Politics in health
The headline read, “SC orders return of P60-B excess funds to PhilHealth.” (News, 12/5/25)
While the recent news is very much welcome, it set off a domino effect of thoughts, which included a heavy dose of doubt about the next steps to be taken and how things will proceed after a win. Can we be blamed for harboring these feelings of negativity? But to help preserve whatever idealism, which my colleagues and I still share, more so with Christmas coming, here is a wish list of where “excess funding” can be directed if it still hasn’t been. The public health concerns that faced us as medical students continue to persist. We are still hoping to see in our lifetime an end to tuberculosis and rabies; adequate control of dengue and malaria; near eradication of vaccine-preventable diseases such as hepatitis B; and in recent years, avoid a further rise in HIV/AIDS and antimicrobial resistance.
In a recent stakeholder meeting where there was a gathering of medical societies, we were asked how we could come together to help. All of us were in agreement that our strong point as doctors is that people still look to us as the source of vital medical information, and we were fortunate to still have the public’s trust and confidence. One of the most measurable pieces of evidence as a pediatrician is how we helped increase national immunization coverage rates by serving not only as key resource speakers or volunteer ground personnel but also as opinion leaders. However, being limited in number and forever challenged by logistics, we have seen that our efforts may have a limited impact on a national scale and the only recourse to further, much less sustain an advocacy involves partnering with political figures. A sad but true reality that is not exclusive to the Philippines.
Recently, you must have heard of the Centers for Disease Control Advisory Committee on Immunization Practices’ recommendation to withhold universal administration of hepatitis B at birth for mothers who test negative for the virus. The news came courtesy of one of our more senior and highly respected colleagues. She asked how the neonatologists and pediatric infectious disease specialists felt about it, and her query reminded me of just how fragile and confused the public can be if we, as bearers and messengers of medical information, do not choose to stick to what has been known about hepatitis B and the benefits of vaccination.
As a briefer, hepatitis B is a virus that can be transmitted through exposure to infected blood and contaminated body fluids, which can also occur during needle sharing, through sexual intercourse and from an infected mother to her child during labor and delivery. While one may clear the disease, there is also a chance that one can suffer from chronic infection. To give maximum impact, as of this writing, hepatitis B remains the only known anticancer vaccine. It is a leading cause of liver disease worldwide, and the earlier one acquires it, specifically in infancy and early childhood, in the absence of timely vaccination, the greater the chances of suffering from cirrhosis, liver damage, and liver cancer.
Existing literature states that “approximately 25 percent of individuals with chronic hepatitis B infection in infancy die prematurely from cirrhosis or liver cancer.” An infected person may be asymptomatic for years, until symptoms of end-stage liver damage appear, which makes the disease particularly dangerous, as they can be the reservoirs or sources of infection for susceptible individuals.
In September last year, I had written about our country being hyperendemic for the disease, the shortage of hepatitis B vaccine and overall, our low national vaccination coverage rates for hepatitis B at birth. While the national government, through public health facilities and Department of Health-run institutions, includes free testing for Hepatitis B surface antigen, along with syphilis and HIV as part of prenatal checkups, we still catch mothers who fail to partake of the test. The reasons given from what we have gathered in these encounters are multifactorial, and sometimes, we can only scratch our heads in disbelief.
How can one not understand that vaccinating her child, especially in the first 24 hours of life, and completing the required number of doses, is protective if she is infected? Or that testing negative for the disease and having no vaccination still leaves her open to acquiring an infection in the future?
It wouldn’t hurt to sound like a broken record if, at the very least, it succeeds in saving one life. The benefits and the advantages of hepatitis B vaccination have long been known. To assume from presumptions of individuals with strong opinions and with wide political influence is dangerous and can be lethal. Hopefully, we do not go through that route.
Include this in my wish list.
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timgim_67@yahoo.com
