Refocus

The logic supporting the proposal is truly compelling. But it still required so much courage to publicly advocate that the early-stage vaccinations be focused on Metro Manila.

Dr. Guido David of the independent OCTA Research Group broke the ice and uttered what might seem utterly impolitic. The situation in the metropolitan center worsened in a matter of days from “serious” to “alarming.” The region, with its teeming masses living cramped together, is among the world’s densest urban centers.

Most of the cities with the highest infection numbers are in the Metro. The region’s hospitals are now filled to the brim with COVID-19 patients. If this second surge of the pandemic succeeds in crushing our health care system, it will happen first in the metropolitan center.

The NCR, we know, exports infected people to the rest of the archipelago. It is the hub of population movement. Each day, tens of thousands of people drive to the NCR to bring their produce. Each day, especially as the hot months approach, people from the NCR migrate to the beaches and the mountains.

The 12 million residents of the NCR must be treated as a mammoth cluster, the metropolis a super-spreader.

It is perfectly logical to concentrate the vaccination program in the NCR. This is the capital of COVID. With the most infected persons per square kilometer, the vaccination program will have immediate impact. The impact of inoculation will be magnified.

If we are able to control infections within a compact and contiguous area, we will be able to control infections nationwide. We are attacking the infections at the source. We will be grabbing the pandemic by the throat.

Why is advocating the most logical vaccination strategy almost like blasphemy?

In this country, we operate on what the French call a “fixed idea.” All social goods emanating from the state must be distributed evenly across all localities. Otherwise, we will hear cries about “Imperial Manila” – the notion that the capital region always gets the lion’s share of resources and social goods to the detriment of the rest of the ethnic and linguistic regions.

The notion of an “Imperial Manila” is a powerful one across the archipelago. It evokes a sense of victimhood, a concept of post-colonial inequality or, simply, a cycle of systemic neglect for the disempowered provinces.

For decades, the equal distribution of the spoils of nationhood defined the congressional pork barrel system. Instead of using available state funds for a scheme of prioritized strategic projects, the pork barrel system subdivided everything so that there is relative parity in the funds going to the districts. Instead of doing big projects, therefore, we ended up having micro-projects benefitting the political careers of legislators but not adding up to a coherent national development strategy.

For instance, instead of building a regional airport, the fund is subdivided evenly across districts and used to construct bus stops. Because of this “fixed idea,” our rail system fell into extreme disrepair. The construction of expressways was left for the private sector to undertake.

When I consulted for Congress many years ago, I came across a curious entry that recurred in the project lists of the districts. The entry read: multipurpose solar drying project. When I looked at what the project actually was, I found a basketball court with a stage beside it bannering the name of the local congressman. At certain times of the year, palay we spread across the basketball court to dry.

Once, the House of Representatives, that controls the national budget, enacted an “El Nino Mitigation Fund” for every district. I asked then Speaker Jose de Venecia why my incessantly flooded hometown merited a share of this fund. We had more than enough water than we need. The Speaker smiled at the naïve question and said that is the way it works.

The other instance I encountered this “fixed idea” was when I was helping execute what would eventually be called the “Nautical Highways” program initiated during the Arroyo administration. Consisting of a chain of “ro-ro” routes that linked the stranded island economies to the main channels of domestic trade, this logistics program involved financing a wide range of projects including port upgrades, investments in roll-on/roll-off vessels, cold chains and silos, produce aggregators and agribusinesses that will make the “nautical highways” viable.

One day, a provincial governor marched into my office demanding to know why no projects were assigned to his province. He had obviously missed the logic of sustaining a complex logistics chain. I told him the “B” in DBP stood for “bank,” not “barrel.” We were out to support a viable chain of businesses and not to distribute political goodies like the pork barrel system does.

I can understand that the initial stock of vaccines (about a million doses) has been distributed to about two thousand vaccination points nationwide. The first priority for inoculation are the health care workers and they are pretty much distributed nationwide.

But when our vaccine stockpile grows dramatically over the next few weeks and more people are included in the priority list, it could serve us well to take a closer look at the OCTA proposal to concentrate the next wave of vaccinations in the NCR.  This will have immediate effect in turning back the dangerous tide of infections we are seeing.

This will require a refinement in the vaccination strategy to ensure the most beneficial outcomes. Let us hope the “fixed idea” will not get in the way of refocusing the strategy to benefit us all.