated to prevention, mitigation and preparedness, and 30 percent is set aside as a Quick Response Fund (QRF).

“What is left of our calamity fund is now being used for our Covid-19 response,” said Rosaroso. These include relief goods, PPE for volunteers, hygiene kits, food packs for residents, as well as LSIs and ROFs (returning overseas Filipinos) undergoing quarantine.

Sulat has hosted close to 200 LSIs since March.

A fourth-class municipality with a population of close to 16,000, Sulat does not have a hospital, but there is one doctor in each of the rural health centers in 18 barangays, said Rosaroso.

As of Aug. 10, there were eight confirmed cases of Covid-19 infection in Eastern Samar and most of them came from Metro Manila. Both Catuday and Rosaroso said there were no confirmed cases in their towns, as they work even on Sundays to ensure health and hygiene protocols are properly implemented.

Mario Candelaria, chairman of Barangay San Francisco in Sulat, said: “An infection here is a nightmare because we don’t have a hospital.”

Noon ‘pag galing Maynila sinasalubong ng mga taga dito, ngayon nilalayuan na (Before, those who arrived from Manila got a welcome, now people avoid them,” said Candelaria.

He said the P110,000 calamity fund of San Francisco has also been used for food packs, hygiene kits, and for disinfecting public facilities.

Exposed and vulnerable

The Philippines ranked second in terms of exposure and vulnerability to climate-related risks in the Global Climate Change Risk Report for 2020 of Germanwatch, the environment think tank. Japan topped the list.

Red Constantino, executive director of the Institute for Climate and Sustainable Cities (ICSC), said the report showed that “Those who are least responsible for the problem, are the ones who are suffering the most. This is unacceptable.”

“The pandemic has largely revealed systemic weaknesses that would have just taken more time to uncover otherwise,” said Constantino.

A man swims neck-deep in water in San Francisco Del Monte, Quezon City at the height of Typhoon Maring in 2017. Photograph: Bernard Testa

The German report noted that strong tropical cyclones such as Bopha (“Pablo”) 2012, Haiyan (“Yolanda”) 2013 and Mangkhut (“Ompong”) 2018 have been recorded in the last 10 years, affecting mostly the poor and vulnerable population.

At least 74 percent of the country’s population is susceptible to multiple hazards, including coastal hazards such as typhoons, storm surges and rising sea levels, according to the 2018 World Risk Report. The report ranked the Philippines third among countries most vulnerable to disaster risks.

The catastrophic impact of Tropical Depression Ondoy in 2009 cost Marikina and Pasig cities P22.54 billion, of which Pasig accounted for 90 percent.

Rich city gets more money

This time around, Pasig City had to let go of critical spending for disaster risk resilience programs due to the pandemic response, said Bryant Wong, the city disaster risk reduction and management officer. These included reducing the number of fire engines and rescue vehicles to be purchased.

“We did not expect Covid-19 pandemic to affect us all, but we need to respond to it the best way we can,” Wong said.

Unlike Sulat and Dolores, however, Pasig City Hall has deeper pockets and generous donors.

Of the P600-million calamity fund for 2020, the city government has spent half for the Covid-19 pandemic response, Wong said.

It also managed to utilize an additional P200 million from the P300 million DRR savings in the last five years.

Other funding sources for Pasig City’s Covid-19 response included a P1.2-billion supplemental fund for the Social Amelioration Program (SAP) and another P1.2 billion for tablets to be used by students for online classes, from the Special Education Fund.

The city also received P136 million from the Bayanihan fund, equivalent to one month of its IRA.

Wong said private donations of beds, PPEs, hygiene kits and rapid testing kits worth P50 million boosted the city’s pandemic response.

The private sector also donated 100,000 food packs to Pasig.

In the case of Sulat and Dolores towns, there are no big corporate donors, which meant that the money for food packs distributed to locked-down residents came from their calamity funds.

Funding sources

Undersecretary Ricardo Jalad of the Office of Civil Defense, also the executive director of the National Disaster Risk Reduction and Management Council Council (NDRRMC), told local government units (LGUs) in a webinar in July to learn “to adjust, transform and adapt strategies to manage response to Covid-19 pandemic and prepare for multiple hazards from natural calamities.”

During the webinar, John Aries Macaspac, a director of the Department of Budget and Management (DBM), enumerated funding sources for the Covid-19 response, including the Special DRRM Trust Fund or the savings from DRR funds in the last five years, a month’s worth of IRA from the national government and realigned funds from the General Fund. LGUs may also use 20 percent of their development funds for the purchase of PPEs, rapid test kits, vitamins, medicines, accommodation and expenses of health workers, construction of rental quarantine facilities, mobile testing labs, tents, shelters for the homeless, and training for pandemic response, under guidelines issued by the DBM and the Department of the Interior and Local Government (DILG).

The “Bayanihan to Heal as One” or Republic Act 11469 allocated P37 billion for the emergency Covid-19 response of LGUs. It allocated P12.4 billion to all cities; P18.39 billion to municipalities and P6.2 billion to provinces.

Constantino said responses to the Covid-19 pandemic and climate emergency should go hand in hand, as both require the expertise of scientists and policies and actions based on evidence.

Scientists, he noted, advised physical distancing to prevent the transmission Covid-19 while waiting for a vaccine to be developed. Scientists have also stressed the urgency of limiting the rise of global temperatures to below 1.5 degrees Celsius to avoid the worst impacts of the climate crisis.

“We do not have the luxury to choose whether we need protection from the deadly fevers induced by the novel coronavirus or from an increasingly feverish planet. Just as climate change is not an environmental problem but a development crisis, so is Covid-19 not merely a human health crisis but an ecological problem,” said Constantino.

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About the Author:

Estrella Torres is a journalist who has worked for major English dailies in the Philippines for 20 years. She is now the Head of Media and Communications of Save the Children Philippines. Save the Children implements a program on improving the quality of disaster response and preparedness in the typhoon-stricken municipalities of Sulat and Dolores in Eastern Samar.

Bayanihan 2 and 2021 budget leave millions of unemployed behind

by IBON Media & Communications

The latest July 2020 labor force survey (LFS) figures confirm the inadequacy of the Duterte administration’s response to what is developing into the worst jobs crisis in the country’s history. The Bayanihan 2 and the proposed 2021 national government (NG) budget give the appearance of assistance but will leave millions of jobless and distressed Filipinos behind. The level of aid for the people is much too small for the magnitude of the crisis at hand.

This year will likely see the biggest contraction in employment in the country’s history. Employment contracted by 1.2 million in July 2020 from the same period last year, falling to 41.3 million employed according to the latest LFS. This comes after the reported 8.0 million year-on-year contraction in April 2020. For the whole of 2020, IBON estimates employment to fall by 2-2.5 million from last year. This will far surpass the previous record employment losses of 833,000 in 1980 and 821,000 in 1997.

The crisis of joblessness is unprecedented. The official unemployment rate of 10% in July 2020 brings the average of the first three rounds for the year so far to 11% which is not likely to improve much even when the October round results come out. The 4.6 million officially reported unemployed in July 2020 is already 2.1 million more than in the same period last year.

Adding 4.6 million unemployed and the 7.1 million underemployed means that the government acknowledges at least 11.7 million Filipinos jobless or looking for additional work to increase their incomes in July 2020. IBON however has long pointed out that official unemployment figures since 2005 tend to underestimate the real number of unemployed Filipinos by around 2-2.5 million annually.

Moreover, the labor department has already reported 604,403 overseas Filipino workers seeking assistance of which only a little over one-third (237,778) have been helped so far. In a press briefing today, they also said that they expect another 200,000 to need help until the end of the year.

Official figures likely underestimate the extent of the problem. However, even going by these, the inadequacy of the government’s response to directly help the people is clear.

Bayanihan 2 promises Php5,000-8,000 in emergency cash subsidies and other assistance for poor households, displaced workers and OFWs. However, only Php19.2 billion is budgeted for cash subsidies and other assistance which is just 3.8 million beneficiaries at most. The aid will also just be a mere Php37-60 per person per day for a month or even less than the official Php71 poverty threshold.

In the proposed 2021 NG budget, there is no provision for substantial emergency cash subsidies beyond existing social welfare department programs such as the Pantawid Pamilyang Pilipino Program (4Ps) and smaller programs. Indigent pensioners are not getting any increase in their pensions. Even the labor department’s Tulong Panghanapbuhay sa Ating Disadvantaged/Displaced Workers and Government Internship Program (TUPAD-GIP) program gets just a meager Php3.2 billion increase to Php9.9 billion.

Micro, small and medium enterprises (MSMEs) are also not getting the focused assistance that they need. There are 997,900 MSMEs employing 5.7 million workers aside from hundreds of thousands more unregistered establishments with millions more workers. Formal sector establishments had over Php21 trillion in expenses in 2018. In July 2020, the DTI said that 26% of companies they surveyed closed operations and another 52% were only partially operating. Those partially operating also said their income was down by 90 percent.

The Php77.1 billion Bayanihan 2 budget for production and enterprise support will cover only a small fraction of workers in MSMEs, and is even shared with farmers and fisherfolk. In the proposed 2021 NG budget, the MSME Development Program is even getting a Php416 million budget cut to just Php2.3 billion. The budget of the Small Business Corporation (SBC) stays the same at just Php1.5 billion.

In their press briefing today, the economic managers projected a 12% unemployment rate in 2020 (mid-point of the Development Budget Coordination Committee estimate of 11-13%) improving to 6-8% in 2021 then 4-5% in 2022. These optimistic projections cannot materialize without substantially increasing aggregate demand through meaningful cash transfers to millions of distressed households and more support to hundreds of thousands of struggling MSMEs.

Tens of millions of Filipinos and their families will continue to suffer for years without a genuine stimulus program overriding the misguided fiscal conservatism and reckless optimism of the economic managers. #

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Kodao publishes IBON articles as part of a content-sharing agreement.

Mga martir ng sambayanan, binigyang-pugay ng mga aktibista

Isang pagkilos sa Bantayog ng mga Bayani sa Quezon City ang isinagawa noong Lunes, Agosto 31, bilang paggunita sa Araw ng mga Bayani gayundin ay pagbibigay-pugay sa mga martir ng sambayanang Pilipino.

Kinilala sa nasabing pagkilos ang mga frontliner na nasawi laluna ang mga manggagawang pangkalusugan dahil ng pandemya na COVID-19.

PH ‘stimulus’ smallest in region

Philippine spending in response to the COVID-19 pandemic is among the smallest in the region, said research group IBON.

The narrow-minded obsession with ‘creditworthiness’ stops the government from taking the urgent steps needed to restore livelihoods and save the economy. The group said that having economic managers dominated by finance people rather than development experts is the biggest obstacle to real recovery.

According to the International Monetary Fund (IMF) Policy Responses to COVID-19 tracker, the fiscal policy response of the Philippines is equivalent to just 3.1% of its gross domestic product (GDP).

IBON noted that this is the smallest among the major economies of Southeast Asia. This is less than in Singapore (19.7%), Vietnam (13.3%), Thailand (9.6%), Indonesia (4.4%) and Malaysia (4.3%). It is also less than half of the global average of around 6.2% of GDP.

The Philippines’ ranking does not change even if the Bayanihan 2 bill recently approved by the Senate is passed into law, said the group.

The proposed Php140 billion stimulus program is worth just 0.7% of the GDP and will bring the country’s fiscal response only to 3.8% of GDP.

The IMF notes that country data are not always strictly comparable but the figures are nonetheless indicative.

IBON said that upcoming national government (NG) budgets meanwhile see the smallest post-crisis ‘stimulus’ increases in decades, further undermining economic recovery.

Department of Budget and Management National Budget Memorandum No. 136 only foresees a 5.7% budget increase in 2021 falling to an even smaller 1.8% increase in 2022, despite the country facing the worst economic decline in its history in 2020 because of the pandemic.

The budget increase in 2021 would be the smallest in a decade and in 2022 the smallest in over 30 years.

These increases also compare unfavorably with budget increases after the 1997 Asian financial crisis and 2008 global financial and economic crisis.

After the Thai Baht collapsed in 1997, the NG budget rose by 9.3% in 1998 and then by 8.0% in 1999. After the Lehman Brothers firm collapsed in 2008, the NG budget rose by 9.1% in 2009 and by 2.7% in 2010.

The economic managers have been blocking larger stimulus packages proposed by Congress since at least May, the group said.

The House of Representatives and Senate took up more meaningful stimulus measures worth at least Php1.3 trillion or more but stopped when the finance department told them to because these were ‘unfundable’ and ‘unsustainable’.

These measures would have been closer to the global average.

Among others, this also affirms that the so-called power of the purse of Congress is illusory and how the president and executive branch are actually in complete control of the country’s finances. The president can implement a bigger stimulus package if he wants to, said the group.

The obsession of the economic managers with ‘creditworthiness’ is misplaced, said IBON.

Thailand, Vietnam and Indonesia have lower credit ratings than the Philippines but are spending more to respond to and recover from the pandemic. Financing can be raised by reallocating from less productive infrastructure and debt service, and by a more progressive tax system with higher taxes on large firms and the wealth of the country’s super-rich.

The magnitude of the country’s response has to be commensurate to the crisis at hand. This should span health measures, continued cash subsidies to improve household welfare and boost aggregate demand, and support especially to Filipino and domestic market-oriented micro, small and medium enterprises, said the group. #

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Kodao publishes IBON articles as part of a content-sharing agreement.

Bayanihan 2: Too small, hinders health and recovery

by Sonny Africa

The beggarly Bayanihan 2 bill preferred by the economic managers and imposed on Congress is much too small for the magnitude of the crisis facing the country. It makes health and recovery years away and farther than ever.

The Bayanihan 2 bill passed by the bicameral conference committee and ratified by the Senate is worth just Php165.5 billion. Of this, Php25.5 billion is even just a “standby fund”, only available once “additional funds are generated”.

Every centavo spent of Bayanihan 2 is welcome. There’s no doubt about that because the extraordinary scale of the health and economic crisis demands extraordinary spending. The problem is that the Duterte administration is spending far too little for the problem at hand.

Looked at in aggregate, Bayanihan 2 pales compared to the as much as Php1.9 trillion lost in gross domestic product (GDP) in 2020 because of the pandemic. This includes not just what is lost from the economy contracting but from what it should have been if it kept on growing.

But the shortfall is even clearer looking at the details. Bayanihan 2 allots Php30.5 billion for health-related responses spanning tracing, treatment, support for health workers, health facilities and pandemic research.

Bayanihan to Recover as One Act

Yet the health infrastructure spending doesn’t even make up for huge budget cuts here since the start of the Duterte administration. There’s Php10 billion budget for testing but this is in the standby fund and made contingent on finding new funds, which the economic managers are so sparing in doing.

The provision for Php5,000-8,000 in emergency cash subsidies is necessary but only Php13 billion is allotted for this. This is paltry compared to how the lockdown-induced recession has already displaced anywhere from 20.4 million to as much as 27 million of the labor force (43-57% of the labor force), according to IBON’s estimates.

Bayanihan 2 will help just 1.6-2.6 million beneficiaries at most and, even then, not by much. At Php5,000-8,000 per household, it will only give the equivalent of a token Php37-60 per person per day for a month. This paucity is little changed even if the Php6 billion budget for social welfare department programs, Php820 million for overseas Filipinos, and Php180 million for national athletes and coaches is added.

The budget for the transport programs includes Php5.6 billion for displaced public utility vehicle (PUV) drivers especially jeepney drivers. But this isn’t even enough to compensate them for the now five months that the government has kept them out of work and driven into poverty.

Much more substantial cash assistance is needed to improve household welfare in these difficult times. This also has macroeconomic benefit of boosting aggregate demand and stimulating a virtuous cycle of spending and production. Economic activity is impossible and production support will be futile if too many are jobless and have nothing to spend.

There’s Php77.1 billion for production and enterprise support. This includes Php24 billion for agriculture which gives the sector an emphasis in Bayanihan 2 that it is due. There is also Php39.5 billion for government financial institutions (GFIs) to support lending, Php9.5 billion for transport programs, and Php4.1 billion for tourism programs.

The total amount is however only going to help a few of the 997,900 micro, small and medium enterprises in the country employing 5.7 million workers – and probably none of the hundreds of thousands more informal and unregistered enterprises. If available, the additional Php15.5 billion under the standby fund for low interest Land Bank of the Philippines (LBP) and Development Bank of the Philippines (DBP) loans will help but still not be enough.

The Php8.9 billion for education is critical to keep the youth educated and eventually productive. But the budget is a mere fraction of the tens of billions of pesos needed to ensure that schools are safe and have internet connectivity, and to help parents keep their children in school. There are some 70,000 elementary and secondary schools and around 2,000 higher education institutions in the country.

The remaining Php3.5 billion for local government units (LGUs) will also certainly help the recipients but, measured against the scale of the intervention needed across the breadth of the economy, are almost tokenism.

The economy will rebound somehow but this will be slight and Bayanihan 2 is too small to hasten real recovery. The government is the only entity in a position to implement the huge stimulus program the economy needs and there needs to be more boldness to spend and, especially, to raise money for this.

The Duterte administration can raise the money needed if it really wanted to. In the short-term it can realign from infrastructure projects and at least some of the debt servicing to development agencies and friendly official creditors.

Big-ticket infrastructure projects that are no longer economically or financially viable, or are too import- or capital- intensive, can be put off or shelved. Debt service to development banks and the like can be restructured on the argument that there are more pressing uses for scarce government funds.

The government can actually wield its creditworthiness to borrow if needed on favorable terms. The best way to pay for any additional debt is not from more consumption taxes on the people but from higher income and wealth taxes on the country’s super-rich. The huge accumulated wealth concentrated in the few is more than enough for all the stimulus the country needs and can be the foundation of a credible medium-term fiscal plan.

A much more progressive tax system with higher direct taxes is the most rational and sustainable source of government revenues. This most of all means a wealth tax on the country’s super-rich (raising Php240 billion annually from just the 50 richest Filipinos), higher personal income taxes on the richest 2.5% of families (Php130 billion), and a two-tiered corporate income tax scheme (Php70 billion).

The economic managers’ obsession with creditworthiness is the binding constraint to fighting COVID-19 and the economic misery in its wake. This self-imposed fiscal straitjacket is misguided. Spending less, not spending more, is keeping the country off the path to health and recovery.

The country is grossly short-changed by Bayanihan 2. It’s all the people are getting not because it’s all the government can afford but rather because it’s all the Duterte administration wants to give.

Due to public pressure and clamor, DepEd moves school opening to October 5

By Joseph Cuevas

The Department of Education (DepEd) announced last Friday, August 14, the postponement of school opening originally set on August 24, 2020 to October 5, 2020.

According to DepEd, the memorandum given by the Office of the President to defer school opening to October 5 is pursuant to Republic Act No. 11480.

DepEd will use the deferment to provide relief to the logistical limitations faced by the areas placed under Modified Enhanced Community Quarantine and to fill in the remaining gaps of the school opening it is currently addressing.

The Alliance of Concerned Teachers ACT said that DepEd’s decision was brought about by “very valid and sound arguments which the agency can no longer deny.”

“We have proven today that the people’s voices can and will triumph, and we shall continue to push the government to fulfill the requisites for a safe, accessible, and quality education,” ACT said in a statement.

The group added that preparedness at the minimum means a 1:1 module set to pupil ratio ready for distribution by August 24, a 1:1 ratio of laptop to teachers, internet subsidy to teachers and learners, health screening and PPEs for teachers, and medical fund for free treatment if they get infected with COVID-19.

ACT said it received complaints from school heads about the late release of funds from the DepEd Central office as well as depleted school funds for module printing.

The central office only released funds and utilization guidelines for module reproduction on the latter half of July, ACT said.

ACT photo

Many school heads said that the P9 billion downloaded funds from the central office have not yet reached the school level resulting in the failure to deliver the needed modules any day earlier than October given the stringent procurement rules and lengthy processes, the group added.

ACT said that DepEd has not given any assistance to teachers specifically responding to the COVID-19 pandemic, noting that they are not asking beyond “hard-won and hard-earned benefits and entitlements of personnel, as well as already apportioned funds even before the health crisis.”

October 5 falls on International Teachers Day.

Better aid, wage subsidy for private school teachers

ACT-Private Schools also called on the government to support displaced private school teachers and personnel nationwide as the House of Representatives is set to finalize the Bayanihan to Recover As One Act (BARO) Part 2.

ACT-Private Schools secretary-general Jonathan Geronimo said that even with a one-time cash assistance of five to eight thousand pesos will not rectify the past six months of state neglect, and will not at all suffice to cover their needs.

Geronimo challenged the Rodrigo Duterte administration to help educators, particularly the “long ignored private education sector nationwide” by granting a decent amount covering the months of COVID-19 lockdowns.

ACT Private Schools demanded the following:

(1) Better and more dignified aid,

(2) wage subsidy to teachers and staff,

(3) zero-interest loans for small to medium-sized private schools to sustain their operations, and

(4) an allocation of funds for the health and safety of private school teachers and personnel. #

Health workers decry loss of fellow front liner

By Joseph Cuevas

Members of the Jose Reyes Memorial Medical Center (JRMMC) Employees Union-Alliance of Health Workers held a protest rally last August 3 to denounce the death of their fellow health worker who died of Covid-19 they said was due to gross negligence of the hospital management, the Department of Health (DOH) and the Rodrigo Duterte government.

Judyn Bonn Suerte, a JRRMC employee and active union member succumbed last July 31 to Covid 19. He was among the 20 health workers of the hospital infected last month.

In a statement, Cristy Donguines, President of JRMMC Employees Union said that Suerte’s life would have been saved if it had been immediately treated by JRMMC and not brought to Dr. Jose N. Rodriguez Memorial Hospital where he died. 

“It is painful to think but it is clear to us that this is a major negligence of the hospital management and the DOH itself due to their anti-health workers protocols,” Donguines said.

She added that the management blindly implemented the DOH’s defective protocol that led to the death of a health worker of the said hospital.

DOH has instructed all medical center chiefs and hospital directors that all employees admitted to their respective hospital with severe COVID-19 cases should be transferred to any designated exclusive COVID-19 referral hospitals.

The union revealed that the JRMMC has no free re-swabbing test for its health workers after undergoing quarantine protocols.

“It should be one of the protocols to be implemented by the hospital to ensure that they are really fit to work. Worst, in order to make sure that they are really fit to work, they need to pay for re-swabbing test outside of the hospital that costs P5,500.00 for drive-thru and P4,300 for walk-in tests,” it said.

Colleagues mourn the death of Judyn Bonn, an employee of the Jose Reyes Memorial Medical Center who recently died due to COVID-19. (Contributed photo)

‘Generals infesting health response

Meanwhile, more doctors and other health care workers agreed with 40 medical associations who earlier asked the Duterte government to again implement an enhanced community quarantine period in Metro Manila.

A statement signed by almost 200 doctors and health care professionals and issued on Second Opinion Facebook page reiterated that the quarantine was a public health measure aimed at saving lives by stopping the spread of disease.

It also rejected the government’s “military type quarantine” it said is oppressive and devoid of scientific sense and health purpose.

The signatories prescribed the immediate removal of DOH Secretary Francisco Duque and all generals and czars “infesting” the Inter-Agency Task Force (IATF) and replace them with team players from health and related fields.

In addition, the petitioners asked:

* active and aggressive recruitment of health workers;  

* immediate provision of substantial funding and financial support for both national and local government interventions; 

* continuity of care from the primary to the tertiary levels, and between public and private health facilities;

* enhancing capacities in testing, tracing, isolation, and treatment at the institutional and community level, and utilizing appropriate technologies in the promotion of preventive; and

* public health measures and immediate improvement of COVID-19 data processing and management.

President Duterte has placed Metro Manila and provinces of Bulacan, Rizal, Laguna and under Modified Enhanced Community Quarantine starting today. tomorrow, August 4 as recommendation of IATF to President Duterte.

According to DOH, as of August 3, Covid-19 cases has risen to 103,185, including 5,032 new cases while there had been 4,823, infected health workers and 38 deaths. #

Record number of COVID-19 ‘recoveries’ mere window dressing, expert says

The decision by the Department of Health (DOH) to categorize coronavirus patients with no or mild symptoms as “recovered” is mere cherry picking and window dressing, a community medicine expert said.

University of the Philippines College of Medicine professor Gene Nisperos said the decision is problematic as it was applied to many cases a World Health Organization (WHO) guideline meant only for individual patients.

“The WHO guidelines were only meant for individual cases. What the DOH did was to apply it en masse,” the medical doctor explained.

“These recommendations are for individual patients who are assessed and cleared by physicians. Simply extrapolating this to massive data is problematic,” he said.

In its July 30 update on coronavirus cases in the Philippines, the DOH reported 38,075 recoveries in a day.

DOH case bulletin for July 30, 2020

Citing new protocols in the US and Europe, the DOH said Thursday it is now tagging patients with mild or no symptoms as “recovered” 14 days from the onset of symptoms or by the date of specimen collection.

With nearly 40 thousand new “recoveries”, the DOH said the Philippines now has 65,064 patients who have recovered from the virus on the day it reported a record number of new cases at 3,954, bringing the country’s total to 89,374.

Nisperos however said even if the new protocol is a new DOH data management style, it remains inconsistent as it leaves out from the list of active cases the number of validation backlog that currently stands at 37 thousand.

The DOH said there are 22,327 active COVID-19 cases in the country.

The medical doctor said the DOH is merely cherry picking and window dressing the data.

“The data is being presented to fit a narrative instead of the narrative being based on the data,” he added. # (Raymund B. Villanueva)

Beyond capacity and overwhelming incompetence

by Maricar R. Piedad

The Philippines has been in varying intensities of community quarantine for 124 days—a world record in terms of the longest lockdown response to COVID-19. But the fight against the virus is still far from over, and now it seems like the country is back to square one—overwhelmed hospitals, rising number of cases, and overall chaos. All those days in lockdown have been wasted because of the Duterte administration’s louche decisions and inaction on building up the healthcare system’s capacity for COVID-19 response.

The government, more than ever, should acknowledge the graveness of the crisis. It should prioritize implementing solutions to flatten the curve rather than push business-as-usual measures towards so-called recovery when the imminent threat of the pandemic continues to stare every Filipino in the face.

So far, the measures it has taken—lockdowns, limited triage testing, and waiting for a vaccine from other countries—have been passive.

On the verge of collapse

The current healthcare system is now operating close to its maximum capacity with cases exceeding 63,000; already reaching the projection of cases 60,000-70,000 by the end of July and cases is increasing by almost 1,000 daily. Still, government has no clear and concrete plan to expand testing triage and capacity.

The sluggish COVID-19 testing is prolonging the country’s fight against the virus. Only a small portion of asymptomatic cases are being detected because of the absence of mass testing. Compared to the rest of the world, the Philippines has a low number of asymptomatic cases. But this is mainly because less than one percent of the country’s total population has been tested for COVID-19, almost six months after the first reported case. As of writing, only 1,009,511 individuals have been tested.

According to the adjusted estimates of the University of the Philippines (UP) as of July 13, the mean number of hospitalized patients is 23,747 and it can reach up to 28,024. As of now, the total hospital bed capacity is at 15,548, with 1,661 ICU beds, 10,410 isolation beds, and 3,477 ward beds. There are only 1,938 mechanical ventilators available. This means that hospitals may need to double their total number of beds before the end of July to accommodate these patients.

However, hospital bed capacity only increased by about 2,019 beds since last month’s total bed capacity of 13,529, according to the Department of Health (DOH). There was also no significant addition to the mechanical ventilators available which are important to treat critical cases. There was also no notable increase in the COVID-19-dedicated ward and ICU beds. Considering that more suspected and probable cases will be needing hospitalization, the influx of patients seeking medical attention will be beyond the country’s healthcare capacity. The exponential increase in the number of confirmed COVID-19 cases will overwhelm the healthcare system in no time and hospitals will be forced to deny patients due to the lack of facility.

The ICU bed occupancy rate, which is a huge indicator of critical care capacity, is already at 41.2% as of the latest DOH data drop. Ward beds are at 57.1%, and isolation beds are at 48.4% occupancy. Majority of the ward and isolation beds occupied are also located in private healthcare facilities. This is despite public hospitals having more COVID-19-allocated beds. This could mean that majority of COVID-19 patients are compelled to receive treatment from private institutions charging higher hospital bills and out-of-pocket expenses due to limited benefit packages from the Philippine Health Insurance Company (PhilHealth).

Out-of-almost-empty-pocket

Ballooning COVID-19-related expenses of Filipino patients is another major issue that the government should address. The medical bills of some COVID-19 patients have ranged from hundreds of thousands to millions of pesos, depending on the severity of the case. For instance, the bill of one recovered patient reached Php1.312 million for a 15-day confinement. According to the patient, a huge chunk of the medical bill were charges for laboratory tests, doctors’ professional fees, intubation, and the ventilator and respirator she used throughout her admission. Though all her medical expenses were fully covered by PhilHealth, this is no longer the case for COVID-19 patients admitted in accredited hospitals from April 15 onwards.

At the start of the pandemic, the Duterte administration assured the public that it has individuals infected with COVID-19 covered. However, PhilHealth announced in early April that it would no longer shoulder all expenses and would instead implement case rate packages for confirmed and probable cases effective April 15. According to PhilHealth Circular 2020-0009, patients with mild pneumonia can avail of a maximum coverage of Php43,997, while moderate and severe pneumonia patients can have a maximum amount coverage of Php143,267 and Php333,519, respectively. Critical patients, on the other hand, can access a Php786,384-worth maximum benefit.

But PhilHealth computations for these packages contradict the government’s assurances and may not be enough to cover the numerous medical procedures COVID-19 patients must undergo. Medical expenses in excess of the case rates will be paid out-of-pocket, and the amount could be considerable. If the patient with the Php1.312 million medical bill for example had been confined after April 15, PhilHealth would have just paid the Php333,519 maximum coverage for severe pneumonia patients. The remaining Php978,481 or almost 75% of the patient’s total medical bill would have to be paid out-of-pocket.

The abrupt economic shutdown resulted in most Filipinos losing income and struggling with the recent rise in the cost of living, especially the poor and vulnerable. Many of them can ill-afford to pay for medical expenses and may no longer consult doctors despite having symptoms.

Burning Out

Aside from the health infrastructure, the government also needs to reinforce the country’s human resource for health. Even before the pandemic, Filipino doctors and nurses were already treating patients beyond their capacity.  According to the Philippine Health Review 2018, there are 3.9 doctors and 8.6 nurses for 10,000 people. This medical worker to patient ratio is a far cry from the World Health Organization (WHO)-recommended 10 doctors and 20 nurses for every 10,000 population.

A Philippine Institute of Development Studies (PIDS) study also noted that, in a 24-hour set-up, 1 doctor and 2 nurses will be needed to treat 6 ward patients. Critical care patients will need 1 doctor and 1 nurse each as well as other special healthcare workers such as a pulmonologist, intensivist, infectious disease specialist, and mechanical ventilator technicians.

The available healthcare workers in the country will not suffice. With no significant addition to the health workforce, the country’s doctors and nurses will be overwhelmed and exhausted. There will also be a greater risk of infection for medical workers since having more patients could mean more exposure to COVID-19. There are already 3,805 healthcare workers infected and 35 of them have already died. 

The DOH decision to reassign physicians under the Doctors to the Barrios program is another sign that there are not enough doctors in COVID-19 treatment hospitals and reinforcements are urgently needed. However, only 5,216 health workers have so far been hired to fill the DOH-approved 9,297 slots for emergency hire. This slow hiring means medical frontliners continue to work beyond their capacity to treat the piling number of COVID-19 patients. The DOH itself has also noted the difficulty in hiring health workers because many of them have private services that they cannot leave. It also does not help that the entry level salary for healthcare workers is low. For example, a medical laboratory technician—which is under salary grade 6, can only earn up to Php 15,524 per month.

The country’s shortage of personal protective equipment (PPE) is also contributing to the huge number of infected health workers. According to the WHO, the global shortage of PPEs is affecting healthcare workers worldwide. This shortage could have been eased if the country had the means to manufacture its own PPEs, such as a local textile industry. But the country is reliant on imported PPEs. The Philippine Exporters Confederation Inc. (PhilExport) stated that despite factories’ willingness to produce PPEs, they cannot simply do so because of the lack of fabric and other materials. Had there been a Philippine industry for essential health protection needs, infection among front liners and in general would have been minimized.

Overcoming incompetence

The Duterte administration’s failed COVID-19 strategy in ending the current health crisis exposes its incompetence and lack of sensibility. The 124 days spent in lockdown and the opportunity costs incurred during this period have been wasted because the government failed to effectively intervene and keep the healthcare system from collapsing. It should now set its priorities straight and put all hands on deck to amplify health responses.

The government is not prioritizing funding for the healthcare system and social amelioration but it is pushing for ill-timed programs that will allegedly help in the country’s economic recovery. A concrete example is the continuation of the Duterte administration’s “Build, Build, Build” program despite the more pressing need to reallocate more funds for COVID-19 response.

The Philippine Program for Recovery with Equity and Solidarity (PH-PROGRESO) of the government shows that it is more inclined to save big businesses first before the Filipino people. The huge budget allocated for private corporations’ benefit should be realigned to help the overwhelmed healthcare structure. Fiscal measures for health and economic recovery should go hand in hand instead of pitting one against the other since overall economic performance is very much reliant on the well-being of the Filipino work force.  

Inadequate and relaxed response to COVID-19 hinders the Philippine economy from fully opening. It has only been two months since the gradual operation of businesses and since workers returned to their respective workplaces but the government is already losing control of the situation. Aside from the uncontrollable spread of the disease, hospitals are now reporting that they reached their maximum critical care capacity. Forty-eight hospitals already reported that their ICU beds are now full, and it is alarming that 50% of these hospitals are located in the National Capital Region (NCR). Meanwhile, Cebu City—which is the new epicenter of the disease in the country, is also nearing the danger zone in its critical care capacity. If the population of the Philippines’ major economic hubs keep on getting sick, then it will be much harder for the economy to recover its losses.

The government must protect first the Filipino people from the COVID-19 threat. Majority of Filipino workers are at risk of contracting the disease. The economy cannot recover without a healthy workforce to power it. According to UP’s analysis, half of the Philippines’ major economic contributors are considered high risk spreaders of COVID-19, such as construction workers, security guards and commercial drivers. Many of them are minimum wage earners lacking adequate social benefits and protection. This makes them more vulnerable to infection and with limited means to pay for expensive COVID-19 treatment.

The government should speed up the efforts in broadening and building up testing and hospital capacity.  More than ever, it should make healthcare accessible and affordable for every Filipino. This includes making COVID-19 testing and treatment free for all. The pandemic will not be over as long as infected Filipinos are not isolated and treated due to the lack of facilities and expensive healthcare.

In the end, the entire Philippine economy will suffer if Filipinos are not protected from this disease. The economic downgrade will be far greater if the coronavirus crisis lasts longer. The government cannot afford another lockdown since it will not only endanger the economy but will also bring intense hunger and more hardship. It must act now and prevent the health system from collapsing and the Filipino people from succumbing to both the pandemic and to poverty. #