Dead letter law

The coronavirus disease 2019 (COVID-19) pandemic has resulted to many of the country’s killer diseases given less attention, not by choice but due to this unforeseen outbreak. Cancer ailments, for one, remain the primary cause of deaths in the Philippines. Unfortunately, the very law approved in 2019 intending to help and protect cancer-stricken Filipinos remains un-implemented.

This is Republic Act No. 11215, or the National Integrated Cancer Control Act (NICCA), that was signed into law in February 2019. The Council mandated to implement this law has not yet been created up to now. Under RA 11215, the Council must draw up a comprehensive mapping of the path forward to strengthen cancer control, increase cancer survivorship, and reduce the burden on patients and families.

As such, the NICCA Council is the designated policy-making, planning and coordinating body on cancer control attached to the Department of Health (DOH). Obviously, the non-formation up to now of this Council has consequently not executed our country’s national action plans to reduce the incidence of debilitating ailments and deaths due to cancer.

DOH Secretary Francisco Duque III has already raised the alarm that people with non-communicable diseases (NCDs) like cancer are more vulnerable to becoming severely ill or expiring from COVID-19. “The noted under investment in the interventions and preventions and control of NCDs risks the disruption of the vital NCD services due to COVID-19. In the long term, this will ultimately link to a surge in deaths of people with NCDs,” Duque admitted before a recent medical forum.

In our country, the number of new cancer cases reached 153,571 in 2020 while cancer-related deaths were recorded at 92,606.

The NICCA law was supposed to supplement Republic Act 11223, or the Universal Health Care Act, which was also passed into law in 2019. Together, these two landmark laws are expected to reduce the mortality from NCDs by 30% by the year 2030. But the unexpected outbreak of the COVID-19 pandemic made it more difficult to achieve this goal after it fatally interplayed with NCDs such as cancer, the DOH Secretary rued.

Studies showed that patients with cancer who contracted COVID-19 are 16 times more likely to be in the severe or critical stages.

Under the 2021 budget law signed by President Rodrigo Duterte on December 28, 2020, a budget amounting to P620 million was included. According to the DOH Secretary, it was pooled from the P500-million Cancer Control Program fund and the P120-million Cancer Assistance fund. Duque explained that the budget is supported by the P136-million regular allocation for cancer under the NCD budget line item which brought the total to P756 million for the Cancer Supportive Care and Palliative Care Medicines Access Program. This will cover breast cancer, childhood cancer and other priority cancer types.

“This will allow us to cover more priority cancer types, and allow us to aid larger number of cancer patients in minimizing, if not outright, eliminating their out-of-pocket medical expenses,” Duque pointed out. Without the NICCA Council functioning, these funds will automatically revert back to the National Treasury. But if the NICCA Council is functional already, it will be there to ensure the judicious and best use of available resources for the intended beneficiaries of this law.

Paul Perez, president of the Cancer Coalition of the Philippines, appealed to President Duterte to appoint the five representatives from cancer-related sectors comprising this 10-man NICCA Council. The DOH Secretary is supposed to be the ex officio chairman and the heads of four other government agencies as ex officio members.

“Having the law signed is one thing. Having it implemented is another. And, in the era of corona, it is really, really challenging,” Perez pointed out.

“The challenges in cancer are all embodied in the NICCA and its implementing rules and regulations (IRR).  All we have to do is to face these challenges and try to implement what is in the law,” Dr. Corazon Ngelangel, president of the Philippine Cancer Society and professor emeritus at UP-College of Medicine, likewise appealed.

Speaking of IRR, reprinted en toto below is a Letter to the Editor sent by Presidential Legislative Liaison Office (PLLO) Secretary Adelino Sitoy in reaction to my March 24 column “Legislating via IRR.”

“In the first place, the Presidential Legislative Liaison Office (PLLO) has not been historically involved in the formulation and shepherding of Implementing Rules and Regulations of any law. Notwithstanding the foregoing, last year I made a special request to involve the PLLO as observer in crafting Implementing Rules and Regulations to hasten their formulation and also to consult Congress on the spirit and the intent of the laws to be implemented as gleaned from the recorded deliberations thereof. But my request was not acted upon. Until today, PLLO is never notified of nor invited to the drafting of any IRR. Neither is PLLO given any copy thereof. Hence, it could not interact on the IRR on RA 11525.

In regard to my physical absence from my office last year, which was because of the advice of my doctor to refrain from traveling as I was in Cebu, I was working from home all the time, signing official documents, and virtually attending Zoom meetings.

Local politics cannot hamper my work. I have been involved therein for a long, long time starting 1955 as a youthful political leader, then as member of the Sangguniang Panlalawigan of Cebu, and as an Assemblyman. Even while politicking, I still managed to establish the College of Law of the University of Cebu, become its dean, and made its first and second batches break a record among newly-opened law schools – the salutatorian of the first batch and the valedictorian of the second were in the top ten among the bar examinees.”

That said, we leave to him the fate of RA 11215 before this becomes another dead letter law.