Hysteria

One of the reasons cited by foreign investors for bypassing the Philippines in favor of neighboring countries is the unpredictability of many things that affect business here.

We can’t enforce contracts, and regulators don’t have the final say on matters that fall within their mandate. The Supreme Court overturns its own final and executory decisions within such short periods, changing its mind alongside leadership changes in government.

Our justice system is heavily politicized and vulnerable to corruption apart from being notoriously slow.

Even departments within the executive branch can’t get their act together. This circus over the Dengvaxia vaccine is starting to turn into a national embarrassment. President Duterte should step in and order members of his official family to speak with one voice, or at least keep their disagreements within the confines of Cabinet meetings. And he should designate a lead agency in the effort to ferret out the truth.

Because this is a public health problem, the logical lead agency should be the Department of Health. The DOH secretary is a Duterte appointee so the administration need not worry that he might whitewash the investigation or protect the interests of vaccine maker Sanofi Pasteur to the detriment of 800,000 mostly children who have received Dengvaxia.

This issue is complex enough without publicity-seeking, self-promoting lawyers jumping to half-baked conclusions about a public health issue.

Even without the autopsies on the fatalities, we already know what the findings will be of the team (with no forensic pathologist) tapped by the Public Attorney’s Office (PAO), backed by the Department of Justice (DOJ) and, as we have seen in recent statements, by Malacañang. One is that Dengvaxia is directly linked to the deaths from dengue shock of several recipients of the vaccine. Another is that the procurement of the vaccines by the Aquino administration was made with undue haste during an election period, for reasons that the accusers leave to our malicious imagination.

If we go by the statements and actions of officials, we can see that in the eyes of the PAO and DOJ, Sanofi Pasteur and the officials of the Aquino administration involved in the procurement are already considered guilty unless they can prove their innocence.

The possible charges that may be slapped against them include corruption and reckless imprudence resulting in homicide.

There could in fact be guilty parties in this mess, but this is not the way to go about unearthing the truth.

*      *      *

The DOH has tapped scientific experts from the University of the Philippines-Philippine General Hospital to also look into the controversy. The UP-PGH team has come up with more nuanced findings that, when compared with the conclusions reached by the PAO team, can be confusing and only aggravate the anxiety of the Dengvaxia recipients and the relatives of those who have died.

Health Secretary Francisco Duque III announced the UP-PGH findings and said that while two of the 14 fatalities who had received Dengvaxia died of dengue shock, indicating vaccine failure, there was no conclusive finding that Dengvaxia caused the deaths.

Did the vaccine directly cause the deaths, or enhance other illnesses that led to the deaths, or did it fail to protect the recipients against dengue? The answer is best left to expert forensic pathologists to determine conclusively. But it looks like Malacañang, the DOJ and PAO will have none of it; they already have “findings” waiting to be validated by their own team.

You can’t make the “truth” fit preconceived ideas. There can only be one truth in this story.

*      *      *

Sanofi Pasteur, the world’s largest vaccine maker, may have to fork out more to compensate those who suffer from Dengvaxia side effects that are just now being manifested. Such are the risks taken by Big Pharma.

It’s only right that the manufacturer should pay for any harm done by its products. The same goes for any official who might have acted rashly in procuring a drug that puts lives at risk.

But there is a way of handling this probe that will not engender panic.

We can also avoid turning this fact-finding effort into yet another cautionary tale for private companies that are considering whether they should do business in the Philippines.

Because of similar fiascos in the past, contracts entered into by many foreign companies with the Philippine government include a provision that any major disputes must be resolved through international arbitration.

Yesterday, Duque said the DOH is reviewing its contract with Sanofi Pasteur for a possible civil suit in case the company refuses to give a full refund. The move is reasonable, but the government must make sure any such lawsuit will have legs to stand on. Or else taxpayers will be burdened with expensive litigation that the government might lose if it is based mainly on shrill conjecture.

A Sanofi Pasteur executive reiterated yesterday the company’s readiness to cooperate, but stressed that a full refund would indicate that the vaccine is defective – which he insisted is not the case.

A full refund may also encourage similar demands from other governments and individuals.

The website of the World Health Organization (WHO) shows that Dengvaxia has been administered under government programs in the Philippines and Brazil, targeting a million individuals. It is also available commercially in several other countries.

In July 2016, a WHO position paper issued a “conditional recommendation” to use the vaccine in “highly endemic areas.” This was based on recommendations made by the WHO’s advisory body on vaccination.

Following subsequent tests by Sanofi Pasteur, WHO’s current “interim interpretation” of available data is that Dengvaxia “significantly protects against hospitalized and severe dengue” in individuals with a history of dengue. For those who have never had the disease, however, “the risk of hospitalized and severe dengue is significantly increased,” WHO declared.

As of Nov. 30, 2017, this was WHO’s statement on the vaccine: “Pending the full review of the data, as a precautionary and interim measure, WHO recommends that Dengvaxia is only administered to individuals that are known to have been infected with dengue prior to vaccination.”

So WHO is recommending only a modification of the vaccination program. But Sanofi has suffered so much damage to its reputation in this country that the government will likely procure another batch of anti-dengue vaccine only if another pharmaceutical company develops a similar product.

We’re considering here not just a full refund of P3.5 billion and compensation for any victim in case the vaccine is found to be defective. We must also continue finding ways of stopping dengue and saving lives.

Hysteria and hyperventilation can only muddle this complicated issue.