The year that was in public health
MANILA, Philippines – The year 2014 saw many firsts in public health: population hitting 100 million, a new law giving health insurance to all Filipino seniors, and another law requiring graphic health warnings on cigarette packs.
The Department of Health (DOH) was also caught up in controversies. An embattled health secretary resigned before Christmas, and a music video for a health campaign went viral for the wrong reasons.
On top of all that, 5 public health issues in this list by Rappler challenged the country's health system in more ways than one.
It’s safe to say the health department has been on its toes all year round, and hopefully, lessons were learned along the way – through the good and bad.
Measles outbreaks, and the road to 2017
After the country saw an upsurge of measles cases at the start of the year, the DOH started its preparations for a month-long mass immunization in September. After all, children who missed their measles vaccination at an early age contributed to the rise in the numbers.
The outbreaks, although not country-wide, became a concern even for other countries like the United States, Japan, Australia, and Singapore, since the Philippines had "exported" the highly-contagious disease to their shores.
By the end of September – the mass vaccination month – 84% of the 11 million target children were vaccinated for measles-rubella, and the campaign had to be extended until the first week of October.
The country wants to reach a measles-free status by 2017.
MERS-CoV: Not once, but twice
It came as a shock when, in the middle of Holy Week, the health department announced the first laboratory-confirmed case of the MERS Coronavirus (MERS-CoV) infection in the Philippines.
A retesting of the overseas Filipino worker (OFW) yielded negative results, but the incident put in place contact tracing – a mechanism which proved to be valuable when another Filipino nurse reportedly positive for MERS-CoV arrived in the Philippines in August. (READ: DOH: Filipino nurse tests negative for MERS)
It was also the influenza-like illness that prompted President Benigno Aquino III to issue Executive Order 168 in May, creating an inter-agency task force that will manage emerging infectious diseases in the Philippines.
"Through that, na-realize din na to address the concern, kailangan inter-agency (Through that, [the government] realized that to address the concern, the approach should be inter-agency)," Health Spokesperson Lyndon Lee Suy said in a December 11 interview with Rappler.
Mandatory HIV testing?
In May, then-Health Assistant Secretary Eric Tayag first mentioned the suggestion of then Health Secretary Enrique Ona to shift from voluntary HIV testing to "something that’s compulsory."
Groups supporting the fight against HIV/AIDS took offense that Ona was considering this option instead of channeling the health department's resources to community-led testing and a national HIV awareness campaign. They dubbed the country’s "HIV epidemic" as one of the legacies of Ona and the Aquino administration.
The DOH has recorded a total of 5,010 new HIV cases from January to October 2014 – noticeably higher than the 4,072 new cases recorded around the same period in 2013.
Lee Suy said the rise in the number of HIV cases could mean either more Filipinos are not embarrassed to come out and have themselves tested, or more people are really getting infected by the sexually-transmitted disease. It could also mean both.
While mandatory testing remains an idea for now, Lee Suy said the department is currently working towards amending Republic Act 8504 or the Philippine AIDS Prevention and Control Act of 1998 by 2015.
Mental health: Lessons from Yolanda
The numbers are alarming. A few days before the first year anniversary of Super Typhoon Yolanda, the World Health Organization (WHO) estimated that over 800,000 people in Yolanda-hit areas have suffered different mental health conditions over the past year.
The effect of the disaster turned out to be a wake-up call for the Philippines to strengthen its mental health services not only in the affected regions but also nationwide. After all, in a disaster-prone country like the Philippines, there’s no telling where and when the next disaster will strike. The changes should start somewhere; for aid workers, it should start in the community. From the municipal and barangay health workers down to community leaders, it pays to detect mental disorders early on, since 98% of affected people can be treated at home.
WHO Representative in the Philippines Julie Hall said it will take another 6 months before the country sees a decline in the number of people suffering from mental disorders in Yolanda-hit areas. Until then, the health department should continue bracing its mental health services for the next storm.
Keeping Ebola out of PH
Probably the biggest health issue to raise concern worldwide this 2014, Ebola was as real to the Philippines as it was to the rest of the world.
As the number of deaths in West Africa rose each month, the country started reviewing its health system and its capacity to diagnose and respond if and when the deadly virus reaches the country.
Even after WHO called the country’s preparations "systematic" and "meticulous," Lee Suy refused to use the word "prepared" and said the Philippines is only "better positioned" to fight Ebola.
It was for the sake of the country's own preparations that the government decided not to send health workers to West Africa. Instead, the President pledged to give $1 million to the United Nations (UN) to help fight the outbreak.
These preparations praised by WHO were put to test when the first batch of Filipino UN peacekeepers arrived from Liberia, one of the 3 countries worst-hit by Ebola.
The health department was criticized after Acting Secretary Janette Garin supposedly broke quarantine protocols by visiting the peacekeepers. Under her watch, the department also began mandatory quarantine of all OFWs coming home from Guinea, Liberia, and Sierra Leone.
Lee Suy said despite the controversies that hit the department by the end of the year, work continues for an agency whose services cannot stop.
"Whatever has been initiated in 2014, I guess mas mararamdaman naman ang output by 2015 (Whatever has been initiated in 2014, I guess the output would be more felt by 2015)," he added. – Rappler.com