Building back better

After cataclysmic natural disasters, there’s always talk about building back better.

Now that we’re grappling with the worst national crisis we have faced since World War II, we should also have the same conversation. Once this pandemic is over – and it will be, eventually, although after a toll that will surely be more than we can bear – we should build back better. I’m referring, of course, to our health care system.

We shouldn’t be talking only about the infrastructure, although the continuing surge is highlighting the acute inadequacy of our hospital capacity right here in the National Capital Region (NCR).

In fact pre-pandemic, the inadequacy of health facilities not just in the NCR but in other urban centers and top tourist destinations was already being cited by foreigners as one of the minuses in our campaign to lure more international travelers.

Even in several high-end resorts, the best that operators can offer is airlift service to hospitals in the urban centers. Such services, unfortunately, also suffered setbacks with the fatal crash of hospital planes in at least two occasions.

Pre-pandemic, the waiting lines in certain government hospitals in the NCR were already pathetic. Some health care workers or HCWs in these hospitals told me they had to bring their own basic hygiene needs such as alcohol and surgical gloves.

Setting up a hospital building is not enough; it needs all the modern equipment for every stage of health care, from outpatient services such as dialysis to emergency response to intensive care.

And as we are sadly seeing in this crisis, infrastructure and services cannot be expanded without the corresponding additional HCWs.

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It’s ironic that our country, one of the world’s largest exporters of HCWs, is suffering from a lack of health professionals in this crisis. We have always lacked doctors, but now we lack even nurses willing to risk their health and lives to battle this lethal virus.

Nursing was once a hot college course, but the reason was clear: it was a stepping stone to quick employment overseas, where the pay is typically several times higher than the average compensation in the Philippines. Several doctors even studied nursing to work abroad.

We have to create an environment where Filipinos dream of entering the health professions the way some people dream of becoming movie stars, artists, legal professionals, pilots, and why not, president of the republic.

They have to be passionate about their dream; it has to be a life’s calling.

An upside of this pandemic is that it is making a career as a doctor or scientist or epidemiologist sexy, at whatever age. One can even become world-famous, like US infectious disease expert Anthony Fauci.

Making a profession sexy means it has to provide decent pay. Otherwise, even if the passion is there, we will just keep losing our best minds to overseas employers.

We can present as role model microbiologist Dr. Raul Destura, founder and CEO of Manila HealthTek Inc., producer of the only homegrown (and most affordable, at less than P2,000) RT-PCR swab test for COVID. The company has also developed a dengue diagnostic kit.

If Manila HealthTek would go public at this time, its IPO would earn billions instantly.

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This COVID surge will continue until vaccines in sufficient numbers are distributed in the NCR Plus. The additional toll on health, lives and livelihoods will be horrible. This is one of the consequences of dropping the ball on the 10 million Pfizer doses, which should have been delivered last January and instead went to Singapore. As I wrote, that negligence was downright criminal.

Even Uncle Xi has apparently failed to deliver on any promise – whether real or imagined – of providing all the vaccines his Filipino BFF might need.

Today we are going around with a begging bowl, scrounging for scraps from the tables of the advanced economies. This sorry state should lead to a firm national resolve to develop health care security.

We have to get serious about developing an ecosystem that encourages scientific research and development and technological innovation.

We have to show that molecular biology, virology and vaccine development can be deeply fulfilling life pursuits. Incentives can be offered to stoke the interest of our youth in entering the pharmaceutical industry, for example.

One of my most indelible memories of a visit some years ago to Chennai, the picturesque coastal city that is the capital of the Indian state of Tamil Nadu, was the amazing number of health care facilities and learning institutions. Several lined the long coastal area facing the Bay of Bengal; there seemed to be one hospital dedicated to each affliction, and schools specializing in a wide range of scientific pursuits.

With its emphasis on education and science, it’s no coincidence that India has one of the world’s most extensive and affordable domestic pharmaceutical operations, and it hosts the world’s largest producer of vaccines.

While COVID is also rampaging across India, this can be attributed more to the sheer crowding in the world’s second most populous country. India, it must be stressed, has administered first vaccine doses to 105 million of its people (about nine percent) within less than three months as of last week, and the complete two doses to 12.9 million.

The vaccines are Covishield, developed by British-Swedish pharma AstraZeneca with Oxford University, and India’s very own Covaxin by Bharat Biotech.

As I have written, Vietnam and Thailand are also developing their own COVID vaccines. They will certainly sprint past us in all aspects of recovery.

In some areas, there’s no need to reinvent the wheel. We should be able to mass produce our own ventilators, for example.

In April last year, it was reported that the University of the Philippines–National Institutes for Health in Manila had developed a more affordable ventilator for the COVID response. I’m not sure how many of these ventilators were actually distributed. At the time, the Department of Health had said the country had only 1,263 ventilators, 153 of them in Metro Manila.

Taiwan learned from its experience with SARS, and has had one of the best responses to the COVID pandemic.

We should not waste opportunities offered by this crisis to build a better public health care system.