The explicit intertwining of the issues on infrastructure and health is what makes the town of Paracelis, said to be Mt. Province’s last frontier, among the four project areas of the 6th UNFPA (United Nations Population Fund) Country Programme. It has been said that the hierarchy of needs should always be the starting point of all programs seeking to adress the needs at a higher level. This is the case in Paracelis and even in most of the towns in Mt. Province, north of the Philippines, where reproductive health seems to be an abstract in the minds of its people.
Nestled in the interior triboundaries of Ifugao, Isabela and Kalinga is the remote town of Paracelis, Mountain Province. There are two difficult, almost impassable routes to get there – either through the steep and narrow mountainsides of Mount Polis, where boulders and rough mountain rocks combine to make the surface of a road; or by passing through Isabela and the dirt roads of Alfonso Lista, Ifugao. Both paths are characterized by rough, bumpy roads pockmarked with potholes. During the rainy season, the road turns sticky with mud and the two rivers become swollen, making travel next to impossible.
UNFPA’s initial project in the municipality targets four barangays that are equally challenging to reach. Barangays (village) Bantay and Bunot are easier to reach because vehicles can pass through and the routes are relatively passable. Reaching the other two barangays of Anonat and Buringal, however, will require tougher guts.
Anonat can only be reached after an hour-and-a-half motorboat ride in the Siffu River. From there, one has to hike for one-and half hour to reach the town proper. To reach Buringal, the farthest town, one has to pass through several towns in Isabela before reaching the mighty Mallig River in Dommon for an hour-and-a half motorboat ride. The rest of the journey is traveled by long hours of hiking.
During the community appraisal phase of the UNFPA project, the very condition of these roads was identified as central to the people’s quest for better and healthy lives.With the lack of key infrastructures in the area, any development intervention in the towns invariably fails.
Read full article here...
The original article of this appeared in Health Alert Asia Pacific Issue No. 10, 2007 (Supplementary issue). For copies of the newsletter, please email hain1985@gmail.com
Monday, July 30, 2007
Creating Roads to Sexual & Reproductive Health
The explicit intertwining of the issues on infrastructure and health is what makes the town of Paracelis, said to be Mt. Province’s last frontier, among the four project areas of the 6th UNFPA (United Nations Population Fund) Country Programme. It has been said that the hierarchy of needs should always be the starting point of all programs seeking to adress the needs at a higher level. This is the case in Paracelis and even in most of the towns in Mt. Province, north of the Philippines, where reproductive health seems to be an abstract in the minds of its people.
Indigenous Peoples: Living on the Edge
In 2004, no less than the United Nations Economic and Social Committee noted that “indigenous peoples in many countries continue to be among the poorest and most marginalized.” The comment was made in light of the conclusion of the first International Decade of the World’s Indigenous Peoples, which commenced in 1994. Admitting that the the first Decade was a failure, a second International Decade was started in 2005.
Judging from the health situation of indigenous peoples, it seems that the second Decade is bound to be another failure unless concrete measures are taken to improve the lives of indigenous peoples.
This July, HAIN releases the latest issue of Health Alert (Issue No. 10) which delves into the health issues faced by indigenous peoples. The editorial provides a brief profile of indigenous peoples, as well as the importance of land to their well-being. It maintains that unless the indigenous peoples’ right to land and self-determination is respected, no amount of intervention can make a difference.
Two articles, “Health care for the Orang Asli: consequences of paternalism and non-recognition” and “Indigenous people’s survival: our environment, our lives,” give a brief explanation of the indigenous peoples’ concept of health and well-being. Also, the first article examines how paternalism and lack of sensitivity in handling indigenous peoples’ concerns further worsen the people’s health situation. The second article, meanwhile, shows the effect of environmental degradation in the lives of indigenous peoples.
This also features articles on the health situation of Taiwanese and Australian Aborigines. “Saving Taiwan’s Aborigines” shows that Taiwanese Aborigines have shorter lifespan than non-Aborigines. It also highlights the growing concern for the alarming rise of diabetes cases among Aboriginals. “Australian Aborigines: a proud past; a checkered future” takes a look at the higher rate of mental and emotional distress among Australian Aborigines. It is emphasized that the skewed rate does not point to genetic aberrations; rather, it is the direct result of the social disintegration and neglect suffered by Australian Aborigines.
“The Mangyans of Mindoro: Tough life, ailing conditions” illustrates how apathy, government neglect, and militarization adversely affect the health and lives of indigenous peoples.
The last article, “The quest for the green gold,” focuses on biopiracy and how the act further marginalizes indigenous peoples.
The special issue, “Creating Roads to SRH,” provides a fresh angle in the discussion of delivery of health services in far-flung areas; detailing how the lack of roads and other vital infrastructures adversely affect a community.
To request copies of the Health Alert Asia Pacific, please email hain@hain.org or hain1985@gmail.com. We will also post in this blog some of the articles included in this issue.
Wednesday, July 25, 2007
Children’s Medicines
By Michael Tan
Philippinde Daily Inquirer, Pinoy Kasi column
July 25, 2007
View full article here...
The first bill filed in the new Congress was the proposed Cheap Medicines Act. More accurately, the bill was re-filed since it had been proposed in the last Congress but didn’t make it as a law. The bill went through rough sailing, facing tough opposition from multinational drug companies.
Among those lobbying heavily for passage of the bill are advocacy organizations working with the elderly. They’ve rightly pointed out that the country’s expensive medicines have been a terrible burden especially for the elderly, and the families that have to foot their medical bills. Because the elderly are more vulnerable to chronic ailments, they have much greater dependency on medicines, many of which have to be taken on a daily basis. Even with the 20-percent discount offered to senior citizens, the monthly bills for medicines easily run into the thousands, wiping out their savings. The elderly are literally held hostage by the drug industry with a grim message: Pay up, or suffer.
How costly is costly?
But sometimes we forget that there’s another large segment of the population that’s also held for ransom: the children. About 100,000 Filipino children die each year, many from diseases that are preventable and curable.
Let’s tackle the preventable deaths first. Vaccines play a key role in preventing many of these deaths. Fortunately, the government does provide free BCG (for tuberculosis), DPT (diphtheria, pertussis or whooping cough and tetanus), OPV (oral polio vaccine) and hepatitis B vaccines. Additional vaccines for flu, chickenpox, MMR (measles, mumps and rubella) have to be paid for with private physicians, and these can run into several thousand pesos. As far as I know, they’re not reimbursable with PhilHealth or with private health maintenance organizations.
There are many other diseases that are not preventable through vaccines. The leading cause of illness and death among children are acute respiratory infections. Children are also especially at risk for gastrointestinal infections that can cause life-threatening diarrheas.
Philippinde Daily Inquirer, Pinoy Kasi column
July 25, 2007
View full article here...
The first bill filed in the new Congress was the proposed Cheap Medicines Act. More accurately, the bill was re-filed since it had been proposed in the last Congress but didn’t make it as a law. The bill went through rough sailing, facing tough opposition from multinational drug companies.
Among those lobbying heavily for passage of the bill are advocacy organizations working with the elderly. They’ve rightly pointed out that the country’s expensive medicines have been a terrible burden especially for the elderly, and the families that have to foot their medical bills. Because the elderly are more vulnerable to chronic ailments, they have much greater dependency on medicines, many of which have to be taken on a daily basis. Even with the 20-percent discount offered to senior citizens, the monthly bills for medicines easily run into the thousands, wiping out their savings. The elderly are literally held hostage by the drug industry with a grim message: Pay up, or suffer.
How costly is costly?
But sometimes we forget that there’s another large segment of the population that’s also held for ransom: the children. About 100,000 Filipino children die each year, many from diseases that are preventable and curable.
Let’s tackle the preventable deaths first. Vaccines play a key role in preventing many of these deaths. Fortunately, the government does provide free BCG (for tuberculosis), DPT (diphtheria, pertussis or whooping cough and tetanus), OPV (oral polio vaccine) and hepatitis B vaccines. Additional vaccines for flu, chickenpox, MMR (measles, mumps and rubella) have to be paid for with private physicians, and these can run into several thousand pesos. As far as I know, they’re not reimbursable with PhilHealth or with private health maintenance organizations.
There are many other diseases that are not preventable through vaccines. The leading cause of illness and death among children are acute respiratory infections. Children are also especially at risk for gastrointestinal infections that can cause life-threatening diarrheas.
Tuesday, May 08, 2007
Medherbal Pharmacy in Drug Retail
There is politics and economics in every pill. In the Philippines, branded medicines cost almost twice as generics. Media hype often dictates the drug consumption, no matter how unfounded some of the claims and portrayals in commercial ads.
Still with the exorbitant prices of drugs, it has become impossible for most patients to properly complete their medication. Medherbal Pharmacy (MHP) is trying to change that.
MHP is a community-oriented pharmacy promoting quality and affordable generic and herbal medicine. It also gives training on herbal medicine preparation.
The pharmacy was initially a project of the Council for Health and Development (CHD) with the mandate of providing generic medicines for the use of communitybased health programs (CBHP). It also provided affordable but effective medicines to members of organized communities.
When it started to achieve sustainability, the CHD Board of Trustees has decided to transform the project into an enterprise so it could reach more clients. Now it is slowly gaining ground into a wider market with its expansion around Metro Manila.
In line with its mission to provide affordable medicines to the poor, its three branches are located near urban poor communities.
A different business philosophy MHP may be a business entity, but its approach is different from commercial pharmacies.
Unlike other pharmacies that place as much as 30 percent profit of margin per item, MHP’s profit of margin is low; just enough to cover the operational expenses and post a small profit.
The pharmacy also carries generic medicines and herbal medicines. The herbal medicines are sourced from CBHPs to help them support community projects as well as their own programs. MHP buys its herbal soaps from CBHP-Isabela, herbal teas from San Benito SIPAG-KO in Bicol, and ampalaya (bitter gourd) capsules from the Tuazon Community Center Foundation. To ensure the products’ qualities, MHP regularly conducts trainings on syrup making and sterilization.
MHP also assists in the setting up of community-based pharmacies by conducting rainings on herbal medicine and pharmacy management. Organizations who have finished the trainings are then provided with initial stocks of medicines. So far, six community pharmacies have already been established: three in Paranaque, south of Manila; one in Tala; and two in the province of Nueva Ecija. MHP is planning to set up five more community pharmacies before the year ends.
Another thing that differentiates MHP from other pharmacies is its advocacy on Rational Drug Use. Since most of their customers have virtually zero knowledge on RDU, staff actually takes the time to educate them.
Advocacy at work
MHP often encounters some people who still think of amoxicilin as vitamins. “People need to know the right medicines to take, the right dosage, at the right time” says
Socoro Torres, Medherbal’s chief executive officer.
Drug consumption remains a big challenge because of the lack of knowledge about rational drug use as well as proper appreciation of generic drugs. Often people buy medicines inappropriate to their sickness. A majority of the Filipinos still buy drugs based on hearsay from what family members or neighbors say. Most of the time, they tend to buy drugs from what they hear or see on television or simply buy prescriptions given to them some years ago.
Often, lacking proper diagnosis from physicians, their illnesses take a turn for the worse.
Torres explains that cultural factors remain an issue, relating to how multinational drug companies have controlled or overwhelmed popular media with ads. Such example is that of the world boxing champion, Manny Pacquiao. In his endorsement of ibuprofen, he says that he has been using it for 11 years. However, a scientific finding concluded that prolonged use of ibrufropen can likely makes a person’s bones brittle, entirely belying the high profile ad.
Here still lies most of the challenges for MHP, but here is where it has also made significant gains. From an offshoot of CHD’s drug procurement unit then only serving orgnized communities, now it is reaching out to larger crowd that is mostly unfamiliar to the concepts of RDU. The MHP staff are proud to say that they have been somehow successful in slowly influencing some people to follow prescriptions, take a full course of medication or go for herbal or generic versions rather than known brands.
Torres admits that economic issues hinder the promotion of RDU. She says other patients could not afford to buy full dosage of medicines. “There are those who buy one or two tablets of amoxicillin. We tell them the minimum dosage for antibiotics is 15 tablets. We try to lower prices so they could buy the full dosage.” It is unfortunate however, that even if people know about the proper intake of medicines, they have not enough money to buy them.
Even with the enactment of the Generics Act of 1988, she underscores the failure of the government to support local drug manufacturers as well as its failure to regulate the production of medicines.
Due to monopoly pricing, the cost of drugs in the Philippines is one of the highest in the world, second in Asia next to Japan. Branded medicines still dominate the market, accounting for 97 percent of sales.
The Philippines now heavily imports drugs from India through the government’s parallel importation program. If indeed the government really wants to end monopoly and significantly reduce prices, Torres insists that it should instead promote local pharmaceutical companies by increasing subsidy and lowering taxes.
To demonstrate the ill-effects of such problematic trade, experts believe that the rise in number of cases of multi-drug resistant TB is a result of the failure to comply with prescribed medication.
The irony remains starkingly real. Great advances have been made regarding treatment and cure of many ailments, but who can afford them? All these gives MHP more reasons to continue its work.
By Philip Paraan Council for Health and Development (chdmancom@yahoo.com)
Published at Health Alert Asia Pacific (www.hain.org)
Still with the exorbitant prices of drugs, it has become impossible for most patients to properly complete their medication. Medherbal Pharmacy (MHP) is trying to change that.
MHP is a community-oriented pharmacy promoting quality and affordable generic and herbal medicine. It also gives training on herbal medicine preparation.
The pharmacy was initially a project of the Council for Health and Development (CHD) with the mandate of providing generic medicines for the use of communitybased health programs (CBHP). It also provided affordable but effective medicines to members of organized communities.
When it started to achieve sustainability, the CHD Board of Trustees has decided to transform the project into an enterprise so it could reach more clients. Now it is slowly gaining ground into a wider market with its expansion around Metro Manila.
In line with its mission to provide affordable medicines to the poor, its three branches are located near urban poor communities.
A different business philosophy MHP may be a business entity, but its approach is different from commercial pharmacies.
Unlike other pharmacies that place as much as 30 percent profit of margin per item, MHP’s profit of margin is low; just enough to cover the operational expenses and post a small profit.
The pharmacy also carries generic medicines and herbal medicines. The herbal medicines are sourced from CBHPs to help them support community projects as well as their own programs. MHP buys its herbal soaps from CBHP-Isabela, herbal teas from San Benito SIPAG-KO in Bicol, and ampalaya (bitter gourd) capsules from the Tuazon Community Center Foundation. To ensure the products’ qualities, MHP regularly conducts trainings on syrup making and sterilization.
MHP also assists in the setting up of community-based pharmacies by conducting rainings on herbal medicine and pharmacy management. Organizations who have finished the trainings are then provided with initial stocks of medicines. So far, six community pharmacies have already been established: three in Paranaque, south of Manila; one in Tala; and two in the province of Nueva Ecija. MHP is planning to set up five more community pharmacies before the year ends.
Another thing that differentiates MHP from other pharmacies is its advocacy on Rational Drug Use. Since most of their customers have virtually zero knowledge on RDU, staff actually takes the time to educate them.
Advocacy at work
MHP often encounters some people who still think of amoxicilin as vitamins. “People need to know the right medicines to take, the right dosage, at the right time” says
Socoro Torres, Medherbal’s chief executive officer.
Drug consumption remains a big challenge because of the lack of knowledge about rational drug use as well as proper appreciation of generic drugs. Often people buy medicines inappropriate to their sickness. A majority of the Filipinos still buy drugs based on hearsay from what family members or neighbors say. Most of the time, they tend to buy drugs from what they hear or see on television or simply buy prescriptions given to them some years ago.
Often, lacking proper diagnosis from physicians, their illnesses take a turn for the worse.
Torres explains that cultural factors remain an issue, relating to how multinational drug companies have controlled or overwhelmed popular media with ads. Such example is that of the world boxing champion, Manny Pacquiao. In his endorsement of ibuprofen, he says that he has been using it for 11 years. However, a scientific finding concluded that prolonged use of ibrufropen can likely makes a person’s bones brittle, entirely belying the high profile ad.
Here still lies most of the challenges for MHP, but here is where it has also made significant gains. From an offshoot of CHD’s drug procurement unit then only serving orgnized communities, now it is reaching out to larger crowd that is mostly unfamiliar to the concepts of RDU. The MHP staff are proud to say that they have been somehow successful in slowly influencing some people to follow prescriptions, take a full course of medication or go for herbal or generic versions rather than known brands.
Torres admits that economic issues hinder the promotion of RDU. She says other patients could not afford to buy full dosage of medicines. “There are those who buy one or two tablets of amoxicillin. We tell them the minimum dosage for antibiotics is 15 tablets. We try to lower prices so they could buy the full dosage.” It is unfortunate however, that even if people know about the proper intake of medicines, they have not enough money to buy them.
Even with the enactment of the Generics Act of 1988, she underscores the failure of the government to support local drug manufacturers as well as its failure to regulate the production of medicines.
Due to monopoly pricing, the cost of drugs in the Philippines is one of the highest in the world, second in Asia next to Japan. Branded medicines still dominate the market, accounting for 97 percent of sales.
The Philippines now heavily imports drugs from India through the government’s parallel importation program. If indeed the government really wants to end monopoly and significantly reduce prices, Torres insists that it should instead promote local pharmaceutical companies by increasing subsidy and lowering taxes.
To demonstrate the ill-effects of such problematic trade, experts believe that the rise in number of cases of multi-drug resistant TB is a result of the failure to comply with prescribed medication.
The irony remains starkingly real. Great advances have been made regarding treatment and cure of many ailments, but who can afford them? All these gives MHP more reasons to continue its work.
By Philip Paraan Council for Health and Development (chdmancom@yahoo.com)
Published at Health Alert Asia Pacific (www.hain.org)
Tripping Over Trips
India, China, and other developing nations have made headway in producing generic versions of much-needed medicines, but the Trade-Related Intellectual Property Rights (TRIPS) is challenging this increasingly booming sub-industry. The effort to curb the further development of the generic drug industry stems from the fact that generic medicines, which is far more cheaper than branded ones – are eating into the profits of Big Pharma.
Big Pharma’s reaction was typical: all World Trade Organization (WTO) member-countries are required to fastrack the full implementation of the TRIPS agreement.
As the world’s leading manufacturer and exporter of generic medicines, India’s handling of the TRIPS issue had been a rallying point for health institutions and activists worldwide because of its possible ramifications in the global generic drug industry. No less than the World Health Organization and the UNAIDS urged India to take full advantage of the TRIPS flexibilities when it amended the act. India was forced to amend its Patents Act of 1970 in compliance with the TRIPS agreement.
The first sign that India might be caving in to pressures was a December 2004 ordinance it passed that would grant patents to products and not just to the process. The ordinance, which did not go through the Parliament, was passed because India had to beat the January 1, 2005 deadline set by the WTO. The revision would have an impact on the generic industry because Indian manufacturers utilized the original act’s differentiation between “process patents” and “product patents.” With the 1970 Act focusing on process patents, manufacturers were able to produce generic versions of branded medicines through reverse engineering.
The current ordinance has effectively watered down the 1970 Act, but health activists were able to score some points with the inclusion of several amendments, two of which address the most crucial issues. With regards to generic exports, the amendment would still allow foreign countries to export generic medicines from India without having to obtain a compulsary license from the patent holder. Another amendment guarantees existing Indian companies the right to market generic medicines (even those that are still under patent), as long as a royalty fee is paid.
The Indian chapter of the People’s Health Movement (PHM-I), however, cautions that the ambiguous wordings of the revised ordinance might be subjected to abuse. For example, manufacturers may still produce generic versions of new drugs, as long as the producer makes a “significant investment” and paid a “reasonable royalty” to the patent holder. The crucial questions are how significant the “significant investment” and reasonable the “reasonable royalty” are?
In its critique of the new bill, PHM-I admitted that the new ordinance is far from ideal and that certain provisions may have a negative impact on public health. The group pointed out the need for all stakeholders to continue monitoring the bill’s implementation. “This is possible only if both the political and the committed peoples movements mutually appreciate the positive roles being played by them without
trying to take up self righteous positions,” it said.
Sources: Health Alert Asia Pacific, Issue No. 9 (www.hain.org) www.phm-india.org ; www.ictsd.org
Big Pharma’s reaction was typical: all World Trade Organization (WTO) member-countries are required to fastrack the full implementation of the TRIPS agreement.
As the world’s leading manufacturer and exporter of generic medicines, India’s handling of the TRIPS issue had been a rallying point for health institutions and activists worldwide because of its possible ramifications in the global generic drug industry. No less than the World Health Organization and the UNAIDS urged India to take full advantage of the TRIPS flexibilities when it amended the act. India was forced to amend its Patents Act of 1970 in compliance with the TRIPS agreement.
The first sign that India might be caving in to pressures was a December 2004 ordinance it passed that would grant patents to products and not just to the process. The ordinance, which did not go through the Parliament, was passed because India had to beat the January 1, 2005 deadline set by the WTO. The revision would have an impact on the generic industry because Indian manufacturers utilized the original act’s differentiation between “process patents” and “product patents.” With the 1970 Act focusing on process patents, manufacturers were able to produce generic versions of branded medicines through reverse engineering.
The current ordinance has effectively watered down the 1970 Act, but health activists were able to score some points with the inclusion of several amendments, two of which address the most crucial issues. With regards to generic exports, the amendment would still allow foreign countries to export generic medicines from India without having to obtain a compulsary license from the patent holder. Another amendment guarantees existing Indian companies the right to market generic medicines (even those that are still under patent), as long as a royalty fee is paid.
The Indian chapter of the People’s Health Movement (PHM-I), however, cautions that the ambiguous wordings of the revised ordinance might be subjected to abuse. For example, manufacturers may still produce generic versions of new drugs, as long as the producer makes a “significant investment” and paid a “reasonable royalty” to the patent holder. The crucial questions are how significant the “significant investment” and reasonable the “reasonable royalty” are?
In its critique of the new bill, PHM-I admitted that the new ordinance is far from ideal and that certain provisions may have a negative impact on public health. The group pointed out the need for all stakeholders to continue monitoring the bill’s implementation. “This is possible only if both the political and the committed peoples movements mutually appreciate the positive roles being played by them without
trying to take up self righteous positions,” it said.
Sources: Health Alert Asia Pacific, Issue No. 9 (www.hain.org) www.phm-india.org ; www.ictsd.org
Wednesday, February 07, 2007
Migration of Health Professionals: Boon or Bane?
The current wave of health professional migration sweeping developing countries is another black spot in the global health system. Today, the high number of health professionals leaving for more lucrative jobs abroad is straining the public health care systems of the affected source countries.
Exporting Health Professionals
The migration of health professionals is not an entirely new phenomenon, but the latest wave is producing a more pronounced adverse impact on source countries due to the unusually high number of migrating health professionals.
Exporting Health Professionals
The migration of health professionals is not an entirely new phenomenon, but the latest wave is producing a more pronounced adverse impact on source countries due to the unusually high number of migrating health professionals.