I am so worried about the healthcare system that I sometimes want to turn this column into one purely dedicated to health matters.

From the current greedy move by the Department of Finance to grab the funds of PhilHealth, depriving our people of adequate health financing support, to the unresolved and increasingly widening Pharmally scandal that saw billions of money for supplies for our strained health facilities during the COVID-19 pandemic stolen, to the unresolved and now seemingly ignored Bell-Kenz Pharma alleged  MLM scheme among doctors — all are symptoms of a sick health care system. A system that cannot escape the corruption and politicization in Philippine governance.

For this column, however, I will go back to an earlier scandal that can be corrected: the banning of the dengue vaccine against the recommendation of the doctors and experts. It is time to bring back the vaccine.

Let me do my ethical duty now and state that I have no connection or ties to the manufacturers of any vaccine. I will have nothing to do with the government or private  transactions that will result from importing the vaccine and making this available.

Manufactured scandal

In 2017-2018, in what some political observers perceived as an opportunity for Duterte supporters to score points against then-president Benigno Aquino III, his government’s importation and use of the vaccine Dengvaxia was questioned.

Key players were then-senator Richard Gordon, who launched a Senate investigation on the matter. This was early in the Duterte administration and Senator Gordon was in his pro-Duterte phase. Hence his cowardly stance at that time on the persecution of then-senator Leila de Lima and his implication in some ICC documents in Duterte’s drug war. It was a time when Duterte was at the height of his power and popularity and many a politician’s soul was tested. Many failed.

There was also Public Attorney’s Office Chief Persida Acosta from whose office came a series of histrionic and false claims about deaths due to the vaccine — none of which could stand up to expert review.

Some mainstream media practitioners, revealing their own lack of scientific literacy,  if not a capacity for corruption, also participated in the spreading of misinformation. Social media influencers closely associated with Duterte also joined in.

It was on this basis that the government filed cases against government officials that dragged on for years and some of these remain unresolved. This is a form of injustice that has not only affected the people who have been accused. It has also affected the medical community who have seen upstanding members punished for doing their duty while those who have done wrong go unpunished.

It was antics like this that caused the plea of medical practitioners and experts not to ban the vaccine fall on deaf ears. It was antics like these that saw a drop in vaccine hesitancy in the Philippines for all vaccines across the board. If it is true that we will have a life review before we enter heaven, I hope that the perpetrators of this unwarranted brouhaha will be made to feel every morbidity and mortality caused by the loss of confidence in vaccines that resorted from their actions.

Overblown

Every controversy starts with a grain of truth.

“There is no such thing as a perfect vaccine,” wrote the Philippine Pediatric Society in their statement denouncing the misinformation against Dengvaxia and the consequent demonization of medical colleagues. Group after group of specialists and a wider group called “Doctors for Truth” echoed the same sentiments. What frustrated many of us was the Gordon committee’s unequal platforming of minority opinions like those of doctors Antonio and Leonila Bans and scientist Scott Halstead over the WHO expert panel that did give conditional  approval for the vaccine’’s use.

It is also true that vaccinations given to those who had no previous dengue infection caused a bigger risk of subsequently developing serious dengue. But as physician Minguita Padilla writes, “This prospect (of epidemics due to the loss of confidence in health services)  is far more dreadful than the increased risk by 0.2% of getting grade 1 and 2 dengue that may occur after Dengvaxia vaccination in seronegatives compared to those vaccinated after having gotten dengue before, and from which all have been reported to recover.”

Suffice it to say that cost-benefit analyses are always part of drug approvals because all medications do have risks. I continue to rely on the recommendations of the World Health Organization because it reflects the opinion of a majority of experts. As is true of all science, the majority opinion may be wrong, but even those of us who are heretics must work within the parameters of scientific debate and reasoning if we are to remain ethical.

It is not that we had debates that is the problem, it is the politicization of that debate that has resulted in adverse consequences for our people.

Attack on health care

In her opinion piece, Dr. Padilla noted that the dengue vaccine controversy had resulted in a lack of confidence in all health programs, and not just vaccines. She predicted that this would have effects far beyond the Duterte years. 

That has proven to be true. As early as 2019, just one year after the ban, the Philippine Pediatric Infectious Disease Society called for the lifting of the ban in light of the urgent need to address dengue. In its statement, the PIPS reiterated WHO recommendations for the proper use of the vaccine.

For this year, the Department of Health reports that dengue cases recorded from January 1 to June 15 increased by 15% compared to the same period last year. 2024 is the worst year on record for dengue worldwide. In the meantime studies continue to show that Dengvaxia continues to reduce the incidence of dengue. Quality studies like this one, using real world data, show that Dengvaxia should become part of our tools in fighting dengue.

The unavailability of the vaccine has again become a class issue, as some of the rich fly their children to countries where the vaccine is available to get them vaccinated. Indeed, the vaccine has been approved in a growing number of countries.

With my obsessive desire for justice, I wish that those who had politicized the vaccine should be brought to justice. It is the best preventive against the politicization of health issues by the ethically-challenged.

But in the meantime, a good step forward is the dismissal of all cases against those government officials implicated in this scandal.

Most importantly, let us lift the ban on the dengue vaccine for the sake of our people. It would be an important contribution to what should be a serious effort to restore vaccine confidence in the Philippines. – Rappler.com

Sylvia Estrada Claudio is a doctor of medicine who also has a PhD in psychology. She is Professor Emerita of the University of the Philippines, Diliman.