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Bent on blaming Robredo, Duterte may be ignoring rule on vaccine purchase

President Rodrigo Duterte's determination to prove Vice President Leni Robredo wrong about vaccine approvals may be getting in the way of strict obedience to what the Universal Health Care law says is the proper way to purchase health products.

Duterte's public address on Monday night, March 8, included a discussion among the President, Health Secretary Francisco Duque III, and Presidential Spokesman Harry Roque about Robredo's criticism of the government's Sinovac vaccine rollout.

It showed Duterte hellbent on sticking with his and Roque's interpretation that a Health Technology Assessment Council (HTAC) recommendation is not required to secure COVID-19 vaccines.

However, Duque had to repeatedly point out, with great caution, that an HTAC recommendation is in fact required for any government purchase of vaccines or other health products.

While the first 600,000 Sinovac doses may not be covered by this rule because they were donated by China, any vaccine bought by the government – for instance, the one million more Sinovac doses – is.

Duque tiptoes

At the start of the meeting, the health chief read to the President Section 34 of the Universal Health Care law that states that any "investment" by government on drugs, medicines, vaccines, or any other health technology "shall be based on the positive recommendations of the HTA."

HTA stands for Health Technology Assessment. This assessment is carried out by the HTAC.

When Duterte again insisted that the HTAC had merely "recommendatory power," Duque carefully tried to phrase the HTAC's power as recommendatory, but necessary, based on a review of health department lawyers.

"Recommendatory na kailangan daw ho may 'positive recommendation' (It's recommendatory but the positive recommendation is necessary)" he said.

"Our legal division said absent this positive recommendation, the government cannot spend money on this technology or development of any benefit package by the DOH and PhilHealth," reiterated Duque.

TACT. Health Secretary Francisco Duque III explains Universal Health Care law provisions on the purchase of health technology during a meeting with President Rodrigo Duterte in Davao City on March 8, 2021. Malacañang photo

JOEY DALUMPINES/ PRESIDENTIAL PHOTO

Unfazed, Duterte asked his health secretary, "At best, you may or you may not seek the recommendation. Is that within your discretion?"

Duque responded with great tact, "It’s a bit difficult, Mr President."

Duque again read the law's section about how the DOH cannot make any investment in a health product, like a vaccine, without an HTA recommendation.

Still, Duterte doubled down, saying, "So madaling sabi, recommendatory lang (So in other words, it's only recommenatory)?"

The exchange ended on a positive note for Duterte when Duque said that anyway, the HTAC eventually issued a review favorable to the Sinovac vaccines. This then led Duterte to claim Robredo was wrong in claiming there was no HTAC review.

However, at the time Robredo and some healthcare workers called for an HTAC review of Sinovac, no such recommendation had yet been made public.

This was the second public address that Duterte spent a significant chunk of time ranting about Robredo's remarks about the Sinovac vaccine rollout.

No need for HTAC recommendation for future vaccine purchases?

The following day, Roque was asked if, given the discussion between Duterte and Duque, the government would wait for an HTAC recommendation before buying vaccines.

Roque stuck to Duterte's position as if Duque had not spoken at all the night before.

"It's recommendatory, that's what the law says. We will get whatever vaccine we can get, we will use it, whether or not there is a recommendation from the HTAC, because we have an emergency situation," said the Duterte spokesman.

He did not say where in the UHC law states that Section 34 is waived during emergency scenarios.

Roque was one of the authors of the Universal Health Care law, a fact he constantly brings up during pandemic-related press conferences. Duterte, meanwhile, signed the law back in February 2019. – Rappler.com

Pia Ranada

Pia Ranada covers the Office of the President and Bangsamoro regional issues for Rappler. While helping out with desk duties, she also watches the environment sector and the local government of Quezon City. For tips or story suggestions, you can reach her at pia.ranada@rappler.com.

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