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Taking a deeper look at meningo

(This editorial was written by Community Health Education, Services and Training in the Cordillera Region. The Editorial Board shares the same view.)

The Department of Health’s impending declaration that Baguio City is “meningococcemia free” will surely elicit a sigh of relief from many people. But this is no time to relax or to feel secure for the present meningococcemia scare is but a reflection of the moribund state of the Philippines’ public health care system. As we have proven vulnerable in recent months to panic, misinformation and lack of decisive government action that fed the meningo-panic, so too do we remain under threat from all sorts of infectious diseases and chronic illnesses.

The meningo-panic was fed by a basic lack of definite and widespread information dissemination on meningococcemia. People were speculating that the disease could be spread by merely being in the vicinity of hospitals or the public market. Even government-initiated campaigns such as the clean-up drives, although a sound public health measure by itself, did not directly stop the spread of meningococcemia and in fact, served to reinforce the misinformation that the disease came from dirty surroundings.

Money and resources were spent on high-profile campaigns that did not necessarily target the root causes of the outbreak and the consequent panic. This is similar to the National Immunization Day or Libreng Patak campaigns of the DOH which emphasize single-event immunizations rather than striving to provide enough budget to expand the EPI (ironically called the ‘Expanded’ Program of Immunization). This is also the way malnutrition is addressed in this country — by launching a Micronutrient Program which emphasizes certain vitamins and minerals or fortifying certain junk foods, because there is not enough money for feeding programs or for subsidizing farmers.

Because of this budget anemia, immunization for the groups at highest risk of contracting meningococcemia was never a consideration. Although experts explained that World Health Organization guidelines did not advise mass immunization at this time, one cannot help but surmise that COST must have been a primary consideration as well.

When government funds and public health services are insufficient, private interests step in. Private enterprise, from peddlers hawking masks at every street corner along Session Road to rumors of private physicians cornering the supply of vaccines and inflating its true price, thrives in a free market. A judicious policy to take at this time would have been to assume strict government control over the supply, distribution and price of vaccines. But this was not done either as liberalization or “free-market economics” prevails even in a vital service sector as health.

Meanwhile, meningococcemia continues to plague the poor – the urban poor of San Carlos, the market vendors of Hilltop, etc. For after all, the poor are always the worst victims of a moribund public health care system. They have the least means available to cope with this disaster – they cannot afford their own immunizations, stand to lose the breadwinners of their families, and are most vulnerable to the economic repercussions from decreased sales. Alas, even with regards to meningococcemia, the poor can only get poorer.

While the poor have the most to lose from this disaster, all of us actually have much to fear. There is much to fear when our government allots a mere 30 centavos per Filipino per day for our health care. There is much to fear when the major portion of our national budget goes to paying off foreign debts (up to 40% of the budget at times) and funding military spending (15-20%). There is much to fear when profit continues to dictate the supply and distribution of vital medicines and vaccines. There is indeed much to fear from a moribund health care system that cannot deal decisively with meningococcemia. #

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