Friday, April 11, 2008

GMA on generics only provision of the Cheaper Medicine Bill

Arroyo orders generics proviso in cheaper medicines bill removed
ABS-CBN News Online
April 11, 2008

In a bid to break the impasse on the cheaper medicines bill, President Arroyo on Friday instructed the Department of Health to take out the controversial "generics only" provision in the measure.

The Senate and the House of Representatives are still deadlocked over the controversial measure that requires doctors to prescribe only the generic names of drugs and forbids them to even write their preferred brands.

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Arroyo scraps 'generics' provision

BY REGINA BENGCO
Malaya Online
April 12, 2008

PRESIDENT Arroyo wants the "generics only" provision withdrawn in the proposed Cheaper Medicines Bill so it can be approved before the 14th Congress adjourns in June.

Arroyo announced her order to Health Secretary Francisco Duque III during the inauguration of the 11,000th Botika ng Barangay under the President's Half-Priced Medicines Program and the Department of Agriculture's Barangay Bagsakan at Camp Bagong Diwa in Taguig.

She said it was the DOH which proposed the "generics only" provision last year, which is now causing the delay of the bill's passage, because it was the "ideal" bill.

“Who’s Afraid of Drug Price Regulation?” - HEAD

Who is afraid of drug price regulation?

Certainly not the patients, who stand to gain much if prices of much-needed medicine are immediately reduced to low, very inexpensive prices. Definitely not the doctors, who will finally see their patients able to comply and adhere to their medical treatment. And absolutely not the general public, who may yet enjoy a better life when even the most essential and life-saving drugs become affordable.

Who, then, is afraid of drug price regulation? The big pharmaceutical companies and their proxy representatives, who continue to raise the specter of “abuse”, “over-regulation”, “regulatory capture”, and other “complex problems” supposedly posed by price controls.

Health Alliance for Democracy (HEAD) today reiterated its calls for a strong drug price control and a greater regulation of the entire drug industry in the country. The 3,000-strong national organization of doctors and allied health professionals is one of very few stakeholders strongly pushing for regulation, even as the Bicameral Committee of Congress continues to hammer out the Cheaper Medicine Bill.

“Given the highly monopolized character of the industry, no genuine competition will prosper and thrive. It is the inherent nature of monopolies to suppress, to stunt competition, as can be seen from our experience with the Generics Law. This makes regulation at this juncture both a moral and political imperative.” said Dr. Gene Alzona Nisperos, HEAD secretary-general.

Because of the stifling stranglehold of big pharmas, the number of local Filipino drug manufacturers has been greatly reduced, from around 300 in the 1980s to only 27 today, 8 of which are up for sale. Many of these companies are manufacturing only specific drug lines and cannot yet provide genuine competition to big trans-national corporations (TNCs) or provide a backbone to a strong generics industry here.

More than 70% of total drug sales are accounted for by pharmaceutical TNCs, earning some 58.5 billion pesos for the top 10 drug TNCs (excluding United Laboratories) in 2006. By July 2006, the pharmaceutical market grew by 7.4% in value but declined by 3% in volume, reflecting growth that is mainly driven by price.

“All talk about the so-called market forces coming into play is deceptive. These so-called market forces have been around in the last 20 years and have not affected any real change, which is why we are still faced with exorbitantly priced medicine.”

Added Dr. Nisperos, “The industry players, the big pharmaceuticals, have shown that they are unwilling to regulate themselves. Instead, they push their weight around without fear of reproach or reprimand, as what a big pharmaceutical did when it filed a court case against the Philippine International Trading Center (PITC).”

HEAD believes that the current status quo is unacceptable, especially when government line agencies like the Department of Health and the Bureau of Food and Drugs remain incapable of controlling the unscrupulous profiteering by big pharmaceutical companies.

“Filipino patients are dying or being maimed en masse because they cannot afford the medicine they need. If we truly have the interest of the Filipino patient at heart, then regulation is a requisite, not an option, to making medicine affordable in this country.” concluded Dr. Nisperos, “Anything less is a return to the status quo and an absolute betrayal of this interest.”

Friday, April 4, 2008

Nursing still top course

Rainier Allan Ronda
Philippine Star
Friday, April 4, 2008

The Commission on Higher Education (CHED) said yesterday that nursing remains the most sought-after course among college enrollees this school year 2008-2009.

The projected enrollment of CHED’s Office of Policy, Planning, Research and Information (OPPRIS) for this June places enrollees for a Bachelor of Science in Nursing (BSN) education to have the highest number among other courses or disciplines, with about 497,000 expected enrollees this year.

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Oversupply of nurses plagues RP

Gloria Esguerra Melencio
Asia News Network
04/03/2008

The Philippines has oversupply of nurses this year as “world-class schools” in the country continue to produce thousands of nurses and some diploma mill schools churn out countless of practical nurses.

University of the Philippines College of Nursing Dean Dr. Josefina Tuazon and Philippine Nurses Association National President Leah Paquiz disclosed that the oversupply of nurses is fast becoming the country’s problem even as deployment abroad may be the “first choice” for these graduates.

Tuazon explained that due to the numerous nursing graduates this year at 67, 728, hospitals have to get volunteer nurses -- a lot better because they are not paid -- to accommodate the fresh graduates.

High number of graduates of Practical Nursing, a two-year course that focuses on the basics of nursing, aggravates the unemployment problem, Tuazon stressed.

“There is no local demand or positions for practical nurses within the Philippine Health Care Delivery system particularly in the light of the oversupply of nurses and subsequent unemployment of graduate nurses,” PNA’s Paquiz revealed in a written statement distributed to the media recently.

Schools offering Practical Nursing have mushroomed in the country overnight as they promise overseas employment that may await the graduates of this two-year non-degree course. The promise of work abroad, however, is not true as foreign employers prefer the four-year college-degree nurses who passed the Licensure Board Exams, Paquiz added.

The farthest thing that these practical nurses can reach is become nurse assistants, Tuazon noted.

The PNA likewise asked the Commission on Higher Education (CHEd) of the Department of Education to put a stop to other schools’ offering the Practical Nursing program.

The PNA “strongly objects to the institution of the Practical Nursing program and vehemently rejects the proposed ladderization of the nursing curriculum,” the PNA statement said.

The PNA president also disclosed that United States, home to almost 250,000 Filipino nurses in the past years, stopped issuing work visas this year because the quota requirement for migrant workers has already been reached. There were 21,000 Filipino nurses seeking employment in the US in 2007.

The Philippine Overseas Employment Administration deployed a total of 13, 525 licensed nurses around the world in 2006. Of this number, 12, 263 are females and 1, 261 are males.

Saudi Arabia employed some 5,600 Filipino nurses, the highest so far of all Middle East countries in 2006.

Japan has 1.1 million Filipino nurses and licensed caregivers in 2005.

http://globalnation.inquirer.net/news/breakingnews/view_article.php?article_id=128210

HEAD on New DOH Order: “Regulating or Legalizing Organ Trade?”

The much publicized administrative order by the Department of Health allegedly aimed at eradicating the thriving black market of kidney trade may yet result in the exact opposite: the legalization and facilitation of the sale of kidneys and other human organs.

Health Alliance for Democracy (HEAD) warned that this administrative order is a red herring that contains contradictory provisions and paves the way for the virtual legalization of organ trade under the pretext of “management and regulation”.
“We must scrutinize not only what is written but also what is not written in order to arrive at the real nature of this order.” according to Dr. Gene Alzona Nisperos, HEAD secretary-general.

The DOH has touted the AO as the order meant to stop the trade of kidneys and illegal organ trafficking. However, nowhere in the text of the AO are “kidney sale” or “trade and commerce of kidneys” defined or clarified. The term “gratuity” is used but is also vague since the text does not mention anything on what the DOH regards as “acceptable compensation” for the donor. Even in broad strokes, there is no description as to how the DOH seeks to stop kidney trade outside the creation of a board.

“The lofty guiding principles and general policy statements contained in the DOH order are rendered inutile in the absence of clear-cut parameters and limits that should be set in very clear, unconditional terms to actually stop the trade of kidneys and other human organs. Otherwise, what are they really talking about?” said Dr. Nisperos.

Moreover, the AO delineates not only between Living-Related Donors (LRDs) and Living Non-Related Donors (LNRDs) but also between “Directed Kidney Organ Donor” and “Non-Directed Kidney Organ Donor”, which was not present in the superseded AO (AO 124 series 2002).

“90% of kidney transplantations here are from living donors, of which 68% are from LNRDs. This is a whooping 56% increase from 2002 and confirms the overwhelming demand for organ donors.” Added Dr. Nisperos, “This is where exploitation is rampant, as most LNRDs come from the ranks of the poor and marginalized.”

Similarly, “Directed Kidney Organ Donor” means “someone who has a specific recipient in mind to donate to.” This debunks the initial impression that kidney donations will now be more equitably allocated and where Filipino recipients “shall be given priority in the donor allocation.” “Directed Kidney Organ Donor” essentially means that the donor designates the recipient, which further cultivates a pro-rich bias and rampant abuse of the poor.

Thus, HEAD believes that the DOH order not only intentionally misdirects public attention but also preconditions the public to accept LNRDs with directed organ donation, which will still benefit foreign medical tourists and rich Filipino patients, for as long as there is the erroneous notion that ordinary Filipino patients are given equal treatment. The truth is that only non-directed kidneys organ donations will be centralized and “belong to the community...that will be allocated fairly among recipients”.

In short, the current problematic, biased, and exploitative situation remains.
The new AO also creates several new layers machinery, including super-bodies that will implement this order. The Philippine Network for Organ Donation and Transplantation (PhilNETDAT), for example, has the authority and budget of an implementing body but has no clear composition, tenure, and accountability. It can be used by illegal organ traders and black market operators to enter the new processes and legalize their operations.

“The new DOH AO does not offer anything new to address the prevailing problems posed by kidney and organ trade. The DOH fails to confront this complex problem because of its own inherent biases and interests.” concluded Dr. Nisperos. “At best, the AO is just another deceptive government propaganda that should be junked altogether.”

“Generics-only provision playing into the hands of big pharmas” - HEAD

The contentious “generics-only prescribing” provision of the Cheaper Medicine Bill plays right into the hands of big pharmaceutical companies.

The group Health Alliance for Democracy (HEAD) warned that this provision serves only to distract legislators and stakeholders, divert attention from the flaws that need to be addressed, and prevent a thorough discussion of the more salient features of the bill.

According to Dr. Gene Alzona Nisperos, HEAD secretary-general, “While generics-only prescribing is an ideal that all health activists aspire for, it is not the decisive issue at this juncture. Unfortunately, the obstinate insistence on this provision is being exploited by big pharmas and their cohorts so that the more important features of the bill will be glossed over.”

Central features of the bill that need meticulous deliberations include provisions on the national drug policy, parallel importation, compulsory licensing, and drug price regulation. HEAD believes that these are the vital issues that big pharmas have undermined in the bill, and that legislators are being pushed into a position of compromising an exhaustive scrutiny of the bill in order to expedite its passage.

HEAD, the 3,000-member national organization of doctors and allied health professionals, is calling on legislators to “keep their eye on the ball”, to focus on the problem rather than be lured by provisions that will not effectively mitigate the stranglehold of big transnational companies (TNCs) on the drug industry.

“Big pharmaceuticals are not worried about the generics-only prescribing at this point as this will neither directly nor immediately impact on their profiteering.” according to Dr. Nisperos. “They may even exploit this to further their influence on the prescribing habits of doctors.”

“But big pharmaceuticals are deathly afraid of mechanisms that threaten to alter the status quo, especially provisions providing for stronger regulation and fostering increased competition. Enforcing regulation, such as drug price regulation, promoting competition that leads to the development of a self-reliant national drug industry, and implementing a comprehensive National Drug Policy that is linked with the entire Philippine health care delivery system - these are the steps that will dismantle existing monopolies. And these are the steps that big pharmas want to stop.”

Hence, the language and formulation of the bill on these provisions will require careful and repeated examination to prevent flaws or “riders” that will render them powerless. Parts that have been “consolidated” by the congressional bicameral committee should be made available to all stakeholders so that these can be examined further.

Among the things that HEAD is pushing for is drug price regulation that will immediately reduce the prices of a broad range of essential, life-saving, and maintenance drugs. HEAD also wants the drug price regulatory board to be independent, with multi-stakeholder representation, and with direct accountability to an oversight committee of Congress. ###

Outbreaks expose government’s incapacity to manage people’s health

More than three weeks since residents of Calamba and Los Banos, Laguna as well as in San Pablo City fell ill with typhoid fever, still, the government has not been able to determine the cause of the outbreak that affected more than 1,400 persons.

Identification of the cause and source of infection is a basic and crucial step in controlling diseases like salmonella typhi. Even if the Department of Health declared that the outbreak was caused by contaminated water found to have “low-chlorine” level,” the findings are not yet conclusive and do not point to who is responsible.

On the other hand, the government needs to recheck the efficiency of privatized water facilities as these also have a primary role in ensuring public safety in the water they distribute.

Community-based health programs who work closely with marginalized sectors would like to express grave concern about the government’s seeming lack of sense of urgency and decisiveness in times of massive disasters like epidemics.

Almost always, disastrous events expose the government’s incapacity to ensure people’s access to health services as shown in the scores of patients that cramped public hospitals and makeshift wards.

It is an unfortunate yet very notable fact that outbreaks such as these usually victimize the poorest populations of our society because it is they who are most vulnerable to these diseases.

Together with the entire community-based health program communities in the Philippines, CHD calls on the citizenry to be vigilant in asserting their right to basic health services from the local and national government. The people have every right to demand from the government concrete and do-able measures not only during epidemics but also in disease prevention and post-epidemic management in communities.

UN sees more people going hungry in Philippines as rice prices soar

by Cecil Morella
Fri Mar 7

A UN aid official warned Friday that the Philippines may end up having to feed
people to save them going hungry as the market price of rice soars out of
reach of ordinary households.

With prices of rice and wheat spiking in recent months, World Food Programme
country director Valerie Guarnieri told AFP, "I think there's a possibility
that the government would have to feed more people because of rising prices."

"Price rises mean people who previously were able to meet their own food needs
through the market with their own income have been sort of pushed over that
precipice and are no longer able to feed their families," Guarnieri said.

"So we see people who suddenly now would be eligible for assistance," she
said, adding: "We're seeing it in many countries."

The UN agency now provides food aid to about 1.1 million of the Philippines'
90 million people.

Guarnieri said the UN was unlikely to ramp up its food aid to the Philippines
immediately since it is considered a "middle-income country" with lower priority.

She also warned Manila could be hit in the pocket by having to boost spending
on subsidies just to maintain current prices of the lowest-quality rice that
it sells to the poor.

Guarnieri said rising rice prices and tight supplies could impact most
severely on poor households in the rebellion-torn southern island of Mindanao
because "we're looking at people who already spend 70 percent of their income
on food and are having a real struggle meeting their needs.

"So any increase in the rice price to them is going to put them in a very
difficult situation or make a difficult situation even worse."

Globally, she said the UN has appealed to the food programme donors to make
them "understand that we're going to need more resources just to do what we're
currently doing."