[EDITORIAL] #AnimatED: Somebody has to answer for the dengue vaccine disaster

Rappler.com
Let's focus on getting answers to questions and identifying liabilities. At stake here are the lives of tens of thousands of children.

The Senate and the House of Representatives will be conducting separate hearings this week on the dengue vaccines that the government administered on hundreds of thousands of grade school students in 2016. 

Sanofi Pasteur, the French pharmaceutical giant that manufactured Dengvaxia, announced recently that, after 6 years of clinical tests, it found that its dengue vaccine – the first in the world – would actually expose a person to more severe dengue if he had not had the infection before getting the shot.

The risk of contracting the mosquito-borne disease is present before and after getting the vaccine, it’s just that, Sanofi claims, the vaccine could sort of stay the possibility of that severe infection for 6 years at the most.

We get it: drugs, once out in the market, are still subject to continuous tests by the manufacturer. But this doesn’t – and shouldn’t – get anybody off the hook. Current health officials estimate that, of the more than 700,000 persons who received the vaccine, one in every 10 is exposed to the risk and does not know it. 

The problem, in fact, starts there: we didn’t know what we were getting into because, documents and testimonies so far show, then health secretary Janette Garin – a doctor who comes from a political clan – might have kept some crucial information from the public in the rush to complete the P3.5-billion contract. 

In a span of 4 months from the December 1, 2015 courtesy call of Sanofi officials on then president Benigno Aquino III, the government purchased the vaccines and administered them to public school students 9 years and older in Metro Manila, Central Luzon, and Calabarzon. The pharma company even announced, just 3 weeks after that meeting with the former president, that the Philippines was the first country to approve the commercial sale of Dengvaxia. There had been more than 92,000 dengue cases already in the first 9 months of that year. (TIMELINE: Dengue immunization program for public school students)  

Some questions were already raised then, but Garin apparently brushed them aside. More questions were raised right after the first of 3 doses of the vaccines were given to the children, causing the temporary suspension of the program, but the health secretary under the Duterte administration, Paulyn Ubial, lifted that anyway. 

Even more questions are coming out now, but it is imperative for liabilities to be determined. Continuing congressional investigations, along with the separate probes by the justice department and the health department, should also be able to recommend who ought to be prosecuted. 

Here are a few issues that require looking into:

  • Why did Garin ignore the advice of Department of Health (DOH) experts, who said that not enough tests had been made for them to recommend the commercial release of Dengvaxia? She even claimed that the World Health Organization had recommended it at the time – something the WHO denied
  • Did Sanofi disclose to Garin the extent of what they knew about Dengvaxia’s efficacy based on what tests had shown at that time? Or was there conspiracy to release it commercially despite the incomplete tests? The Department of Foreign Affairs, in an official report, said that in May 2015, Garin and Sanofi officials strategized to create a demand for Dengvaxia in the Philippines and convince Congress to fund it. 
  • Did the DOH under Garin inform the Department of Education that the program was part of continuing clinical tests for the vaccine, and therefore had attendant risks? 
  • Why did half of Dengvaxia recipients get the vaccine without their parents’ consent? Were the parents informed and the risks of the vaccines explained? Did they refuse but were ignored? Were children coerced into getting the shots?
  • Was it lawful to have purchased the dengue vaccines using proceeds from sin taxes? There was no allocation for them in the 2015 nor in the 2016 national budgets, but Garin said the cost would be covered by proceeds from sin taxes. The law, however, is clear on what the sin taxes collection could fund, and the national government’s immunization program didn’t fall in any of the categories. 
  • Is the price of the vaccines justified? At P3.5 billion, that dengue vaccination program had the same cost as – if it was not higher than – the annual budget for the entire immunization program of the DOH. 
  • Are there connections between the election season and the apparent rush to implement the program and possible padding of costs? The ban on the release of public funds for programs and projects didn’t start until March 25, 2016, which was also around the time the official campaign for local elections kicked off. Clearly, however, there was impropriety: the vaccines were purchased just before the election period started on January 10, 2016, and the program was launched in the thick of the campaigns for the presidential, vice presidential, senatorial, congressional, and local campaigns. 

Before probes could proceed, however, there are already attempts by various camps to divert attention from the main issue and the main culprits. 

Some Yellows are slow to condemn, even just call out, Garin and the Aquino administration. Using a flimsy “But Duterte admin continued it” defense (yes, it did, and should be investigated for it), they seem uninterested in getting to the bottom of the issue. Is it because doing so would provide Aquino critics with ammunition? 

There are talks as well that Garin’s camp might just cooperate with Speaker Pantaleon Alvarez (Garin was a longtime congresswoman before becoming DOH chief) to put the blame squarely on Aquino’s Malacañang. 

In one corner still, there are public health advocates who wouldn’t speak out against the questionable aspects of the government’s dealings in relation to Dengvaxia. They don’t want the dengue vaccine controversy to undermine the gains of all other immunization campaigns over the years, so they would rather that the media tones down its coverage, and the controversy dies down. 

If agenda like these are set aside then we can focus on getting answers to the questions we’ve listed above, and more. Somebody has to answer for this and be accountable – whether it is Sanofi, Garin, Aquino, or even Ubial and some other Duterte officials too. Proper and thorough investigations should yield credible results.

At stake here are children’s lives. Tens of thousands of them are facing a lifetime risk of contracting severe dengue because there were adults who had interests other than these children’s welfare. They could be your child, your grandchild, your younger brother, your cousin, your goddaughter, your neighbor. – Rappler.com