Words by Celeste Samin and Ethan Pahm
As a country considered to be under the longest lockdown across the globe, our national government has made multiple attempts to properly address the COVID-19 pandemic from military checkpoints to the latest developments of which is pooling of our funds and resources for vaccine procurement.
In response to the health crisis, the Philippine government proposed a Virology Research Fund totaling P2 billion for vaccine research and development under House Bill No. 6793. P284 million has already been set aside from the 2021 budget to be provided to the Department of Science and Technology (DOST). This bill was proposed with the intent to meet the local demand for vaccines due to limited global supply, with the Philippines being the last Southeast Asian country to receive doses of the vaccine.
Our neighboring countries received their vaccines significantly earlier. Singapore received theirs on December 21, 2020, and Indonesia on December 6 of the same year. Malaysia received its doses on February 20, 2021, while both Thailand and Vietnam received the vaccines on February 24, 2021. The Philippines, on the other hand, only received the COVID-19 vaccine on March 4, 2021, from the COVAX facility.
Vice President Leni Robredo released a statement in March regarding the insufficiency of the current efforts in order to achieve herd immunity, that is, having 70% of the population or 77.4 million people out of 111 million citizens vaccinated by the end of the year. The target number should be no less than 300,000 vaccinations per day—a stark number compared to the current pacing of 15,857 vaccinations per day.
Separate government data from the Department of Health (DOH) showed that the country’s daily rate is only at 6,800 per day with a seven-day average of 47,545 vaccinated individuals.
To continue at this rate, we would only be able to vaccinate 1.8 million individuals this year and 2.5 million in the succeeding years. Provided that there is a consistent and stable supply, the vaccine rollout would last three decades. By that time, the country would have likely achieved natural herd immunity which involves the infection and recovery of the 77.4 million people, however, that route would entail the deaths of around 1.5 million Filipinos.
According to the released data by the DOH, only 162,065 of the population have been fully vaccinated while a million have received their first dose as of April 15, 2021. 2.8 million out of the 3.5 million doses at hand are distributed throughout the country, but the remaining 724,580 has not been accounted for. The total supply of vaccine doses increased to 7.5 million on May 8, 2021 but distribution plans are yet to be disclosed by the government.
Various sectors have expressed concern and criticism over the data provided by the DOH. Several lawmakers, such as Senator Sherwin Gatchalian, called it “garbage” and the UP COVID-19 Pandemic Response Team pointed out the “alarming errors” and “inconsistencies” in DOH’s reports. Multiple instances of deaths have been reported as recoveries and 516 cases were reclassified either to another city or somewhere completely imaginary. The dubious “mass recovery” was also a result of the DOH’s adjustment that considered “mild and symptomatic cases who remained healthy for 14 days” as recovered. There was also a mismatch between the numbers disclosed by the DOH and of local government units (LGUs).
Keeping in mind that cases could be potentially higher than “official records”, compare this to the statistics of our Southeast Asian neighbors. As of April 6, 2021, Singapore had the highest percentage of its population vaccinated at 28.5%, Indonesia with 4.92%, and Malaysia with 2.66%. This is a significant difference with the Philippines’ 0.84%. Thailand had 0.46% of its population vaccinated, with Vietnam having 0.06%. From this data, we can see that while the Philippines is not the country with the least percentage of its population vaccinated, it certainly is on the lower end.
Despite having a lower vaccination rate, there’s a sharp difference with the total number of cases between the Philippines and its neighboring countries. Countries like Vietnam and Thailand had a scaled up mass and targeted testing to address community transmission, using these data to support the imposed quarantine measures. This led to Vietnam having 3,000 positive cases with 35 deaths in a population of 97 million and Thailand, with a total population of 70 million having 73,000 positive cases with 303 deaths. A huge difference with the Philippines that has a population of 111 million with currently 1 million positive cases and 18,000 deaths.
The government has always insisted that the large population of the country hindered it from properly mitigating the effects of the pandemic. Harry Roque himself had said last June 10, 2020 that in comparison to how New Zealand had properly halted the spread of the virus, the Philippines simply could not keep up due to factors such as the population and landmass of the country.
However, contrary to the government’s claim that population is a large factor in vaccine distribution, Indonesia still has a higher percentage of its population vaccinated than the Philippines, at least four times the percentage of our country’s vaccinated population, actually. It is worth noting that Indonesia contains more than double of the Philippines’s population having 273.52 million citizens.
It has become evident that the number of imported vaccines is insufficient, not to mention costly. As of May 1, 2021, the vaccines delivered to the Philippines are Sinovac, Astrazeneca, and Sputnik V.
A single dose of Sinovac is said to be P650 or roughly 14 USD, Astrazeneca at P144 to P192 (3 USD to 4 USD) per dose, and Sputnik V at P480 (10 USD) per dose—clearly, expensive given our large population along with the fact that some vaccines require more than one dosage per person. Not only that, but to properly store these vaccines, one would need to meticulously maintain proper temperatures for each distribution facility. Because otherwise, the vaccines will lose their potency. This signifies that additional expenses for logistics and storing such as for transport trucks and local facilities with proper equipment will also be incurred.
High local demand and costs entail the mandate for a potential solution: locally manufactured vaccines.
But why can’t we make our own vaccines?
Let us uncover this initiative’s various roadblocks considering the limitations of the current pharmaceutical industry in the country, and some deeply-rooted bureaucratic and multisectoral issues.
House Bill 6793: The Philippine Virology Science and Research Institute
One of the approaches to mitigate the adverse effects of COVID-19 is House Bill 6793, authored by Albay Representative Joey Salceda. The significant lack of information about the virus led to an inadequate response to the outbreak—highlighting the importance of prevention in addressing public health emergencies. The bill’s focus is through the development of the Virology Science and Technology Institute of the Philippines which has the objective of establishing a collaborative network of knowledge and research.
A point of consideration is the Philippine National Vaccination Deployment Plan with the DOH spearheading the task group. The plan explicitly states that its role is to identify potential COVID-19 vaccine delivery strategies and to ensure that vaccines are properly distributed to the population. The problem is that governance for the bill, ironically, was handed off to the DOST as seen in Section 8 of the bill.
Not only that, but even the ranks of the proposed virology institute itself are set up in a way that could cause miscommunications and inefficiencies. It is specified under Section 9 that the members would come from all sorts of departments such as the Department of Health, the Department of Agriculture, three selected members from the private sector, and more. This would mean that anything found by the institute would first have to go through its governing body, then to the heads from DOST, then back to the DOH for approval, and only then would they be able to take action.
This is not an isolated case. Similar problems with the so-called red-tape occurred within the DOH even at the first few months of the pandemic. It’s the same department that slowed down the procurement of testing kits and machines, aggravated by the bureaucratic limitations set by the Bureau of Customs (BoC) and the Food and Drug Administration (FDA). The BoC also required importers of COVID-19 related products to obtain special authorization from the FDA, through a Certificate of Product Notification or a Certificate of Product Registration. Personal Protective Equipment (PPE), such as masks and other medical products, needed to go through registration despite them being scarce in supply at the time for medical workers.
It was due to reasons like these, a shortage in testing kits among other things, that resulted in an underreported number of initial cases for the virus. The lack of PPE, had also exposed thousands of frontline workers to COVID-19.
Internal conflicts and division
There are currently multiple teams and departments, from both the public and private sectors, independently working on vaccine manufacturing as well as research and development. Under the proposed House Bill 6793 for establishing the Virology Institute, it would require the cooperation of all those entities involved. Vaccine production efforts come with an apparent lack of organization and coordination between the important public health sectors as observed by their separate activities.
Last June 2020, DOST Secretary Fortunato de la Peña said that they have been in touch with “several international partner institutions” for vaccine development collaboration. This is in partnership with the Philippine Council for Health Research and Development (PCHRD) along with an expert panel from the University of the Philippines Manila and local pharmaceutical companies to discuss the execution of clinical trials in the country.
In return for serving as a hub for vaccine clinical trials, the Philippines would be supported by foreign companies for local COVID-19 vaccine production, given that the results of the trials are favorable. The DOST claimed and assured their support for the private sector’s clinical trials and assistance for product registration. They made this official on April 15, 2021 when they announced that they are “in talks” with six potential vaccine manufacturers, all of which are foreign-based. It mentioned the possibility of local vaccine production, but not specified whether it is for COVID-19 doses, by late 2022.
On a separate event, the National Task Force Against COVID-19 was the frontman in securing the commitment of the Serum Institute of India, the world’s largest vaccine manufacturer, to help the country produce its own vaccine. This is despite the fact that the policy-making body is the Inter-Agency Task Force (IATF) on Emerging Infectious Diseases as led by the DOH. As a result, they should have been the ones in talk with the Serum Institute of India instead of the National Task Force Against COVID-19, the role of which is for the implementation of the policies and decisions by the IATF.
For the private sectors, the OCTA Research team, through Fr. Nicanor Austriaco, disclosed their research conducted in the United States, on COVID-19 oral vaccines which are yet to undergo animal testing. Similarly, an Israeli-Filipino firm filed their application to manufacture oral vaccines in the country which is yet to be approved by the Philippine Economic Zone Authority (PEZA). It is notable how the OCTA Research team is conducting their experiments abroad, a testament to the lack of government support for research and development as seen by the P76 million DOST budget cut for research in 2021; they have provided 284 million pesos to DOST for equipment purchase under the virology research institute while simultaneously cutting their research budget.
Scientists are further provided with an additional bureaucratic nightmare by having to prove their need for equipment to military politicians and personnel heading their respective departments. An example would be that the National Task Force (NTF) Against COVID-19, tasked to implement the National Action Plan (NAP) to address the pandemic, is handled by three former military generals with no background in public health. Defense Secretary Delfin Lorenzana is the overall head of the NTF, Interior Secretary Eduardo Año as vice-chair, and Carlito Galvez Jr. as the Chief Implementer of the NAP or commonly called the vaccine czar.
Even the “contact tracing czar” Baguio City Mayor Benjamin Magalong, who ironically downplays the need for contact tracing, was a retired police officer who has also violated quarantine protocols.
The incoming money, may it be donations, gifts, grants, or loans for the Virology Research Fund would also be subjected to a rigorous process of approval. It would first be directed to the President “upon the recommendation of the Secretary of the DOST and Secretary of the Department of Foreign Affairs (DFA)”, rendering it susceptible to budget cuts. Even research donations can now possibly be allocated for the military, given the government’s history of priorities.
The particular roles of the DOST, the DOH, and even the National Task Force Against COVID-19 in their general attempt to boost local production are unclear due to the lack of cooperation and general plan of action. In addition to the confusion, these sectors and groups would all be vying for limited funds allotted for vaccine research and development. They will also be undergoing the bureaucratic process of application and review for funding and implementation. This poses the possibility of unsolicited internal division among the institutions, further preventing proper vaccine manufacture, development, and deployment.
Aside from the governmental hurdles for local vaccine manufacture, there are already enough obstacles for developing countries like the Philippines. Manufacturing and supplies are not distributed evenly due to information gatekeeping and obstruction of COVID-19 vaccines done by the great countries. This is why 100 countries are asking other World Trade Organization (WTO) members to agree with lifting the COVID-19 related intellectual-property (IP) rights.
Neoliberalism and foreign prioritization
DOST Usec. Rowena Guevara claimed that vaccine manufacture is “best suited to the private sector” and that private companies should be at the “forefront” of development, shifting the government’s responsibility, yet again, to the private sector.
Income generation has always been the top priority of companies and the ongoing health crisis is no exception. Pfizer, for instance, insisted on reserving their intellectual property rights, ensuring their expected $15 billion profit for the year 2021 from COVID-19 vaccines. By withholding the patent, transnational pharmaceutical companies like Pfizer are able to dictate the price of vaccines and hold developing countries like the Philippines by the neck; we would have no choice but to take global market prices because of the severity of the current situation which would only be augmented by vaccines. The inability of the country to produce its own vaccines makes it reliant on the five multinational corporations controlling 80% of the global vaccine supply.
The economic policies in place further expose us to neocolonialism by rendering our country dependent on great countries with large pharmaceutical manufacturing industries. It impedes the country’s overall independence and development by handing a principal part of our funds to foreign companies and industries which then gets to dictate local prices and services.
An example is the parallel drug importation program signed by former President Gloria Macapagal-Arroyo on June 6, 2008. The Universally Acceptable Cheaper and Quality Medicines Act of 2008 made it significantly easier to import cheaper versions of branded medicines and sell them to the public. This, along with the fact that multinational companies which had manufacturing plants in the country closed down their facilities over the years, and began to import from corporate production centres abroad, shows that the government has a greater inclination towards importing pharmaceuticals compared to having them locally manufactured.
The government’s so-called loyalty to these foreign corporations, albeit asserted that it is to “stimulate” and “revive” the economy, doesn’t actually help the citizens. Because when foreign commodities are heavily favored over local production, it only helps these international companies achieve their target superprofits. And what makes it worse is that the national government not only allows this to happen, but has also perpetrated this disservice; a manifestation was during one of the most infamous periods of Philippine history, the Marcos regime.
The Philippines had suffered from an economic decline ever since Ferdinand Marcos seized power. The Marcos administration, alongside rampant crony capitalism and corruption, had used the declaration of Martial Law to, “open up and restructure the Philippine economy according to the needs of foreign monopoly capital.” In other words, prioritizing foreign agenda and profit over local production.
He institutionalized the export of cheap labor from the Filipino citizens, and also bypassed constitutional restrictions on foreign exploitation on Filipino petroleum and gas—allowing foreign oil and gas corporations to completely take over our natural resources.
While the gross domestic product (GDP) had initially looked “optimal”, it was actually an inaccurate depiction of the country’s progress. It incorrectly assumed that economic gains were evenly spread across the population, evidently shown in the massive wealth inequalities between the social classes at the time.
Because of economic policies like these, demanded by the US-dominated International Monetary Fund (IMF) and World Bank (WB), Marcos had increased the national debt fifty-fold from $599 million in 1965 to $28.3 billion when he left as a deposed dictator in 1986; debt that is still being paid today by the current generation and is still going to burden the generations to come. (Read: How the Marcos-World Bank partnership brought PH economy to its knees)
Inefficiencies in vaccine procurement and deployment
Hypothetically, even with sufficient funding and government support, local vaccine manufacture would require the time this country cannot afford anymore. The Philippines faced its own hurdles, from institutional infighting to budget cuts that derailed local vaccine development and is the reason why the administration’s pandemic response is centered on vaccine procurement and deployment, highly-militarized response, and on the continuous imposition of nation-wide quarantine.
Senator Panfilo Lacson disclosed how DOH Secretary Francisco Duque failed to accomplish the necessary paperwork in order to secure the 1 million doses of the Pfizer vaccine for the Philippines by January of this year. The paperwork in question was the Confidentiality Disclosure Agreement (CDA) that had even been followed up by the Pfizer country representative. Instead, the shipment had gone to Singapore where 55,000 people have already been vaccinated by Pfizer as of February 2021.
Despite the limited vaccine supply and the disqualification from being part of the priority groups, many politicians also continue to cut the vaccination line. While having only 336,656 health care workers (HCWs) vaccinated out of 1.7 million individuals, politicians such as Mayor Elanito Peña from Minglanilla, Cebu still continue to rationalize their cutting in line by falsely claiming to be a frontliner as well. Several mayors from different municipalities have also committed this act, and note that with every cut, a frontliner or a high-risk person loses their dose.
DOH Undersecretary Maria Rosario Vergeire issued a statement that urged Filipinos to report people who were cutting the line. Ironically, even the DOH is aware of those who cut in line but they have yet to penalize all violators. This is further evidenced by how Tim Yap and actress KC Concepcion only paid P1,500 for throwing a birthday party and violating quarantine protocols, while ordinary citizens are beaten and exhausted to death.
There was also a case in Bicol of how 7,000 doses of the AstraZeneca vaccine were wasted during transport. Senator Nancy Binay had believed that the thermometer used by the third-party logistics company was faulty. This defective thermometer had actually changed how the vaccines were stored, and the potency and effectiveness of the vaccines were supposedly affected—but the DOH later issued a statement that the vaccines were still in usable condition. Nevertheless, this incident expresses state neglect and carelessness.
Instead of a unified and proactive effort towards local vaccine manufacture, the majority of the aforementioned steps taken by various sectors are solitary and uncoordinated, contributing to the inability of the country to produce vaccines. This leaves us reliant on limited global supply controlled by imperialist countries. As a result, the Philippines is far from reaching its goal of mass vaccination by the end of the year.
President Duterte continued to encourage citizens to wait for the vaccines, but not every Filipino could afford to wait, as the daily tally of cases now ranges around 10,000 per day, bringing the total cases to more than a million; our country was the “second worst-hit” by COVID-19 in Southeast Asia and the ICU and emergency rooms of hospitals, specifically in the National Capital Region (NCR), are now reaching 86% occupancy. As they near their critical threshold, not only COVID-19 patients would be unable to receive proper treatment, but also other emergency patients.
The government’s refusal to view the pandemic as a public health crisis is costing the lives of millions of Filipinos. As we lose more lives while waiting for the “promised solution” to the pandemic, public officials continue to praise and celebrate the “resilience” of our exhausted medical frontliners. Data further proves that reliance on vaccines alone will not solve the pandemic, contrary to our government’s plan of action.
Each day, the government’s current response results in around 10,000 positive cases and 100 deaths. When Presidential Spokesperson Harry Roque bragged about the government’s success in “beating COVID-19”, he boasted of 18,000 deaths as well.
If the government continues to act and regard the pandemic as a sole economic and military crisis, there would no longer be a need for vaccines because no Filipino would be alive to use it.
And even if the powers that be decide to recalibrate their pandemic response tomorrow, their efforts are already futile because the individuals who died at the hands of the state yesterday and today can no longer be revived. [P]
Photos from PNA.gov.ph
Design by Jun Vince Dizon