Message at the 2nd Philippine Pharmaceutical Regulatory Affairs Summit and PAPPI 16th Biennial Convention
Thank you very much. Maraming salamat po. Maupo po tayong lahat.
Thank you, Mona, for campaigning for me three years ago and for being a very able partner of our Metro Laylayan Angat Buhay program. But before I proceed, may I first greet the officials who are with us today. Of course, Ms. Maria Lourdes Santiago, Deputy Director General of the Food and Drug Administration (FDA) and other FDA representatives who are present; Dr. Yolanda Robles, President of the Philippine Pharmacists’ Organization; of course, Ms. Mona Maracha, President and the other members of PAPPI (Philippine Association of Pharmacists in the Pharmaceutical Industry); board directors; Mr. Teodoro Padilla, Executive Director of PAPPI—ay, PHAP (Pharmaceutical Healthcare Association of the Philippines) pala, PHAP. Sorry. Nagpipilit kasi ako magbasa nang walang salamin. [laughter] Ayaw pang tanggapin iyong katandaan. Ms. Aleth Therese Dacanay, President of the PACOP (Philippine Association of Colleges of Pharmacy), magandang hapon po; the other distinguished speakers and guests from PAPPI partner companies; fellow workers in government; ladies and gentlemen; a healthy afternoon to all of you. [applause]
Mahirap daw magsalita ng 1:30 p.m. kasi kapag busog iyong mga tao, inaantok. [laughter]
In 2014, right after a huge storm—parang Typhoon Glenda yata iyon—in a small barangay in the town of Ocampo, Camarines Sur, I met an old lady I later came to know as Lola Espy. Siya po iyong nasa picture. I willnever forget her. She was 70 years old, I think, at that time and already had difficulty walking but she was carrying a huge bundle of dirty clothes that she was going to wash in a stream several meters from where she lived. I couldn’t believe my eyes.
It turns out, laundry was the least of her concerns. She lived in a dark, tiny, makeshift hut with a dirt floor, torn walls, and tattered roof that looked so frail against the stormy skies. Inside was her grandson who was bedridden because of cerebral palsy. She had been taking care of him for 34 years at the time—the day I met them.
On good days, she said, they eat rice with water and salt. I was then a member of the House of Representatives but I remember asking myself, how can we, in conscience, live in a world that neglects the likes of Lola Espy?
I posted pictures of Lola Espy and her grandson on social media and wrote about their plight. So many kind-hearted people sent food and groceries on a regular basis. In fact, my former grade school schoolmates built a new house for Lola Espy and her grandson, bayanihan style. Lola Espy passed away last year, having experienced the outpouring of love and support from people she did not even know personally. For a few years in her long life of difficulties, at least, she was part of a loving community.
But for so many years, Lola Espy and her grandson gravely needed regular medical checkups, medicines, and treatments. Unfortunately, as you well know, for millions of Filipinos, access to quality healthcare and services remain an elusive dream. Primary health services are concentrated in urban areas, while rural communities have very little or no health facilities at all.
Meanwhile, in urban centers, pharmacies witness our people’s silent suffering every day. You can often see people clutching their prescriptions worriedly, buying medicine good only for a day or two, wondering how they can buy the rest.
Several studies found that despite measures to improve medicine access, many are still unable to afford the medicines that they need. The state of health facilities, especially in remote areas, are deplorable. Worse, we do not have enough doctors and nurses who are willing to serve in these locations. For the few who do, providing timely and quality treatment can be frustrating because of the lack of medical equipment, ambulances, other needed health equipment, and facilities.
But there is also good news. A growing number of players in the manufacturing sector are starting to produce medicines locally, which provides anopportunity to lower their cost within our borders. We hope there will come a time when we will no longer need to import from other countries, which makes us vulnerable to currency, quality, and supply risks. This development will encourage multi-national corporations to put up plants here and boost jobs and livelihood at the same time.
The ASEAN Integration presents both threats and opportunities. There is talk of opportunities for health research and innovation like developing highly skilled workers and researchers amidst the changing nature of work, Business Process Outsourcing for medical transcriptions, research and development on communicable and tropical diseases, building an ASEAN Network for innovating medicines, diagnostics and vaccines, and how the government and the private sector can effectively cope with the ever-changing times.
Under the idea of an integrated ASEAN economy, I understand that there are other discussions about creating common metrics and regulations, and harmonizing standards on policies that promote healthy competition, intellectual property rights, and customs procedures, as well as laboratory testing and certification of exported products.
How do we then ensure that our pharmaceutical industry is ready to compete with the rest of the world, and that every Filipino has access to quality, safe, and affordable healthcare?
First, we need to come up with streamlined and effective health regulations so that Filipinos can have access to safe, quality, affordable, and equitable health care. These are critical in engaging the private sector in advancing the universal health care initiative.
The problem is that health regulations are often overlooked perhaps because it is complex, complicated, and controversial, but there is no room for complacency when it comes to the health of our people. Everything hinges on our people’s wellbeing: productivity, creativity, and growth. That is why it is very important that we continue coming together, share best practices, and standardize and integrate our processes and our guidelines so that we gain better knowledge on who, what, and how best to regulate.
Second, there should be better systems in providing our people with information regarding their options, especially when it comes to medicines. Usually, patients do not demand for medical services or lower prices because they are simply not informed. For instance, if you say you want a Paracetamol in a drug store, the persons manning the counter would immediately give you a certain brand. We need to inform our people that they have other options, so that they can make better decisions.
Lastly, we need to create innovative ways in improving access to medicines, especially to those at the poorest, the farthest, and the smallest communities. And one of the ways to do this is through collaboration.
When I was still in Congress, we partnered with Seaoil Foundation in creating a Senior Wellness Program for the Third District of Camarines Sur which I was representing. We realized early on that government did not have baseline numbers that we could use to design a responsive program, so we started from scratch, brought specialists to do in-depth medical assessments of patients, and created an inventory of their illnesses, the interventions that they need and their prescribed medications. When we did, we discovered that the medicines that were available for free at their local health centers were not usually the medicines that the seniors needed! So based on the health profiles that we created, government was already able to provide for the correct medical treatments and the right medicines. Because of that simple exercise, senior citizens did not have to worry anymore about the cost of staying healthy.
When we designed this program, we were coming from a deep conviction that access to healthcare should not discriminate between the rich and the poor and that quality and affordable healthcare should be available for all Filipinos.
When I became Vice President, I swore an oath to uplift the lives of the Filipino people, especially those in the fringes or what we call the “pamilya na nasa laylayan ng lipunan.” And one of the ways to achieve that is to prioritize healthcare and include it as one of our key advocacies through our anti-poverty program called Angat Buhay. Our dream is simple: To ensure that every Filipino has equal access to healthcare.
But the Office of the Vice President in the Philippines is quite unlike its counterparts in other countries. It has one of the smallest budgets in the entire bureaucracy, making it very difficult to create and carry out programs. The only thing expected of us is to carry out ceremonial functions. But I kept telling my staff early on that it would be a disservice to the people if the only thing that we did for six years were ceremonial duties, so we found a way to innovate by transforming our office from a mere ceremonial one to a more advocacy-driven office.
So we chose to be a bridge between the country’s greatest needs and our people’s greatest strengths. Specifically, we forged partnerships with the private sector and development organizations to reach out to the poorest, the farthest, and smallest communities, where many still do not have access to healthcare, nutrition, livelihood, and so on.
In San Remigio in Cebu, for instance—I don’t know if any of you here comes from San Remigio; it’s in northern Cebu—we have been working with both the local government and our other partners to address the mental health needs of the community. We first visited San Remigio in March of 2017 to visit a fishing community and with our partner, Physicians for Peace to turn over wheelchairs and assistive devices for Persons with Disabilities. But while we were there, we discovere dthat there was a large number of mentally ill residents locked up in cages and chained by their families because of their violent tendencies.
We learned that an NGO called Americares was already doing a mental health program for the local community. So we thought of supplementing it and decided to partner with the Philippine Mental Health Association. With their help, we did a mapping of the community to have a clear baseline that will guide the creation of the most effective strategy and intervention for the community. Since then, barangay health workers have been trained on the intricacies of dealing with mental illness and regular medicines and community-based treatment are already being provided to the patients.
We also built a mental health facility for the residents. With the help of our partner, Solana Foundation, we were able to provide beds and other furniture and equipment for the facility. And just last February of 2019, we finally turned over the mental health facility to the local government unit.
In the course of our work in San Remigio, we encountered a 41-year-old college graduate who was diagnosed with depression with psychotic features after his father and his brother were murdered in 2006. These kinds of illnesses, we were told, are more difficult than most, since society responds to them in a very dark way. There is discrimination, judgment, and fear—all of which are not helpful for someone who wants to get well. Treatment usually goes on for a long time, sometimes for an entire lifetime. Many experts have noticed that depression and other mental illnesses have reached epidemic proportions today.
We all need to do something to help those who are suffering in this manner. Since this 41-year-old’s inclusion in the program in 2017, he has experienced a marked improvement in his mental condition because of the monthly consultations and medications. We are very pleased to note that he is now working as a helper and a construction worker in San Miguel Elementary School—a huge step towards living an independent, empowered, and productive life. And he is just one of the many whose lives are being transformed because of the program.
Under Angat Buhay, we also have a mode of engagement with the urban poor sectors in Manila called Metro Laylayan, where we have been delivering different social services [to] communities in Metro Manila. Since its launch, we have already visited ten cities and municipalities, providing medical, legal, employment, livelihood assistance and services to over 10,000 individuals.
One of the families who have benefited from the program is the Antipuesto family of Parañaque City. Tatay Prudencio and Nanay Jane have three sons. For 19 years, Tatay Prudencio has been cooking and selling bopis in the community, while his wife works as a househelper. Tatay Prudencio sells from 5 o’clock in the afternoon until late evening and sometimes, when Nanay Jane goes home in the evening, she would help Prudencio sell bopis in his sidecar. When we visited the family, we found out that Tatay Prudencio’s sidecar was just made out of wood and is no longer in good condition.
Thanks to PAPPI, we were able to give the Antipuesto family seed capital—[applause]—and they were now able to buy a new sidecar, allowing Tatay Prudencio to have a more reliable means of transport that would enable him to sell more bopis in the community. Hindi niyo po siguro nalalaman, every time mayroon kaming Metro Laylayan visit, kasama namin iyong mga PAPPI—PAPPI representatives. [applause]
If I am not mistaken, PAPPI also partnered with us in Marikina and Muntinlupa in providing livelihood assistance and distributing medicines and medical counselling. Kung hindi din ako nagkakamali, Mona, iyong tinulungan natin sa Muntinlupa, PAPPI gave 10,000 pesos and we visited the family who was the beneficiary a week after. Pagbalik namin, mayroon na silang sari-sari store—[applause]. So, ‘di ba, nakakatuwa na for 10,000 pesos, you’re able to transform the lives of families. Ang iba, iyong 10,000 [pesos], parang in a few days kung saan lang napupunta. Pero this family— Kaya nakakatuwang tulungan.
And we are looking forward to more partnerships with you in the future. Sana po hindi kayo magsawang tumulong.
We need your help, your expertise, and we need your dedication in ensuring that our people have improved access to healthcare. The government cannot do it alone. I am convinced that, together, we can make our health care system work [better] for patients and health professionals alike. The impossible can always be possible when we are willing to do everything to succeed.
Kaya maraming, maraming salamat po for everything that you do and maraming salamat for having me in this beautiful occasion. Sana po in the succeeding days—hininhto lang namin, Mona, iyong Metro Laylayan kaisi eleksyon. Pagtapos ng eleksyon, puwede na naman tayong tumuloy at I hope more of you will be able to join us in our regular outings to these poor communities.
Mabuhay po kayong lahat! Maraming salamat po. [applause]