written on 31.08.2010

Interview with Enrique Ona, Secretary, Department of Health (DOH)

Universal Health Care for All Filipinos: Making this dream a Reality

I assumed office as your secretary of health barely a month ago with this single order from the president: make the dream of universal healthcare for all Filipinos a reality. This shall be the standard by which my performance, and that of the Department of Health, shall be measured.

This is a tall order, no doubt. That task at hand is arduous and definitely not easy. We have to address existing inequities in health care services, maldistribution of our health workers, the lack of access to essential drugs, inadequate financial risk protection and high out of pocket expenditures.

Universal health care seeks to answer all of these problems, but not totally.

But what is universal health care?

Universal Health care means that all Filipinos have equal and fair access to affordable healthcare at the time and place of need. That every Filipino has social health insurance that can protect them from financial ruin he is enrolled and registered in Philhealth and is eligible for Philhealth benefits. Thus by 2013, we aim to hit the target of at least 85% Philhealth Coverage.

By then , our citizens should have access to health services through Philhealth-accredited providers, with neither physical distance nor high cost as a hindrance. Accreditation by Philhealth shall be a health provider’s badge of timely appropriate and quality health care.

The mark of universal coverage also means deepening the protection provided by our national social health insurance program (NHIP). We will improve Philhealth benefits both for in-patient and out-patient services. This should drastically reduce the out of pocket expenditure from the current 54% to 35% to prevent millions of families to fall into the cracks of poverty.

Universal access to medicine is an indispensable component of universal health care. To this end, we will pursue measures to improve access to medicines. The use of affordable quality generic drugs shall be our primary instrument to increase medicines access through the strict implementation of the Generics Act. At the same time quality will be ensured through implementation of the provisions contained in the FDA Strengthening Act.

Presently, the department of health is revising the 2987 National Drugs Policy into the proposed Philippine medicines Policy of 2010 in response to the need for a recalibrated strategy to protect public health given the change in health care, both at the national and global levels. Our country already bears a significant part of the global burden of important health threats such as tuberculosis, malaria, and chronic diseases. Aside from these, we also face the challenges of intensive trade globalization, the implementation of the WTO-TRIPS agreement, and the emergence of new diseases with the potential to become pandemics.

The proposed Philippine Medicines Policy 2010 shall be the roadmap of the entire health sector and our partners in addressing the medicines access gap in the country. Through the strategies we propose, we want to assure that the government will adequately meet its obligations to protect public health through sustainable access to medicines. At the same time, we recognize the need to work with other stakeholders such as your (the pharmaceutical) industry. By this, we mean that we nurture an investment climate conducive for the industry to continuously produce medicines compatible with our country’s public health needs.

The Philippines, as a signatory to the 2000 United Nations Millennium Declaration, seeks to achieve the millennium development goals, among them Target 15 which calls for providing access to affordable essential drugs, in cooperation with pharmaceutical industries.

Given the government’s lack of resources, the President has enunciated the establishment of public-private partnerships as a means to address the pressing needs of our countrymen. The department of health through the national Center for Pharmaceutical Access and Management and the Philippines Chamber of Pharmaceutical Industries has established good models of public-private partnership long before the President issued his call. This is seen in our joint efforts to continuously improve generics availability and use, educate our consumers and participate in discussions that are criticlal in the implementation of government programs with regards to medicines. On this note, let me thank the PCPI for your continuous support and active participation during the sessions of the Advisory Council on Price Regulation and your inputs to the proposed Philippine Medicines Policy. They are invaluable as together we identify win-win solutions to address the lack of access of our citizens to quality essential drugs.

Clearly, the promotion of generic drug use is crucial in making medicines more accessible to many Filipinos. Thus, I thank you for doing your share which has resulted in the wider acceptance of generics both among our doctor prescribers and patients alike. For example, based on the latest survey conducted by IMS Health, it is now evident that more doctors have confidence in generics with data revealing that pure generics prescription has increased from 26.1% in February 2007 to 33.1% in February 2010. This increase was seen in all major therapeutic classes. Both Government and private health providers are increasingly prescribing generic medications.

Let me also bring you good news that very recently, the department of health has forged a partnership with the SM Group of Companies and they pledged to help us actively promote generics in all SM activity centers nationwide.

In the days to come, the National Center Pharmaceutical Access and Management shall be rolling out drug entitlements for priority diseases and for vulnerable and special populations. This is an opportunity for local manufacturers to do business with government if you can provide the products that we need at the most affordable price to reach and benefit as many patients provided that your companies are GMP certified.

Ultimately, only a robust national pharmaceutical industry capable of producing safe, efficacious and quality medicines will ensure unhampered medicines access for the Filipino. I shall see to it that the proposed National Medicines Policy of 2010 will include providing government support to the local industry so that you become viable, competitive and self-reliant…capable of meeting our country needs particularly in times of emergencies.

We shall encourage local research and development to strengthen our domestic capacity to manufacture essential vaccines, drugs and medicines for our country’s public health needs.

Strategies to this end include a review and possible revision of tax policies imposed on local pharmaceutical companies. In coordination with the board of investments incentives can b given to GMP certified firms. Assistance to other companies for them to acquire GMP Certification shall also be explored. Finally, there will be a business plan emphasizing the development of the local industry’s competitive advantage in the manufacture of essential biotechnology and pharmaceutical products.

National self reliance in medicines is the key towards universal access to medicines for the Filipino.

As we all aspire to make the dream of universal healthcare for all Filipinos, I am confident that the continued and unqualified support of the Philippine chamber of pharmaceutical industry shall bring us closer to achieving universal access to essential quality medicines.

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