LAST week, health advocates lost a staunch media ally with the demise of the well-known former detainee and newsman, Julius F. Fortuna. His life as an activist and his achievements as a journalist were written in the many newspaper accounts of his sudden death of a heart attack at the age of 61.

What is less known and hardly talked about is that Julius cared strongly about health issues. He was very knowledgeable about the connections between health and poverty and supportive of pro-poor health reform initiatives. This was manifest in the fact that he frequently wrote about and included in his media forums (including the weekly Kapihan sa Sulo) issues such as unaffordable medicines, deplorable hospital services for the poor, inadequacies of the national social health insurance scheme, and inequities in health services for women and children.

Those who favor the passage of the reproductive health bill by congress will miss the reliable support of a friendly journalist with the passing of Julius.

Critics within the international public health community deplore the high media profile approach to the on-going A/H1N1 or "swine flu" pandemic taken by global health authorities and the health officials of some governments. On the other hand, defenders of the way the pandemic has been handled argue that media involvement is an essential part of enabling wide dissemination of health information necessary to involve the public in the global containment efforts.

Whatever the public health merits or drawbacks of the wide publicity given to the event, the fact is that there have been some apparent over-reactions on the part of some health agencies as a result.

The decision of the Hong Kong authorities to quarantine an entire hotel early on in the influenza scare is an example, although at that time there was still reason to be fearful of the organism whose behavior among humans was not quite known yet.

But the harsh measure of virtually incarcerating an entire group of teenaged football players by the Singapore disease control agency was a clear case of a panic reaction without due concern for the scientific basis of health interventions. By the time the affected boys were identified, they had already entered Singapore and must have had some local contacts. Thus quarantine was unlikely to have been an effective containment measure. Although it is reported that the team was quartered in very comfortable accommodations, the psychological impact of restriction of movements on 15-year-old lads is yet to be determined.

The Singapore case illustrates the one major defect in the global response to the A/H1N1 pandemic – a full reliance on biomedical technology-based actions without adequate regard to the social and behavioral dimensions of the issues. The World Health Organization and, following its lead, most health authorities all over the globe, have repeatedly touted laboratory diagnosis, treatment with anti-virals, and vaccine development as the mainstays in the anti-swine flu armamentarium. Social determinants, effects on the poor, environmental factors, and economic issues are either given mere lip service or simply swept under the rug.

Here in the Philippines, the widespread and inappropriate use of medicines and products like face masks has fostered a drug store boom without really having any real impact on the problem. School closures were completely uncoordinated and generally immaterial. Most protective measures were taken more because of unfounded fears than because of true awareness of public health principles.

Pharmaceutical companies have been particularly involved in taking advantage of people’s fears by engaging in various forms of misleading market spinning. Multinational firms that participate in the international vaccine development programs have been taking turns in announcing the imminent availability of their respective versions of the A/H1N1 vaccine. Some local producers have advertised their symptomatic remedies as effective remedies on the basis of brand names that tend to confuse issues of relief and cure.

Fortunately, at the moment, despite the single reported death, the virus has not been as deadly in the Philippines as had been feared. It is hoped that the public health communities both here and globally have learned important lessons from this year’s main health event. Unless, more attention is given to the role of social and economic issues, when a more deadly organism starts the next pandemic, tragedies could well be especially severe among the poorest of the earth.

The saddening and maddeningly unnecessary shooting incident in Imus, Cavite should call the attention of health authorities to the apparently endemic health hazards posed by violence in this country. In another occurrence, a six-year-old boy accidentally killed his soldier-father with the parent’s own service weapon. While incidents involving firearms are often looked upon as a simple police issue, it may be relevant to look at health angles and other social perspectives.