Budget for disease surveillance cut amid outbreaks

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Metro Manila (CNN Philippines, September 24) — The allocated budget for disease surveillance — which is crucial in the monitoring of vaccine-preventable diseases — has been cut amid outbreaks of measles, dengue and polio in the country.

Research Institute for Tropical Medicine (RITM) director Celia Carlos told the Senate Health panel on Tuesday that their proposed budget for disease surveillance has been slashed by ₱80 million for 2020.

Carlos said they would still need about ₱50 million more for next year.

Despite this, Carlos said they have expanded their surveillance to cover other areas and other diseases.

The World Health Organization (WHO) defines public health surveillance as the continuous, systematic collection, analysis and interpretation of health-related data needed for the planning, implementation, and evaluation of public health practice.

Among other things, surveillance can serve as an early warning system for impending public health emergencies.

The RITM was instrumental in discovering the reemergence of polio in the country. Amid poor surveillance response from hospitals, Carlos said the RITM’s national polio reference laboratory decided to conduct environmental surveillance which found a mutated polio virus derived from a vaccine in waterways in Tondo in Manila and Davao.

The first two confirmed cases of polio in 19 years turned up in Laguna — near Manila — and in Lanao del Sur — near Davao City.

“This dramatizes the importance of surveillance in the vaccine or immunization programs. The surveillance should start before a vaccine is introduced as baseline, and then a follow-through as the immunization program is being implemented so that we know if cases are being controlled or whether cases are reemerging,” Carlos said.

Senator Nancy Binay made a pitch to Senate Health committee chair Christopher “Bong” Go to consider raising the budget of the RITM for disease surveillance.

Baka there’s a need for more environmental surveillance. Baka may iba pa tayong vaccine-preventable diseases na madi-discover niyo through your surveillance,” Binay said.

[Translation: Maybe there’s a need for more environmental surveillance. Maybe we still have other vaccine-preventable diseases that you would discover through your surveillance.]

Go, who is also sponsoring the Health department’s 2020 budget, said he would consider the proposal.

But what if disease surveillance is insufficient?

“We will have emergence of all diseases if no surveillance is in place,” Philippine Pediatric Society President Salvacion Gatchalian told the Senate.

The Health department faces a ₱10-billion budget cut if Congress does not change the allocations given to it under the proposed fiscal plan for 2020.

The left-leaning Makabayan bloc has proposed to cut funding for the Armed Forces of the Philippines, the President’s confidential intelligence funds and the war on drugs to hike the Health department’s budget by ₱17 billion.

Meanwhile, the House leadership is looking to realign allocations to increase funding for the Agriculture, Health, Energy and Education departments.

The huge budget cut comes as the country faces outbreaks of various vaccine-preventable diseases, due to a drop in immunization rates blamed on the panic caused by the Dengvaxia vaccine, which has been revealed by its manufacturer to cause severe dengue among those who have not had the disease.

The WHO reported in April that the Philippines is the fifth country with the highest number of reported measles cases since 2018. Outbreaks have been declared in several areas, including Metro Manila.

Meanwhile, Parañaque became the 36th local government unit to declare a state of calamity due to dengue. The Health department has declared a national dengue alert over the spike in cases of the mosquito-borne disease.

The country, facing a polio outbreak 19 years after the WHO declared the Philippines free of the disease, is now one of the few countries in the world known to have cases of polio today.