Healthcare 'grossly neglected' in 'middle-income' Philippines, groups say
Health Secretary Francisco Duque III in a recent interview claimed that the country's healthcare system was not weak and that the Philippines was not a third world country.  
The STAR/Mong Pintolo

Healthcare 'grossly neglected' in 'middle-income' Philippines, groups say

Franco Luna (Philstar.com) - February 6, 2020 - 5:00pm

MANILA, Philippines — Health Secretary Francisco Duque III said this week that the Philippines was not among the poor countries that the World Health Organization said have "weak health systems, and which are ill-prepared to deal with [the novel coronavirus outbreak]."

The WHO had earlier said the world should support and help those countries that have "weaker health systems", noting most of the cases had been in China, an economic giant. 

“Yung sinasabi nila, yung weak health system yung mga talagang mahihirap na bansa. ‘Yun ang mga tinutukoy nila na weak health system na mahirap, mga developing third world countries, eh tayo middle-income country na tayo. Hindi tayo kasama diyan,” he told DZMM, referring to an advisory by the World Health Organization.

(What they mean by weak health systems only really applies to poorer countries. What they're referring to is developing third-world countries, but for us, we're middle-income. We're not included in that.) 

President Rodrigo Duterte has als assured the public that the ongoing scare is no cause for concern. 

WATCH: 'Everything is well': Duterte assures nation on novel coronavirus risk

"Everything is well in the country. There's nothing really to be extra scared of that coronavirus thing," Duterte told reporters after meeting with top officials on the outbreak.

"Although it has affected a lot of countries, but you know, one or two in any country is not really that fearsome."

For peasant group Kilusang Magbubukid ng Pilipinas, these sentiments were indicative of the government's complacency and negligence over the worldwide scare. 

'Nothing to worry about' 

Although the Philippines has only three confirmed cases so far, there are also 133 persons under investigation for the virus in the country as of the Department of Health bulletin on Wednesday. 

READ: How the 2019 nCoV caused worldwide panic: A timeline

As of Thursday morning, there have been more than 28,000 confirmed novel coronavirus cases across the world. The Department of Health has pointed out that, based on current data, the death rate for 2019-nCov Acute Respiratory Disease is 2% 

Health officials have also repeatedly pointed out that none of the confirmed patients are Filipino and that all of them came from Wuhan, which indicates "zero local transmission."

READ: 'Zero local transmission' of nCoV in Philippines, Health department emphasizes

But, KMP said, the outbreak is happening after "chronic neglect of the country’s public health infrastructure."

"Despite the drastic shortage of medical personnel and inaccessible health facilities nationwide, the 2020 health budget was even slashed by P10 billion," Danilo Ramos, KMP chairperson said in a statement.

In October 2019, a think tank released a Global Health Security Index which placed the Philippines 53rd out of of 195 countries examined. However, the Philippines also scored zero in five of the index's health security categories, as The Economist's Intelligence Unit concluded in the report that no country in the world was fully prepared to withstand a pandemic

Academics and activists alike have been saying that the Philippines has long been in a health crisis. In 2016, Duterte's first year in office, a study by NGO Viva Salud found that "8 people out of 10 in the [Philippines] report never having had a medical checkup or physical examination in their life."

READ: The Philippines scored '0' in 5 indicators on the Global Health Security index. Here's why

"For all the possible qualifications for 'weak', it is undeniable that our health system is fragmented and lacking in several measures," Coalition for the People's Right to Health co-convenor Josh San Pedro told Philstar.com in an online exchange. 

“The reality is that access to healthcare in the country is still far from ideal. Only 43% of barangays have a functional [barangay] health station [or] center, and the ratios of health workers to the population is overwhelming," he told Philstar.com in an earlier interview in October.

Even government officials have acknowledged the holes in the country's healthcare system.

As early as January 13 of this year, Speaker Alan Peter Cayetano admitted that Philippine healthcare had endured a long period of neglect. “The decades of neglect, brain drain, and lack of investments in health infrastructure have caused the decline of healthcare in the country,” he told reporters earlier about the House of Representatives' supposed push towards securing Universal Health Care in the country.  

'Not a third-world country'? 

According to the World Population Review, the term 'third world' generally refers to nations marked by high poverty rates, economic instability and lack of basic human resources, especially in comparison to its other counterparts. 

"The thing about the 'middle income' country status is that it is a World Bank indicator based on economics, something the WHO doesn't necessarily use," San Pedro said.

"We know that health outcomes are related to, but not necessarily a function of, economic status."

That the Philippines is a developing economy is a well-documented fact: Academic journals and organizations like the World Bank, the United Nations, the International Monetary Fund, Investopedia and Climate and Development have all listed the country as such. 

Towards the end of 2019, healthcare groups were vocal in calling the public healthcare situation in the country a crisis of its own, pointing at a lack of funding. The Philippine General Hospital in Manila, for example, suffered a budget cut of P2.77 billion for 2020 from a P3.23 billion allocation the year before. 

READ: Groups warn of health crisis

By 2019's end, the country also had the outbreak of infectious diseases and growing distrust in vaccines to reckon with. These came as the Department of Health was supposedly bracing for the implementation of the Universal Health Care Law in 2020.

Think tank Ibon Foundation in a report on Tuesday also said that "while the allocation for the health sector in the national budget increased from P177.7 billion in 2019 to P185.5 billion in 2020, its overall share in the national budget fell from 4.85% to 4.52%."

The research group said that the smaller financial share given to health care demonstrates the low priority afforded to it. 

"The fact that your health workers are facing an artificial shortage because of a brain drain and poor renumeration is indicative of the system's failings," San Pedro said. 

"One doctor for every 33,000 patients? When WHO target is 1:1000 and the DOH's own standard is 1:400, I don't think an allegedly 'middle income country' should be proud of such things."

In the Philippines, the health worker-to-person ratio stands at only 19 per 10,000, far below the World Health Organization recommendation of at least 45 health workers for every 10,000 persons, or a ratio of 1-1.5 doctors per 1,000 population.

'Confusion and frustration'

For San Pedro, the crux of the matter is that governments should be acting with urgency due to the unpredictability of the virus in lower-income countries.

"Our greatest concern is the potential for the virus to spread to countries with weaker health systems, and which are ill-prepared to deal with it," he said. 

"No matter how much the Duterte regime denies its inefficient response to the 2019-nCoV onset and the poor state of health services in the Philippines, it cannot cover up the torrent of confusion and frustration," OFW group Migrante International said Thursday. 

"In addition, poor pay and government neglect continues to exacerbate brain drain among Filipino health care professionals."

Duque has also started pointing fingers this week, from the media's supposed 'fake news' coverage of the crisis, to his own office. 

"As long as the country’s public health system remains grossly neglected, the Filipino people will continue to be severely vulnerable, no matter how benign or serious new diseases can be,” Ramos said. 

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