HEALTH Secretary Ike Ona has taken forced leave to give him the time to answer the charges against him. Allegedly, Secretary Ona committed an irregularity in purchasing vaccines that were not cost-effective. Newspapers also reported that Secretary Ona is being criticized for additional funding for the renovation of the Research Institute of Tropical Medicine (RITM) and for the proposed rehabilitation of the Jose Fabella Memorial Hospital.
President Noynoy Aquino or PNoy just doesn’t like the guy. It is said that Secretary Ona has not been able to answer the hard questions asked by the President. And mind you, no one in the Cabinet has been spared from the President’s meticulous questions.
Further, it is said that the bias of Secretary Ona is curative care and favors the upgrading of hospitals. Hence Secretary Ona is branded as a “hospitalist.” On the other hand, the President’s bias is preventive and primary health care.
Biases are unavoidable. Ona’s being a “hospitalist” results from his long experience in working in both private and public hospitals. His bias becomes a problem only when he neglects primary and preventive health care or pursues hospital improvements at the expense of basic health. Said differently, the Secretary’s bias cannot be taken away from him, but such bias must not impinge on the administration’s health objectives and priorities.
But this has not been the case. The record shows that the Department of Health under the leadership of Secretary Ona has taken a holistic approach of reforming the whole system.
Let us review the criticisms against Ona. In itself, nothing is wrong with renovating the Research Institute of Tropical Medicine. In fact, its upgrading has become all the more relevant in order to deal with the threat of the spread of the Ebola virus. That the request came late is understandable, given that this was a reaction to the unanticipated recent emergence of the threat posed by the Ebola virus.
In itself, nothing is wrong with rehabilitating the Jose Fabella Memorial Hospital. In October 2013, the United Kingdom’s Daily Mail described the Jose Fabella Memorial Hospital as “the world’s busiest maternity ward where women sleep five to a bed and 100 babies are born every day.”
The most pernicious attack against Secretary Ona is the alleged corruption pertaining to the purchase of pneumonia vaccine in 2012.
Secretary Ona approved the purchase of pneumococcal conjugate vaccine (PCV) 10. The issue revolves around whether to purchase PCV 10 or PCV 13. Secretary Ona opted to purchase PCV 10, which is cheaper by a dollar for every dose than PCV 13. PCV 13 covers the vaccination for three additional diseases, explaining its higher price compared to PCV 10.
But from a medical or scientific perspective, both PCV 10 and PCV 13 are equally effective. The advantage of PCV 10 is it costs less. The advantage of PCV 13 is that it vaccinates three additional diseases.
From the point of view of public health policy, PCV 10 is sufficient to address the vaccination of the poor children especially. Having the PCV 13 vaccination to cover the additional three diseases is not decisively significant in meeting the objective of providing free immunization to poor children. Other less costly interventions can address the diseases not covered by PCV 10.
For rich countries, purchasing PCV 13 instead of PCV 10 is easy to do.
But for many developing countries, the question of cost is part of the equation in making the policy. Thus the UNICEF leaves to member countries which PCV to get. (The Philippines bought the PCV from UNICEF).
To use a metaphor, one need not buy a BMW to traverse a modest distance when a Toyota can do the job.
Thus on the surface, at least based on the information available to the public, the issue about purchasing PCV 10 instead of getting the more expensive PCV 13 is not about corruption. It is a policy issue. (The point is, the information available is not enough to make a conclusion that the purchase was tainted with corruption).
But ultimately, Secretary Ona serves at the pleasure of the President.
And the President doesn’t like the guy.
In the event that Secretary Ona leaves office, let us remember the gains of the Department of Health under his leadership. Secretary Ona is not a radical reformer like his predecessors: the late Johnny Flavier, the late Quasi Romualdez, and Espie Cabral. But it was under Ona’s watch that the increase in sin tax rates, the reproductive health reform, the strengthening of the Philippine Health Insurance Corporation, and the graphic health warning on cigarettes were all legislated. These were the issues that Flavier, Romualdez and Cabral fought for.
In sports parlance, Ona achieved a hat trick.
FILOMENO S. STA. ANA III coordinates the Action for Economic Reforms.