H1N1 and the Philippine response

Friday, 10 July 2009 18:24 Mighty Rasing

Despite assurances from the Deparment of Health (DOH) that the cases of Influenza A(H1N1) infection in the Philippines are "mild," people are still worried as the number of cases in the country continues to rise.

The World Health Organization has declared a pandemic alert level six, citing widespread human-to-human transmission. The declaration, however, does not mean that the virus has become worse, according DOH. The classification reflects the increasing rate at which the virus is spreading worldwide.

Local outbreak

In June, ABS-CBN news reported that the DOH declared a community-level outbreak in Jaen, a remote town in Nueva Ecija. According to Inquirer.net, "The Department of Health (DoH) declared a community outbreak in Barangay Hilera outside Jaen town proper after 92 human contacts of 11 school children found positive for the virus also showed influenza-like symptoms. This meant that 6.3 percent of the village's population of 1,622 has been affected."

A low-level community outbreak was also declared within Metro Manila, according to Newsflash. The Philippines has reported the highest number of H1N1 cases in Southeast Asia, although all of them are mild.

A 49-year-old woman who died on June 19 was declared the first H1N1-related casualty. DOH secretary Francisco Duque reiterated, however, that A(H1N1) was not the direct cause of her death, as she succumbed to heart failure ''aggravated by severe pneumonia''. He further said, "In other countries which have reported A(H1N1) deaths, majority have pre-existing, medical conditions."

A strain on RP's resources

Pharmaceutical companies worldwide have accelerated the production of anti-flu vaccines, such as Tamiflu and Relenza. Novartis, a Swiss company, announced the successful production of the first batch of swine flu vaccine on June 12. By this coming fall, the company will be able to supply 30 governments with the vaccine. Yahoo News reports that the United States government ordered $289 million worth of swine flu vaccine back in May.

Should the price of the vaccine be high, this will put additional strain on the budget of the Philippine government. This may even contribute to the lower growth rate projected for the coming year and the strain on the economy brought about by the global recession, as reported by Bloomberg.

The Philippines also faces the reality of migrating doctors and nurses, which may compromise the readiness of the health sector in dealing with the H1N1 virus. The California Nurses Association reports that the Philippines loses 16.7% of its medical workforce to developed countries such as the United States, Australia, Canada and United Kingdom, among others. The website goes on to criticize the policy of these countries to get nurses through immigration noting the importance of these nurses and doctors in providing medical care to their countries of origin.

Between 1994 and 2003, around 85,000 nurses have left the Philippines to work abroad. A lot of these nurses used to be medical doctors, according to the Center for Migrant Advocacy. The country's medical industry has had a long trend of nurses and doctors going abroad for greener pastures. Yet, with the occurrence of a global pandemic such as the A(H1N1), such continuous outflow of medical professionals will only undermine the readiness of the health sector to deal with the pandemic.

A strategy of "mitigation"

Abandoning its earlier strategy of containment, the DOH on June 30 shifted to a policy of mitigation, which means "preparing households and health facilities to respond to the challenge posed by A (H1N1) in anticipation of more confirmed cases."

Duque asked the Department of Education, Commission on Higher Education and Philippine Information Agency to help in the department's nationwide information campaign. He highlighted the importance of good hygiene, together with the avoidance of crowded places, as the best prevention method. Compared to SARS and Avian Flu, A(H1N1) is mild and unlikely to be fatal.

Earlier this month, the DOH asked Congress to release a P19 billion supplemental budget to stock up on anti-flu vaccines. Still, the DOH has come under fire over the speed of its response to the pandemic.

"This kind of pay-as-you-go mentality over the 'mildness' of A (H1N1) cases in the Philippines is unfortunate, and could catch us off-guard should a more lethal strain of A (H1N1) appear," Senator Edgardo Angara wrote in his column in Business Mirror. He also noted the high incidence of malnutrition and other aggravating factors such as hypertension, asthma and rheumatoid arthritis among others that could make the present situation of the Philippines worse.

Photo: “Epidemia de Pánico / Panic Epidemy” by Eneas De Troya, c/o Flickr. Some Rights Reserved

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