April 26, 2018, 6:22 am
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1 Philippine Peso = 0.07044 UAE Dirham
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1 Philippine Peso = 0.3869 Argentine Peso
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1 Philippine Peso = 52.91139 Colombian Peso
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1 Philippine Peso = 2.1869 Algerian Dinar
1 Philippine Peso = 0.24445 Estonian Kroon
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1 Philippine Peso = 0.52167 Ethiopian Birr
1 Philippine Peso = 0.01562 Euro
1 Philippine Peso = 0.03879 Fiji Dollar
1 Philippine Peso = 0.01369 Falkland Islands Pound
1 Philippine Peso = 0.01368 British Pound
1 Philippine Peso = 0.08493 Ghanaian Cedi
1 Philippine Peso = 0.89893 Gambian Dalasi
1 Philippine Peso = 172.6122 Guinea Franc
1 Philippine Peso = 0.1407 Guatemala Quetzal
1 Philippine Peso = 3.94879 Guyana Dollar
1 Philippine Peso = 0.15041 Hong Kong Dollar
1 Philippine Peso = 0.4519 Honduras Lempira
1 Philippine Peso = 0.11558 Croatian Kuna
1 Philippine Peso = 1.23341 Haiti Gourde
1 Philippine Peso = 4.85501 Hungarian Forint
1 Philippine Peso = 266.4557 Indonesian Rupiah
1 Philippine Peso = 0.06754 Israeli Shekel
1 Philippine Peso = 1.26972 Indian Rupee
1 Philippine Peso = 22.70809 Iraqi Dinar
1 Philippine Peso = 805.52361 Iran Rial
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1 Philippine Peso = 2.37438 Jamaican Dollar
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1 Philippine Peso = 2.06782 Japanese Yen
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1 Philippine Peso = 76.83161 Cambodia Riel
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1 Philippine Peso = 17.26122 North Korean Won
1 Philippine Peso = 20.47315 Korean Won
1 Philippine Peso = 0.00575 Kuwaiti Dinar
1 Philippine Peso = 0.01573 Cayman Islands Dollar
1 Philippine Peso = 6.25738 Kazakhstan Tenge
1 Philippine Peso = 158.78405 Lao Kip
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1 Philippine Peso = 0.31433 Moldovan Leu
1 Philippine Peso = 0.95589 Macedonian Denar
1 Philippine Peso = 25.29728 Myanmar Kyat
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1 Philippine Peso = 0.15492 Macau Pataca
1 Philippine Peso = 6.75105 Mauritania Ougulya
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1 Philippine Peso = 0.29862 Maldives Rufiyaa
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1 Philippine Peso = 0.35542 Mexican Peso
1 Philippine Peso = 0.07476 Malaysian Ringgit
1 Philippine Peso = 0.23032 Namibian Dollar
1 Philippine Peso = 6.88531 Nigerian Naira
1 Philippine Peso = 0.59455 Nicaragua Cordoba
1 Philippine Peso = 0.15025 Norwegian Krone
1 Philippine Peso = 2.02693 Nepalese Rupee
1 Philippine Peso = 0.02661 New Zealand Dollar
1 Philippine Peso = 0.00738 Omani Rial
1 Philippine Peso = 0.01918 Panama Balboa
1 Philippine Peso = 0.06167 Peruvian Nuevo Sol
1 Philippine Peso = 0.06232 Papua New Guinea Kina
1 Philippine Peso = 1 Philippine Peso
1 Philippine Peso = 2.21711 Pakistani Rupee
1 Philippine Peso = 0.06525 Polish Zloty
1 Philippine Peso = 105.81128 Paraguayan Guarani
1 Philippine Peso = 0.06981 Qatar Rial
1 Philippine Peso = 0.07297 Romanian New Leu
1 Philippine Peso = 1.17426 Russian Rouble
1 Philippine Peso = 16.19889 Rwanda Franc
1 Philippine Peso = 0.07192 Saudi Arabian Riyal
1 Philippine Peso = 0.14921 Solomon Islands Dollar
1 Philippine Peso = 0.25758 Seychelles Rupee
1 Philippine Peso = 0.34621 Sudanese Pound
1 Philippine Peso = 0.1621 Swedish Krona
1 Philippine Peso = 0.02526 Singapore Dollar
1 Philippine Peso = 0.01369 St Helena Pound
1 Philippine Peso = 0.42589 Slovak Koruna
1 Philippine Peso = 146.33679 Sierra Leone Leone
1 Philippine Peso = 10.79785 Somali Shilling
1 Philippine Peso = 382.92676 Sao Tome Dobra
1 Philippine Peso = 0.16782 El Salvador Colon
1 Philippine Peso = 9.87687 Syrian Pound
1 Philippine Peso = 0.2317 Swaziland Lilageni
1 Philippine Peso = 0.60153 Thai Baht
1 Philippine Peso = 0.04709 Tunisian Dinar
1 Philippine Peso = 0.04287 Tongan paʻanga
1 Philippine Peso = 0.07793 Turkish Lira
1 Philippine Peso = 0.12937 Trinidad Tobago Dollar
1 Philippine Peso = 0.56552 Taiwan Dollar
1 Philippine Peso = 43.65171 Tanzanian Shilling
1 Philippine Peso = 0.50153 Ukraine Hryvnia
1 Philippine Peso = 70.73264 Ugandan Shilling
1 Philippine Peso = 0.01918 United States Dollar
1 Philippine Peso = 0.54066 Uruguayan New Peso
1 Philippine Peso = 154.48792 Uzbekistan Sum
1 Philippine Peso = 1138.30075 Venezuelan Bolivar
1 Philippine Peso = 436.67051 Vietnam Dong
1 Philippine Peso = 2.02071 Vanuatu Vatu
1 Philippine Peso = 0.04846 Samoa Tala
1 Philippine Peso = 10.24242 CFA Franc (BEAC)
1 Philippine Peso = 0.05178 East Caribbean Dollar
1 Philippine Peso = 10.24242 CFA Franc (BCEAO)
1 Philippine Peso = 1.85386 Pacific Franc
1 Philippine Peso = 4.79287 Yemen Riyal
1 Philippine Peso = 0.23169 South African Rand
1 Philippine Peso = 99.53011 Zambian Kwacha
1 Philippine Peso = 6.94093 Zimbabwe dollar

Doctors for truth?

DR. Walden Bello, Ph.D., author of the below statement, was a member of the Philippine House of Representatives from 2009 to 2015. He resigned on principle from Congress, owing to differences with the administration of former president Benigno Aquino III on the Disbursement Acceleration Program (DAP), the Mamasapano Raid, and the Enhanced Defense Cooperation Agreement with the United States. His is the only recorded resignation-on-principle in the history of the Philippine Congress.

Citations in his statement directed me to another stakeholder in the tragedy--Dr. Maria Rosario Capeding--who wrote, with others, the “Clinical efficacy and safety of a novel tetravalent dengue vaccine in healthy children in Asia: a phase 3, randomized, observer-masked, placebo-controlled trial.”--Lancet 2014; 384:1358-65. Dr. Capeding figured prominently in last December’s Dengvaxia inquiries.

Dr. Bello’s statement, on the Dengvaxia tragedy, initially released by Rappler: The Social News Network--below excerpted for limited space:

...There is in the “Doctors for Truth” position paper an implicit defense of the principals on the grounds that “there is no perfect vaccine.” The doctors conveniently forget that the purpose of rigorous clinical trials before a drug is brought to market is to reduce to as close to zero as possible the likelihood that, a) the drug will not work, or that b) it is dangerous, or that c) it has destabilizing side effects.

Measured by the yardstick of accepted statistical probabilities, Dengvaxia failed resoundingly, an event that is rigorously documented and explained in a Research Report that appeared in one of the leading journals of medical research, New England Journal of Medicine (Vol 373, No. 13, Sept 24, 2015), about half of whose authors were connected with Sanofi Pasteur.

The Report, which appeared before the Sanofi contract was made and the vaccination program was implemented, revealed that clinical trials showed that previously uninfected children of a certain age group showed a disturbingly higher risk than previously infected children to contract severe dengue after being vaccinated.

Indeed, so concerned were the editors that they accompanied the article with an editorial titled, “A Candidate Vaccine Walks a Tightrope.” According to the editorial, which hit the dengue research field like a thunderbolt, “Most eye-catching is the suggestion that CYD-TDV [Dengvaxia] vaccination was associated with an elevated risk of hospitalization for dengue among children younger than 9 years of age (but most markedly, among those 2 to 5 years of age) when they were naturally infected in the third year after vaccination.”

It concluded that “we still lack definitive immune correlates of protection or vaccine-associated disease risk. A lesson from these trials, and from our understanding of the natural history of dengue epidemiology, is that partial, waning immunity is a particularly unwelcome outcome after vaccination…Live vaccines need to be sufficiently potent in their infectiousness and replicative capacity to initiate immunity in both unexposed recipients and those with partial immunity…The bumpy road to a vaccine-based solution for dengue continues.” 

Despite this red light from a high-powered research team that included its own researchers, Sanofi Pasteur rushed a flawed product to the market to beat the competition and the DOH authorities pushed the vaccine on over 800,000 children in 2016, with no investigation of whether or not they had been previously exposed to dengue. One does not need to be a medical expert to come to the conclusion that the haste with which this vaccine was brought to the field was simply inexplicable from a public health point of view.

It’s a safe bet that very few of the doctors who signed the statement took the time to read the New England Journal of Medicine research report and editorial, for no self-respecting medical professional with the least bit of acquaintance with these documents, would have attached his or her signature to a statement that blithely defends the principals on the ground that “there is no perfect vaccine.”

The signatories compound their irresponsibility by saying that “we urge the DOH not to remove the vaccine from the market altogether,” allegedly to provide protection for those not yet found to be at risk of severe dengue infection stemming from vaccination. But contrary to its previous claim that Dengvaxia provided “consistent efficacy and longer-term safety profile in a study population 9 to16 years of age,” Sanofi retreated from this assertion and attached no age exemptions in its later, November 29, 2017, statement as to who should not be administered the vaccine.

Moreover, in banning the vaccine from the market altogether, the current DOH leadership is not panicking but simply adhering to the time-honored precautionary principle, which says, in this particular instance, that just because severe dengue infection has not yet surfaced in some categories of tested subjects that have been vaccinated does not mean that it is safe for the people in the same categories in the general population to use it.

The finding that those vaccinated who had no previous dengue infection could incur severe dengue demands that administering the drug to all age categories in the population, whether they have been previously infected by dengue or not, should be immediately withheld on the grounds that loss of immunity and susceptibility to severe dengue might take longer to emerge among some categories of the tested subjects. This does not mean a permanent ban, but one that can only be lifted after more rigorous trials carried out over a long period of time prove that the vaccine is safe for all age groups of previously infected or non-infected people.

The signatories bemoan the “expert bashing” that is taking place in public hearings. Have they asked themselves why this bashing is taking place in the first place? The distrust of experts stems from the fact that in the case of Dengvaxia, the experts have so spectacularly failed the people on a matter of public trust: the experts in Sanofi for rushing a dangerous vaccine to the market, and the experts at the DOH for carrying out a mass vaccination program that they knew – or should have known given the published findings--carried grave dangers for many of its intended recipients....

...But with the absence of even the slightest criticism of the principals and the misplaced focus on the opportunists, one might legitimately bring up the question whether the statement is not really an attempt by some in the medical profession to circle the wagons to protect colleagues who are likely to be guilty of criminal endangerment of public health. And given the lack of any criticism of Sanofi’s breath-taking wrongdoing, one might further raise the question if the “Doctors for Truth” statement is not really an attempt by the same people to also come to the defense of the pharmaceutical industry.

This is a legitimate issue since the industry’s relations with the medical profession everywhere in the world is very tight, with doctors and hospitals enjoying perks and donations from members of the pharmaceutical cartel that is cynically called “Big Pharma.”

Medical professionals serve on the international and local boards of the drug giants, and there is a revolving door between private practice, public health service, and corporate employment. For those passing through the revolving door, this translates into very lucrative income indeed, one that could be threatened by a more guarded public response to the products of the multi-billion-dollar industry.

In the interest of transparency, it might be good if the public were to demand that the “Doctors for Truth” fully disclose their professional associations, if any, to Sanofi and other members of the global pharmaceutical cartel, including their local affiliates and marketing arms. Thus concludes Dr. Bello.

***

Dahliaspillera@yahoo.com
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