Europe is in the midst of a pretty bad second wave of COVID infections. For us, thanks to DOH Sec. Francisco Duque, we are only now seemingly getting out of the first wave.
But with more people going about their regular lives, a second wave can bring us back to where we started. The virus is still very much among us and the number of cases can rapidly go up again.
If we get into the second wave, will our officials get it right? Or will they get it wrong again?
Let us, first of all, make sure we have the proper resources and tools to do things right.
Despite the flurry of Bayanihan appropriations in recent months, it seems we still do not have enough budget to fix the health infrastructure to respond to another epidemic. Take a look at the 2021 budget passed by the House.
Of the P1.1 trillion for infrastructure, only P2.3 billion or 0.21 percent was allocated for the construction of hospitals and health centers. Contrast this with the allocation of an eye-popping P19.1 billion to the National Task Force to End Local Communist Armed Conflict.
I know ending the communist insurgency is important but dealing with the pandemic is a national emergency. The communists have been at it for over 50 years, and it is doubtful throwing oodles of money at the problem will end their rebellion. Only social and political reforms will deny them the fertile ground that supports them.
COVID, on the other hand, requires resources to save lives. Can the 2021 budget cover the enormous cost for those infected with and hospitalized for COVID-19?
With PhilHealth’s failure to pay the Red Cross, swab tests have to be paid for by the patients themselves. Hospital bills can run to half a million to more than a million pesos.
Then… how do we protect everyone else from infection? President Duterte keeps on putting his faith on a Chinese or Russian vaccine. But wherever the vaccines will come from, we have to pay like everyone else in the world.
Setting aside funds for COVID-19 vaccines sounds sensible. But as Sen Ralph Recto pointed out, the 2021 budget doesn’t seem to have enough set aside for vaccines.
It is also possible that the vaccines will not be available next year, or at least in enough quantities for all 110 million of us. What do we do in the meantime?
Does DOH have containment measures so that the need for the vaccines would not be as pressing for us to avoid more deaths? We can learn from the experiences of countries that successfully brought down their infection and mortality rates.
Former economic planning secretary Ernesto Pernia admits, in a recent article, our government response to the COVID pandemic is problematic.
“The Philippines is now known to have the highest level of COVID-19 infections relative to population in this part of Asia, and its economy the slowest to recover. These can be attributed to differences in both health system capacity and government COVID-19-response spending.
“One reason our health system capacity has been constrained to respond quickly and effectively to the crisis is that we have severely underinvested in social infrastructure (hospitals and health centers) and supplies, not to mention connectivity nationwide, particularly outside Metro Manila.
“In addition, we have taken for granted our health personnel (medical doctors, nurses, etc.) as regards remuneration and working conditions, thereby inducing them to leave for greener pastures abroad.
“A study finds that a $1 investment in health can result in a $2 to $4 multiplier effect on the economy (fewer premature deaths so larger work force, higher labor productivity, and lower absenteeism) depending on a country’s income level (McKinsey, July 8, 2020).”
Pernia explains that our capacity to deal with the pandemic appears to be the weakest in ASEAN, as reflected in our highest caseload despite the longest lockdown.
Pernia cites comparative data (as of September 2020) from the Asian Development Bank (ADB) showing that the Philippines has spent the lowest—a total of $21.45 billion, equivalent to 5.83 percent of gross domestic product (GDP) and $201.11 per capita on health infrastructure. These numbers are the lowest among the six ASEAN major economies.
“Vietnam, a relative latecomer with a lower income per capita than the Philippines, spent $26.50 billion, or 10.12 percent of GDP, and $277.40 per capita. Correspondingly, Indonesia’s numbers are $115.78 billion,10.94 percent, and $432.54 per capita; Thailand, $84.09 billion, 15.96 percent, and $1,211.20 per capita; and Malaysia, $78.45 billion, 22.07 percent, and 2,488.18 per capita.”
Former BSP deputy governor Diwa Guinigundo pointed out that “basic public access to hygiene facilities is beyond the reach of some seven million Filipinos based on 2019 data from the Department of Health.
“The exhortation to wash hands, wear facemasks and face shields is meaningless. They cannot wash their hands because neither water, nor soap is available.
“There is a high level of awareness, but the poor cannot afford these health protocols.” Their housing units are small and cramped making social distancing impossible.
Now that we are in the budget season, we should closely watch what our legislators will do to the health budget. They habitually cut the DOH budget, supposedly because the department doesn’t have the capacity to spend.
Indeed, there are serious management problems at the DOH. But with the pandemic still a major concern, we need to allocate enough funds even if we have to cut pork and intelligence funds to do so. The people’s health needs must now be top priority.
According to Sen. Sonny Angara, who is now leading the Senate deliberations on the budget, the health budget proposed for 2021 is P127.28 billion. That looks like an improvement over 2019 which was P97.65 billion and the 2020 allocation of P100.560 billion.
Sen. Sonny says there will be funds for health facilities of P4.78 billion for 2021 and foreign assisted projects worth about P5.2 billion. Let us make sure budget allocations are enough.
There is clearly so much work to be done to make sure we get it right when the second wave strikes.
Boo Chanco’s e-mail address is bchanco@gmail.com. Follow him on Twitter @boochanco.