First of two parts
WHAT has happened to one Dr. Enrique Ona, Secretary of the Department of Health (DOH)?
And I say that not to criticize him. I say it with compassion and empathy for this DOH
Secretary who has fallen silent in the midst of criticism and controversy, missing reports and unofficial sex education videos included.
It takes much reading between the lines, and a sense of how nothing happens in government without an untold narrative behind it. Especially with this yellow government and its pretense of transparency, and with a media that’s complicit in the silence that surrounds issues that are as major as, oh I don’t know, the life and death of thousands of Filipinos whose health are at risk.
And it’s really what strikes you about the controversies that surround the seeming downfall of Dr. Ona. It looks so well-orchestrated, so well-planned, that it doesn’t take a genius to see how the President will not allow him to come back. You can hear it already: the President will invoke how “his bosses” have decided in favor of accepting Dr. Ona’s resignation. Never mind that very few have spoken about this issue at all, and fewer are equipped to even really take a stand about it.
The tale of taking a leave
The first time we heard about Dr. Ona taking a leave of absence as DOH Secretary, it had something to do with a hair dye allergy. It was of course ironic that the country’s Secretary of Health would get an allergy from hair dye, the latter being something that’s cosmetic and unnecessary, and which should be no health risk.
Then it was revealed that other than the hair dye allergy, this leave was about an administrative process that Dr. Ona was undergoing, which included a “complicated report” he needed to submit to the President about everything “from vaccination to the reported urgent need to rehabilitate the Research Institute of Tropical Medicine where possible patients of Ebola virus may be held and treated.” (Philstar.com, 5 Nov)
The President himself said Dr. Ona needed to take a leave in order to answer his questions, “specifically about the vaccination campaign – on the balance between the preventive and curative aspects of medicine or public health <…> I always emphasize to him – shouldn’t our mission be to ensure that no one gets sick so they no longer have to go to hospitals? And for him, he has this balance that we have several hospitals that need to be upgraded.” (ManilaStandardToday.com, 4 Nov)
Of course there were rumors about how the President was unhappy with Dr. Ona’s performance, even as Spokesperson Edwin Lacierda asserted that the Persident was “satisfied” with Ona’s work as DOH Secretary: “You’ve seen the work of DOH and its various programs were instituted under the leadership of Secretary Ona – we’ve increased Philhealth coverage, we’ve increased the number of vaccinations, all these were done under the leadership of Secretary Ona <…> The President is satisfied with each Cabinet member and there’s no reason to say otherwise.” (MB.com.ph, 31 Oct)
Vaccines beyond recommendations
In November, we heard about the issue of Dr. Ona’s procurement of PCV10 pneumonia vaccines versus PCV13; the latter is considered to be the “more cost-effective” option.
PCV13 is more expensive but covers more diseases; Dr. Ona decided on the cheaper PCV10 in order to deliver more vaccines to more children, reportedly against the “suggestion” of the National Center for Pharmaceutical Access and Management, the Formulatory Executive Council and the World Health Organization (WHO). (AsianJournal.com, 14 Nov)
The WHO has reportedly denied it had questioned the DOH decision; too many have criticized Dr. Ona for having decided against a WHO recommendation anyway. True or not, it sounds to me like the Secretary of Health decided against the recommendations of “credible” agencies, and had the prerogative to do so. That’s no different from say, the President deciding not to declare a National Artist, no matter the “credible” institutions that have recommended her.
I digress. Certainly we might question Dr. Ona’s decision to procure PCV10 over PCV13.
But also it’s important to question what the basis should be of decisions such as this one and what the limits are of the Health Secretary’s freedom to decide. To some extent it seems like this is nothing but a matter of perspective: pick the drug that’s cheaper and will mean maximum number of children given the pneumonia vaccine; or pick the more expensive drug that will mean less children treated, but protected from more ailments.
The decision of Dr. Ona was one that was premised on the urgency of vaccinating more children against pneumonia. So the question is really about whether or not his notion of urgency was valid.
To be concluded tomorrow