FRIDAY |JANUARY 4, 2008 | PHILIPPINES

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‘One point that may attract dissent is the provision intended to strengthen the Generics Law of 1988.’

Congressional
Christmas gifts


 

Today, Christians throughout the world celebrate the birth of the infant Jesus. By all accounts the birth did not take place in an ideal setting from the public health perspective. Christ’s mother was a high-maternal risk teen-aged girl without benefit of such prenatal preventive interventions as tetanus immunization. She gave birth in a stable surrounded by farm animals any of which could harbor and transfer infectious organisms to both mother and child. Except for Joseph, the human father, there were no other persons, let alone professional health workers, in attendance.

But then again, this was a very special birth. There was no need of human intervention to prevent perinatal adverse events from harming either mother or child. In lieu of birth attendants, shepherds from nearby fields and angels from the heavens appeared to glorify what turned out to be the most important baby of all time for the Christian world.

Two thousand years later in this modern day and age, there are still many women who give birth to children in very high risk situations. For many, scientific methods of ensuring reproductive health and responsible parenthood are unavailable because of lack of access to information and services sue to poverty or governmental neglect.

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The Philippine Congress has given the Filipino people a welcome Christmas present in the form of legislation that will help halt the increasing prices of medicines. Although the Senate had easily passed its version of the "Affordable Medicines Bill", the House version, labeled the "Cheaper Medicines Bill" had some stormy moments and barely squeaked through before the Christmas break.

The bicameral negotiations to reconcile the two versions promise to be, at the very least, quite interesting. There are several contentious points marking the differences between them.

The House Bill mandates the creation of a "Drug Price Regulatory Board" to ensure that prices of essential medicines are not allowed to exceed maximum limits to be set by government. This notion is anathema to free market advocates who are fairly well represented in the Senate. A compromise version of this proposal may well be an appropriate solution to what could be an impasse that could frustrate cheaper medicine proponents.

While price control may be the most high-profile issue, there are a number of other differences that may well further delay the law’s passage. There were a number of attempts in the lower House to dilute some of the intellectual property provisions of the Senate Bill. For example, there was strong criticism of the provision that would prevent patent-holding multinational companies from using minor chemical alterations to extend a drug’s patent monopoly period (also known as "ever greening"). If any of these alterations are allowed, the intellectual property revisions would be so badly flawed as to allow global pharmaceutical giants to maintain hegemony over vulnerable markets like the Philippines.

One point that may attract dissent from some quarters of the medical profession is the provision intended to strengthen the Generics Law of 1988. The article prohibits the inclusion of brand names in medical prescriptions altogether. The more conservative older practitioners have raised an old argument that emphasizes the notion of physicians’ sole prerogative to decide what medicines his patients take.

Many younger doctors, trained in the post-Generic era, may find this notion rather quaint and not in keeping with the times of patient-centered team approaches to health care. Nevertheless, their more senior colleagues do have a point when they argue that there may be issues of patient safety if safeguards at drugstore level are not put in place by government regulatory bodies. In any case, most advocates of generic drug use believe that the strengthened provision, if it remains, should be the subject of intensive stakeholder discussions during the preparation of the implementing rules and regulations.

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The General Appropriations Act is another possible bone of contention in the bicameral discussions between the Philippine Senate and the House of Representatives. The House proposal includes a major increase in social expenditures including the budget of the Department of Health. One danger is that the bulk of these increases will again go to expensive curative fixtures such as retained hospitals. Of particular public health interest is the proposed one billion peso budget for tuberculosis control – a critical measure if the Philippines is to be weaned from donor-dependency in its major public health programs.

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The first Rafael M. Salas Golf Cup will be launched on January 17, 2008 at the Eagle Ridge Golf and Country Club, General Trias Cavite, with former President Fidel V. Ramos leading some of the nation’s most avid golfers. The tournament is for the benefit of the advocacy group, the Philippine Forum for Population and Development.


Email address: quasir@mozcom.com

 




















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