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Promotion, protection of breastfeeding practices reap rewards

By Angelica Carballo Pago/Philippine Center for Investigative Journalism

Exclusive breastfeeding among infants 0 to 5.9 months has nearly doubled, from 30 percent in 2003 to 58 percent in 2019.

Women should still breastfeed despite the pandemic, even those found to be positive for Covid-19, according to a Department of Health (DOH) memorandum. This shows how the government has been relentless in promoting breastfeeding in the face of a formidable opponent – milk manufacturing giants who have made their way into the consciousness of Filipino mothers through massive advertising.

Despite the passage of the Milk Code 33 years ago, myths and unfounded beliefs persist amid aggressive promotions by milk manufacturers that claim to give a child advantage in terms of health and IQ points.

Only 35.1 percent of babies are exclusively breastfed until 5 months of age, according to the 2019 Expanded National Nutrition Survey of the Department of Science and Technology – Food and Nutrition Research Institute (DOST-FNRI), although exclusive breastfeeding percentages have been increasing since 2003, but took a dip in 2015.

Nathalie Verceles, director of the University of the Philippines Center for Women’s and Gender Studies, said the Milk Code was meant to protect the interest of mothers and babies from aggressive marketing strategies of formula milk companies. (See related story: Milk and the pandemic: Milk Code confusion cripples LGUs response for infants)

Mothers need support, according to Save the Children Philippines health and nutrition adviser Dr. Amado Parawan. A mother’s decision to breastfeed, he said, predates the birth of the child and will depend on what she believes – or is made to believe. This decision can also be affected by the support she gets – or doesn’t get – from home, work and community.

Maryjoy Mota shows the bottle used to feed baby Pia, when her family was able to scrape a few hundred pesos to buy formula milk. Photograph: Buck Pago

Here’s a timeline of breastfeeding policies and how they have influenced breastfeeding rates.

May 1981 – The International Code on Marketing of Breastmilk Substitutes is adopted by the World Health Assembly. The aim is to protect and promote breastfeeding by ensuring appropriate marketing and distribution of breastmilk substitutes.

20 October 1986 – President Corazon Aquino signs Executive Order 51 or the Milk Code with its Implementing Rules and Regulations (IRR). The Code regulates advertising of breastmilk substitutes, including infant formula, other milk products, foods and beverages, feeding bottles and teats.

1990 – Guided by the World Health Assembly resolutions, which state that “follow-on or follow-up formulas are unnecessary because after six months the baby starts to take complementary foods together with sustained breastfeeding,” improvements were introduced on the IRR, such as the ban on follow-on formulas. This was prompted by the 1987 Wyeth’s invention of follow-on milk for children aged six months and above that undermined the importance of breastfeeding. When the Milk Code was being drafted, follow-on milk was not yet invented. “Complementary food” includes food that is part of the local culture.

2 June 1992 – The Rooming-In and Breast-Feeding Act, Republic Act (RA) 7600, is passed, provides legal basis for rooming-in as a national policy to encourage, protect and support breastfeeding.

2003 – The exclusive breastfeeding percentage among infants 0-5.9 months stands at 29.7 percent.

2004 – The Task Force Milk Code begins discussion and debate on the first draft of the revised IRR of the Milk Code. Among those consulted was Swiss multinational Nestlé, who represented formula milk companies.

23 May 2005 – DOH Administrative Order (AO) 2006-0014 or the National Policies on Infant and Young Children is issued. It states that in times of crisis, breastfeeding is the first and best feeding option for infants and young children. It requires mothers and babies to remain together after delivery. Support must be given for mothers to breastfeed even in crisis or emergencies.

2006 – The Pharmaceutical Healthcare Association of the Philippines (PHAP) seeks a temporary restraining order on the revised IRR’s implementation. After initially denying PHAP’s petition, the court overturns its decision and issues a TRO on the revised IRR.

28 May 2007 – DOH AO 2007-0017 or the “Guidelines on the Acceptance and Processing of Foreign and Local Donations during Emergency and Disaster Situations,” states that “Infant formula, breastmilk substitutes, feeding bottles, artificial nipples and teats shall not be items for donation. No acceptance of donation shall be issued for any of the enumerated items.”

09 October 2007 – The revised IRR of the Milk Code takes effect after the Supreme Court partially upholds its validity. It strikes down certain provisions, such as the prohibition on advertising and promotion of breastmilk substitutes and introduces sanctions not found in the law.

01 April 2008 – The Department of the Interior and Local Government releases AO 2008-0055, or the “Guidelines on the acceptance and processing of foreign and local donations during emergency and disaster situations.” It endorses DOH AO 2007-0017 to all local government units.

2008 – The exclusive breastfeeding percentage among infants 0-5.9 months rises to 35.9 percent.

16 March 2009 – RA 10028 or the Expanded Breastfeeding Act, which amends RA 7600, is signed by President Gloria Macapagal Arroyo. It establishes standards for workplaces, health facilities (with the establishment of milk banks) and public places, and calls for breastfeeding breaks and designated facilities in the workplace.

Infographic by Alexandra Paredes

2011 – The exclusive breastfeeding percentage among infants 0-5.9 months rises anew, to 48.9 percent.

21 December 2012 – RA 10354 or The Responsible Parenthood and Reproductive Health Act of 2012 is signed by President Benigno Aquino III. It includes breastfeeding as an element of reproductive health care and provides a basis for breastfeeding promotion and education.

2013 – More than half, or 52.3 percent, of infants 0-5.9 months are exclusively breastfed.

2015 – The exclusive breastfeeding percentage among infants 0-5.9 months dips for the first time to 48.8 percent.

29 November 2018 – RA 11148 or the “Kalusugan at Nutrisyon ng Mag-Nanay Act” is signed by President Rodrigo Duterte. The law seeks to address the malnutrition of infants and young and lactating women.

2018 – The exclusive breastfeeding percentage among infants 0-5.9 months recovers slightly to 54.9 percent.

17 April 2019 – RA 11311 or “An Act to Improve Land Transportation Terminals, Stations, Stops, Rest Areas and Roll-On/Roll-Off Terminals, Appropriating Funds Therefor and for Other Purposes,” establishes lactation stations in transport terminals, stations, stops and rest areas.

2019 – Exclusive breastfeeding improves to 57.9 percent.

Infographic by Alexandra Paredes

11 May 2020 – DOH Memorandum No. 2020-0237 or the “Interim Guidelines for the Delivery of Nutrition Services in the Context of COVID-19 Pandemic” states that mothers who are asymptomatic, or those with close contacts, suspect, probable, or confirmed case of COVID-19 who do not have severe illness and/or who are not in respiratory distress, can continue breastfeeding, provided that they observe strict infection control measures.

15 May 2020 – DOH Memorandum No. 2020-0231 or the “Guidelines on the Standardized Regulation of Donations, Related to EO 51,” provides guidelines on how LGUs can help provide nutrition for non-breastfeeding children under 3 years old. While donations are banned as stipulated in various laws and orders, LGUs can procure formula milk and give them to identified families. The memorandum still upholds the promotion and protection of breastfeeding for infants and young children. #

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Sources:

Food and Nutrition Research Institute for breastfeeding data

Babymilkaction.org for Milk Code RIRR timeline

Milk and the pandemic: Milk Code confusion cripples LGUs response for infants

By Angelica Carballo Pago/Philippine Center for Investigative Journalism

The indiscriminate distribution and use of breastmilk substitutes, especially during emergencies, can change feeding practices and put babies at greater risk of illness.

What you need to know about this story:

  • Experts are calling for measures to ensure the health and safety of infant and young children, which can easily be undermined by the milk industry’s aggressive marketing initiatives.
  • The Milk Code does not ban formula milk procurement and distribution by local government units, provided they follow guidelines set by the Department of Health (DOH).
  • Marketing and advertising of products within the scope of the Milk Code, however, are prohibited. Donations of formula milk and breastfeeding substitutes from manufacturers and distributors of these products are banned.
  • Local government units are clueless to the finer details of breastfeeding and infant and young child nutrition laws, to the detriment of mothers, infants and young children in need especially during the current Covid-19 crisis.
  • Milk companies use disasters and crises to market their products, and DOH data show a rise in Milk Code violations during the enhanced community quarantine period.

Here’s one unintended consequence of the Covid-19 health emergency: Parents and guardians are desperately finding ways to feed their babies, with some even begging on the streets or on social media. With lockdowns making it harder to provide proper and adequate food for the family, their health and nutrition — especially of babies — are at risk.

Local governments attempted to solve the problem by distributing formula milk to mothers, only to find out that donations are not allowed by the Milk Code, a 1986 law regulating the marketing and distribution of breastmilk substitutes.

Worse, formula milk makers seem to be taking advantage of the situation to undermine strict government regulations, experts observed.

During the Enhanced Community Quarantine (ECQ) in March, Maryjoy Mota, a 37-year-old resident of Antipolo, posted on the Antipolo City Facebook group that her two-month-old granddaughter needed diapers and formula milk.

Maryjoy’s daughter, 17-year-old Hazel, had just given birth to Pia (not their real names), two weeks before the ECQ was enforced throughout Luzon in mid-March. Maryjoy’s post drew a hundred other comments from mothers and guardians in the same situation.

With Hazel giving birth to Pia two weeks ahead of her due date, the doctor immediately prescribed a formula milk brand, PreNan, developed for premature newborns. Weighing just 1.7 kilograms, the baby had to be placed in an incubator.

“We were not given any other options or brands, nor given any instructions or assistance to start breastfeeding,” Maryjoy said.

Even when Hazel went for check-ups at the barangay and the district health centers before she gave birth, there were no instructions on breastfeeding, which could have helped them save some money instead of spending it on formula milk, she said.

Maryjoy’s comment on Antipolo City’s Facebook page, asking for milk and diapers for her grandchild.

Sought for comment, an official of the Rizal Provincial Hospital System – Antipolo Annex 1, who asked not to be named, insisted that the hospital followed breastfeeding protocols. But Pia weighed below the 2.5-kilogram birth weight threshold and showed signs of sepsis, the official said.

The formula milk prescribed to Pia met the baby’s caloric requirements, which might not be sustained by breastfeeding, the official said.

But with no income, it was impossible to buy the 400-gram can of milk, which costs P641. Maryjoy’s common-law husband, Ricky, lost his construction job because of the pandemic, while Pia’s parents were unemployed teenagers.

While some local leaders were aware of the plight of new mothers like Hazel, the Milk Code posed an obstacle. Sangguniang Kabataan Chairman Arky Manning of Barangay San Isidro in Taytay, Rizal learned this the hard way.

The Department of Health (DOH) gave Manning a memo for violating Executive Order (EO) 51, or the Milk Code of 1986, by “accepting and distributing milk formula donations” given to mothers with infants in Taytay in April and May 2020.

Manning explained that it was part of the “Tulong Kay Baby (help for baby) project,a donation drive that he had organized with his friends. They bought milk and diapers using funds given by private individuals. No mass distribution or random donation of milk happened, he claimed.

Manning was one of the 291 violators flagged by the DOH from March 1 to July 24, largely covering the ECQ period in Luzon. Reports of violations came from the general public, submitted through http://mbfp.doh.gov.ph. MBFP, which stands for DOH’s Mother and Baby-Friendly Philippines, is the reporting platform for violations of the Milk Code and the Expanded Breastfeeding Act of 2009 (Republic Act 10028).

The list of violators included health workers, non-profit organizations, and local executives such as Manning, and Mayors Andrea Henares of Antipolo City and Marcy Teodoro of Marikina City.  Also on the list were celebrities such as Say Alonzo and Marian Rivera Dantes, who together with Nido, a brand that Dantes endorses, and the YesPinoy Foundation, were reported to have distributed follow-on formula. Dantes even posted it on Instagram to her 9.4 million followers.

EO 51 issued by former President Corazon C. Aquino, otherwise known as the Philippine Milk Code of 1986 or simply, the Milk Code, regulates the marketing of breastmilk substitutes, including milk formula, breastmilk supplements and other similar products by prohibiting the advertising and promotion, whether written, audio or visual, for such products. It adheres to the International Code on Marketing of Breastmilk Substitutes, adopted by the World Health Assembly in May 1981. Breastfeeding advocates have hailed the Milk Code as one of the strongest breastfeeding protection laws in the world.

The Milk Code’s Revised Implementing Rules and Regulations (RIRR), released 30 years after the law was signed, prohibits the donation of infant formula and breastmilk. Administrative orders from the DOH and the Department of the Interior and Local Government (DILG) further disallow the donation of infant formula milk and breastmilk substitutes in times of disasters and calamities.

According to data from the Food and Nutrition Research Institute, exclusive breastfeeding rates have continuously gone up in the last 10 years, reaching 57.9 percent in 2019. The global exclusive breastfeeding rate stands at 41 percent. The United Nations targets to increase global breastfeeding rates to 50 percent by 2025. (See sidebar: Promotion, protection of breastfeeding practices reap rewards)

Marketing is prohibited, the milk is not

Health Undersecretary Maria Rosario Vergeire said the law did not bar local government units (LGUs) from procuring formula milk.

“If local government units procure formula milk, the law does not cover it. EO 51 is a regulatory tool used by the Department of Health to regulate the advertisement of manufacturers that formula milk is more important than a mother’s milk. That’s our first objective — we would like to know that breastmilk is still the best for babies,” she said.

DOH Memorandum No. 2020-0231, dated May 15, 2020, laid down the guidelines on the standardized regulation of donations covered by the Milk Code. Formula milk and breastmilk substitutes can still be provided to those in need, with the following conditions:

  1. The local government unit buys it using its own budget (procurement);
  2. Breastmilk should still be the first choice and the procured formula milk is given to identified mothers/infants, not distributed en masse;
  3. Distribution, preparation and use of breastmilk substitute and formula milk must be done under the supervision of health and nutrition workers;
  4. There should be no brand name, logo or identifiable marks of the manufacturer; and
  5. No public relations, announcement or the likes may occur.

Dr. Mianne Silvestre, executive director of Kalusugan ng Mag-Ina (mother’s health) Foundation, echoed Vergeire’s explanation.

“The Milk Code is there to regulate the marketing and advertising of formula milk and breastfeeding substitutes, and not to penalize parents who give these products to their children,” Silvestre said. “Nobody goes to jail for feeding formula milk to their babies.”

Sharing a similar view, Dr. Paul Zambrano, a technical specialist at Alive and Thrive, a private initiative to reduce child undernutrition by improving infant and young child feeding practices, said: “Marketing (of formula milk and breastmilk substitutes) will undermine the practice of breastfeeding and complementary feeding with healthy food after six months. It’s meant to save lives. It is meant to prevent the top killers of children in that age group – diarrhea and pneumonia. ”

The problem, Silvestre said, was that formula milk was being marketed as the first option instead of breastfeeding. This goes against the hierarchy of infant feeding choices laid out in the Global Strategy for Infant and Young Child Feeding published by the World Health Organization (WHO), which states that donated breast milk from a wet nurse or milk bank takes precedence over formula milk.

Infographic by Alexandra Paredes

Even for Covid-19 positive mothers, the WHO still recommends continued breastfeeding and rooming of babies with their mothers. Transmission of Covid-19 through breastmilk or breastfeeding has not been established.

No guidance for LGUs

What can and cannot be done under the code does not seem to be clear to local governments, even to the DILG. In an interview with PCIJ, Interior Undersecretary Jonathan Malaya, affirmed that the ban extends to selective distribution of milk to identified mothers and babies and referred to the National Nutrition Council website for guiding policies.

Taytay’s Manning said no guidance came from any government agency, particularly the DOH or DILG, on how they could respond to the needs of mothers and their babies.

During the quarantine, local officials, such as Quezon City Councilor Ariel Inton, repeatedly appealed to the DOH to lift the ban on milk donations.

In a Facebook livestream, Inton, a lawyer, gave practical advice to barangay officials planning to distribute formula milk to their constituents. “Tell them that you are handing it out as loans or ask for coins so they won’t say it’s a donation, so you can give the children something to eat,” Inton said.

For Ynares, while the Milk Code has an important purpose, it can also be a “bane during crisis.”

“It poses a huge challenge for families and the government to provide essential nutrition required for child growth and development particularly during extraordinary times,” the Antipolo City mayor said.

A National Nutrition Council advisory said that LGUs should consider that some recipients of pandemic relief goods have young children and pregnant and lactating mothers. Families are supposed to be monitored by Barangay Nutrition Scholars and Barangay Health Workers, who will provide them with low-cost, one dish-meal recipes as well as recipes utilizing their relief goods.

But Maryjoy said there were no vegetables and nutritious food in their relief packs. The lack of proper nutrition may have affected her daughter Hazel’s milk supply, she said.

“The first relief pack we received had three kilos of rice, two cans of sardines, and two Lucky Me noodles,” she said.

There was one instance, Maryjoy said, when her family received a few kilos of rice and 16 pieces of dried fish (tuyo). To increase Hazel’s milk, Maryjoy bought malunggay and cooked it with noodle soup.

While the DOH had specifically instructed that assistance should be provided to breastfeeding mothers, Maryjoy said no one from her barangay came to ask how her daughter and granddaughter were doing. “They only gave me a 150-gram pack of powdered Bear Brand milk, only for her to drink, but none for the baby,” Maryjoy recalled.

The usual relief pack distributed by LGUs during the quarantine period contained a few kilos of rice, canned goods and instant noodles. The nutrition council however urged LGUs to include dark green and yellow vegetables; root crops; legumes, beans and seeds; fruits; poultry and eggs; meat or fish; and pasteurized fresh milk.

Only a few cities and municipalities were able to distribute fresh produce.

Maryjoy shows the 150-gram pack of powdered milk she received after lining up at the barangay hall. She believes the lack of nutritious food affected Hazel’s (not her real name) milk supply. Photograph: Buck Pago

“We are in a crisis situation, and even the government’s hands are tied because of supply chain problems. The local government units have to procure thousands and thousands of produce to give to their constituents who need it not now, but yesterday. That is the limitation, and we understand when canned goods are distributed given the situation,” said DILG’s Malaya.

Malaya pointed out that on top of the relief packs given to households, a one-time cash assistance was given in the form of the Social Amelioration Program (SAP).

“The family can go to the market and buy what they think is nutritious food for lactating mothers. The government has already provided funds for them and they can make that choice if they wish to,” Malaya said.

But for Maryjoy, the SAP she received had to be divided among three households.

The P6,500 is to be divided among three families, with each receiving P2,000, but I get to have the extra P500 because it was I who lined up for that money,” Maryjoy said. Most of what she got eventually went to repaying debt incurred when her husband lost his job.

Milking disasters

Breast or bottle? This question remains contentious. Since the Milk Code was enacted in 1986, the milk industry has taken advantage of every possible loophole to undermine the law. When the Milk Code took effect in 1987, international milk manufacturing company Wyeth invented the follow-on formula for babies six months old and beyond.

The Milk Code’s implementing rules and regulations (IRR) were revised to include a ban on advertising follow-on formula in 1990. A revised IRR was drafted in 2006, adding further safeguards 30 years after the Milk Code was signed, but this was challenged all the way to the Supreme Court.

A report released in May 2020 by WHO, United Nations Children’s Fund and the International Baby Food Action Network said that despite the pandemic, milk companies continued to skirt laws in many countries and continuously promoted their products.

“There is no guarantee that these donations will occur over the long term,” said Dr. Nathalie Africa-Verceles, director of the University of the Philippines Center for Women’s and Gender Studies. “The intention really is to introduce the product and to generate dependence with the belief and the hope that women will continue to patronize the products that they were provided for free initially.”

Studies have shown that mothers exposed to breastmilk substitutes were highly likely to abandon breastfeeding, and the indiscriminate distribution and use of formula milk put infants at greater risk of illness, which might be fatal.

A study in Indonesia in the aftermath of the May 2006 earthquake in Yogyakarta and Central Java found that the distribution and use of breastmilk substitutes resulted in changes in feeding practices. Uncontrolled distribution of infant formula exacerbated the risk of diarrhea among infants and young children during the emergency, the study found.

“(The Milk Code) is very relevant because let’s look at what the companies do during times of emergencies, they use it to try to market the product,” said Zambrano.

DOH data confirmed these observations. The health department noted that a rise in reports of Milk Code violations from the public began to occur in the week when the strict lockdowns  began, peaking during the week of April 6 to 12 with 90 cases.

Infographic by Alexandra Paredes

Apart from solicitations, there were product advertisements, such as Marian Rivera-Dantes’ Instagram post. Corporate and private donations also happened online, mostly through Facebook posts, according to the DOH data.

Zambrano pointed out that the relevance of the Code had always been questioned during emergencies. He recalled a situation in Cagayan de Oro after typhoon Sendong in 2011 when distribution of formula milk became rampant.

Silvestre downplayed the matter and said only a few mothers were unable to breastfeed their babies due to medical or physical reasons.

“These few cases are being hyped up to rationalize the lifting of the prohibition during emergencies. When in fact, it is during emergencies when we should intensify the protection of mothers to enable them to breastfeed their babies,” Silvestre said.

Formula milk manufacturers have been accused several times of unscrupulous means of advertising their products, targeting mostly low-income families or those who can least afford their product.

A 2018 report from Save the Children Philippines revealed that baby formula brands in the Philippines are using “aggressive, clandestine and often illegal methods” to get poor mothers to choose their product over breastfeeding.

Hospital staff also gave brand-specific recommendations to mothers who had just given birth, clearly a violation of the Milk Code. The report named Nestle, Abbott, Mead Johnson and Wyeth as the companies who are using these illegal tactics.

All four companies denied the allegations in separate statements sent to the Guardian in 2018.

Cheapest, but not the best

Hazel is helping her mother with their online selling business, earning a few extra pesos to help augment their family’s income. She expects breastfeeding to be temporary and will likely go back to feeding Pia formula milk.

Maryjoy said they had begun feeding Nestogen One to Pia, the cheapest in the market at P78 per box. It wasn’t prescribed by the doctor.

“But Pia doesn’t want it, she won’t swallow it,” Maryjoy said.

As Hazel handles deliveries and client meet-ups for their online selling business, Maryjoy has no choice but to give Pia formula milk. 

“I need to go back to school,” Hazel said.

Asked where they will get the money to buy formula milk, Hazel shrugged. –PCIJ, October 2020

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Editor’s Note: The real names of Hazel and her baby, Pia, were not used because they are minors.

Proposed 2021 health budget shrinks, neglects public health–IBON 

by IBON Media & Communications

Research group IBON said that the lower budget for the public health in the proposed national government budget for 2021 will keep health care inaccessible and expensive for too many Filipinos. The pandemic highlighted the lack of capacity in the privatized health system. IBON however criticized the merely fleeting increase in health spending and the cuts next year in important health areas.

The Department of Health’s (DOH) budget is at least Php171.5 billion in 2020, consisting of the Php104.5 billion under the General Appropriations Act (GAA) 2020, Php49 billion under the Bayanihan 1 law, and at least Php18 billion under the recently passed Bayanihan 2 (RA 11494). IBON noted that the proposed Php131.7 billion DOH budget for 2021 is Php39.8 billion or 23.2% less than this.

IBON said this indicates a merely short-term response to the pandemic and an unchanged trajectory of health privatization including allowing the public health care system to whither away. In particular, health infrastructure spending and support for public hospitals are seeing large cuts next year.

The proposed 2021 budget for the Health Facilities Enhancement Program (HFEP) covering the building of health infrastructure and purchase of medical equipment is just Php4.8 billion. This is 62.9% less than this year’s Php12.9 billion budget composed of Php8.4 billion under the GAA 2020 and Php4.5 billion under Bayanihan 2. 

The HFEP budget has actually been falling steeply under the Duterte administration in the regular GAAs even before the pandemic, IBON pointed out. It was Php30.3 billion in 2018, Php15.9 billion in 2019, then Php8.4 billion in 2020. The group also noted that the government’s Php1.1 trillion infrastructure program for 2021 only allots Php2.3 billion or one-fifth of one percent (0.2%) to the DOH, which is also a 36.7% cut from the GAA 2020. 

Health privatization-driven budget cuts for public health facilities like this have already caused public hospitals numbering 730 in 2010 to fall to just 433 in 2018.

The proposed 2021 budget for health workers and supporting the operation of DOH hospitals also falls by Php1.7 billion or a 2.6% cut, from Php64.3 billion in 2020 to Php62.6 billion next year. This is because the Php12.6 billion increase in Human Resource for Health (HRH) and DOH hospital budgets in the GAA 2021 from GAA 2020 is off-set by the discontinuing of Php13.5 billion in fleeting support under Bayanihan 2.

The government has played up how the 2021 budget for Human Resources for Health (HRH) Deployment increases to Php16.6 billion from Php10 billion in 2020 to hire 26,035 health workers. This seems urgent because the government doctor-to-population and government nurse-to-population ratios have been worsening under the Duterte administration, between 2016 and 2018 – from 1:32,644 to 1:33,909 doctors and from 1:17,269 to 1:17,769 nurses.

However, the health sector group Alliance of Health Workers (AHW) has pointed out how this increase is only temporary and does not indicate a sustained increase in health workers for the public health system. They highlight that 14,553 DOH plantilla positions will still remain vacant in 2021 with public hospitals still understaffed and government health personnel still overworked over the long-term.

AHW also points out that 23 of 66 DOH hospitals, which many of the poor depend on, will see their maintenance and other operating expenses (MOOE) budgets cut by Php4 million to as much as Php209 million. IBON meanwhile noted how the budget of two COVID-19 referral government owned- and -controlled (GOCC) hospitals will also be cut next year. The Lung Center of the Philippines sees a 2.9% budget cut to just Php405 million in 2021, and the Philippine Children’s Medical Center (PCMC) a 13% cut to just Php1 billion.

The budget of the Epidemiology and Surveillance program that is crucial in controlling the spread of diseases through timely data and research has already been cut by over 50% from Php263 million in 2019 to Php116 million in 2020. Yet despite its obvious importance in dealing with pandemics, IBON said, government proposes to reduce it further to Php113 million in 2021.

The budgets for the National Reference Laboratories (NRL) and Health Information Technology (HIT), which are vital in detecting, testing, databasing and reporting coronavirus cases and other emerging diseases, are also slashed.  The proposed allocations for NRL and HIT decrease from Php326 million to Php289 million, and Php1.2 billion to Php97 million, respectively.

The second biggest chunk of the proposed 2021 health budget, or Php71.4 billion, still goes to the Philippine Health Insurance System or PhilHealth. While noting recent corruption controversies in the agency, IBON pointed out that it is difficult to reconcile the unchanged budget with increasing health expenses of Filipinos. At the same time the group stressed that government resources are better spent on expanding and improving the public health system rather than subsidizing private health sector profits.

IBON said that the Duterte administration should increase funding for health infrastructure, personnel, and operations. Filipinos right to health and affordable health care cannot be realized if, as is happening today, more and more of the country’s health system is being turned over to the profit-driven private sector. The group stressed that this will always result in health care that is too expensive and health capacity that, as the pandemic has shown, is insufficient for public health emergencies. #

It really hurts: Economic infrastructure over health

by Jose Lorenzo Lim

The Philippine economy contracted 16.5% in the second quarter of 2020 which was attributed mainly to declines in manufacturing, transportation and storage, and construction. The Duterte administration is counting on infrastructure to stimulate the Philippine economy’s recovery. To do this, the Development Budget Coordination Committee (DBCC) is allotting Php1.1 trillion for the government’s infrastructure budget in 2021.

Are the planned infrastructure projects really what the economy needs right now after everything that’s happened this year? How much of the infrastructure helps fight the COVID-19 pandemic? Or is the government just building the same road and transport infrastructure from its pre-pandemic plan?

Unchanged priorities

Long before COVID, the Duterte government’s Build, Build, Build (BBB) Program planned Php8-9 trillion in infrastructure projects from 2017-2022. This included supposed high-impact projects such as railways, urban mass transport, airports and seaports, roads and bridges, and “new and better cities”.

The government’s priority for such infrastructure projects and economic infrastructure stays, as reflected in the proposed 2021 budget. The budget for the Department of Public Works and Highways (DPWH) is Php613 billion for roads (Php59 billion), bridges (Php157.4 billion), and flood management projects (Php125.8 billion). There are also allocations for local programs (Php176.1 billion), and the convergence and special support program (Php50.2 billion).

Interestingly, Php23.9 billion of the convergence and special support program is for access roads leading to tourism destinations, Php1.9 billion on access roads to airports, and Php2.5 billion on access roads to seaports.

The Department of Transportation’s (DOTr) proposed 2021 budget meanwhile spends Php107.4 billion on railways, aviation, and maritime infrastructure programs. Of this, Php107.2 billion will be spent on railways. The Rail Transport Program includes projects from the 100 infrastructure flagship projects (IFP) such as Metro Rail Transit (MRT) 3 Rehabilitation, the Metro Manila Subway, North-South Commuter Railway System, and the PNR South Long-Haul Project. The DOTr also proposes Php1 million on aviation infrastructure and Php166 million on maritime infrastructures.

The National Economic and Development Authority’s (NEDA) 100 IFP list includes 15 infrastructure projects targeted to be completed in 2021 worth Php181 billion. Eleven of these are in the transport and mobility sector, one is in information technology, one is in urban development and redevelopment, and two are for water resources. This affirms transportation and mobility as BBB program priorities.

However, the infrastructure priorities are puzzling and the government seems to be getting ahead of itself with all that interconnectivity infrastructure.

As it is, the coronavirus still hasn’t been contained over seven months since the pandemic broke out in the country. Many businesses aren’t able to reopen and many families are still jobless or have low incomes even with lockdown restrictions eased. It is not just unclear but actually doubtful that many of the infrastructure projects proposed will help all those who will remain distressed next year.

The pandemic also exposed how inadequate the country’s public health system is. First, in containing the pandemic with insufficient mass testing, contact-tracing, isolating and smart quarantining. And, second, in treating all COVID-19 and non-COVID-19 patients needing health care.

Health neglect

What is the state of the country’s health facilities? Government data shows that there are 1,236 hospitals as of 2017, 65% of which are private-run. Privatization has resulted in there being more private hospital beds (54,317) than public hospital beds (47,371) as of 2016.

These private hospitals that dominate the country’s health system are the same ones that are now charging exorbitant rates to COVID-19 and non-COVID-19 patients to attain their desired profitability. For them, health care is about returns to investment more than returning the sick to good health.

Privatized health is also the reason why bed capacity is falling further and further behind the country’s needs. For a profit-seeking hospital, excess bed and healthcare capacity is in effect idle capital and correspondingly a drain on profits.

The Philippines has never reached the World Health Organization’s recommended ratio of 20 beds per 10,000 population. Philippine Statistics Authority (PSA) data shows that the situation has even worsened from 14.4 beds per 10,000 population in 1990 to only 9.9 beds per population in 2014. In terms of community health services, only 47% of barangays across the country had health stations in 2018.

The country is very much in need of healthcare workers as well. The PSA reports a ratio of one government physician to 33,000 Filipinos, which is far from the WHO-recommended 1:1,000 doctor to population ratio. The number of public health nurses is also concerning at a ratio of 1 to 50,000 Filipinos. Add to this how Filipino health frontliners are themselves succumbing to COVID-19 due to poor working conditions and lack of equipment, facility, and financial support. The dearth in health facilities and health care workers will persist if the government continues to neglect the health sector.

Has the government’s infrastructure program been adjusted to meet deficiencies in health infrastructure highlighted by the pandemic? The government has actually touted some health-related infrastructure to help fight COVID-19.

The latest IFP list is yet to be released. In a recent interview though, Secretary Vince Dizon, Presidential Adviser for Flagship Programs and Projects, announced that 8 projects that could not be completed anytime soon had been taken out from the 100 IFP. These were replaced by 13 projects related to the digital economy, water projects, and healthcare.

Dizon said that the most important healthcare project is the Virology Institute that would be built in New Clark City. A Virology Institute could really complement the Philippine healthcare system, if only there were enough healthcare facilities to begin with. But the opposite is true.

A look at the Department of Health’s (DOH) proposed 2021 budget shows that the Health Facilities Enhancement Program (HFEP) only gets Php4.8 billion. This is a huge cut from its Php8.4 billion budget this year and especially compared to its Php30.3 billion budget in 2018.

The proposed HFEP budget is just as much as the DPWH’s Priority Bridges crossing Pasig-Marikina River and the Manggahan Floodway Bridges Construction Project valued at Php4.8 billion, which is just one of the agency’s projects in Metro Manila.

The country needs more health infrastructure more than ever. COVID-19 and non-COVID-19 wards are overwhelmed yet the government decides to slash the budget for health facilities and still prioritize economic infrastructure in the form of roads and bridges. Many other essential elements of the health budget are also being defunded in 2021.

Time to reprioritize

The onslaught of COVID-19 exposes the insensitivity of the Duterte administration and how irrelevant the BBB program is in meeting the country’s most urgent needs. Health infrastructure clearly needs to be expanded.

Yet the priority is still disproportionately for infrastructure projects supporting the profit-making of transport contractors, foreign transport sector firms, and corporations in the service- and trading-oriented sectors of the economy.

The government has to invest much more in strengthening the public health system, in building public health facilities, and in advancing health research and development. Health care workers also need to be protected, paid decently, and supported to be able to give Filipinos the quality and affordable health care they deserve. #

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.

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)