OPINION: Should Aquino, Duterte be held liable for dengvaxia deaths?

Raissa Robles

Posted at Feb 10 2018 05:28 AM

Should former President Benigno Aquino III be held responsible for dengvaxia deaths?

Of course.

Along with President Rodrigo Duterte.

Both implemented the program: President Aquino for THREE MONTHS, and President Duterte for FIFTEEN MONTHS.

Duterte bears a bigger burden because he continued it despite the fact that the World Health Organization (WHO) had already issued a position paper outlining the risks.

In late July 2016—weeks after Duterte became President, the WHO finally came out with its findings and recommendation:

“…vaccination may be ineffective or may theoretically even increase the future risk of hospitalized or severe dengue illness in those who are seronegative at the time of first vaccination regardless of age.”[i] As this risk had at that time not been seen in the age groups for which the vaccine was licensed, WHO issued a conditional recommendation, emphasizing the use of the vaccine in populations having been previously infected with dengue virus.

To minimize illness for seronegative vaccinated people, WHO recommends enhancing measures that reduce exposure to dengue infection among populations where the vaccine has already been administered. For vaccine recipients who present with clinical symptoms compatible with dengue virus infection, access to medical care should be expedited to allow for proper evaluation, identification, and management of severe forms of the disease.”

By July 1, 2016, Duterte had assumed office and Paulyn Ubial was his Secretary of Health. Despite the WHO position paper, Ubial said she continued the dengvaxia vaccination program.

Over a year later in December 2017, Ubial told a Senate committee probe that certain House lawmakers had pressured her into expanding the vaccination program.

See: news.abs-com timeline

Duterte could have stopped the program when he assumed office in July, but he didn’t. Ubial temporarily halted it TEN MONTHS LATER in May 2017. But she resumed it in June 2017. Then scrapped it SIX MONTHS LATER in December 2017.

When the Duterte government finally stopped giving vaccinations, spokesman Harry Roque said: “He (Duterte) would have done the same thing (Aquino did) because he himself has suffered from dengue and you can’t deprive the people of what they thought would be protection against a deadly disease when it existed.”

Are dengvaxia deaths, if criminal neglect is proven, an impeachable crime?

Most probably.

The bar for impeachable crimes has fallen quite drastically, if you watch the House committee deliberation on the impeachment of Chief Justice Maria Lourdes Sereno.

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I have also long been waiting for Senator Dick Gordon, who wears the double hat of chairman of the Philippine Red Cross, to summon before his probe committee someone from the Red Cross as well as the International Federation of the Red Cross.

He could then ask them—politely, or in his trademark bellicose berating style – if they had endorsed the use of dengvaxia.

The Philippine Red Cross is a prestigious and respected Philippine NGO and volunteer organization. It is a member of the International Federation of the Red Cross.

In other words, both the Philippine Red Cross and International Federation of the Red Cross are what you would call “influencers”.

On March 9, 2016, during the heat of the 2016 electoral campaign where Gordon was running for senator, the International Federation of the Red Cross website published a news release.

The release was entitled: “Philippine Red Cross aids efforts to halt dengue and avert Zika.”

It was accompanied by a photo that had the following caption: “The IFRC plans to support the Philippine Red Cross health teams and volunteers to spread awareness of the dengue vaccine to health centres and communities. Photo Credit: IFRC”

The name of the dengue vaccine was not mentioned in the news release. But it was most probably the dengvaxia vaccine of Sanofi. By then, dengvaxia was the only commercially available anti-dengue vaccine in the country.

The caption indicated that the Philippine Red Cross itself mobilized its health teams and volunteers “to spread awareness of the dengue vaccine to health centres and communities.”

The story did not contain any of the words of caution that we are hearing now—that those who have not had dengue should NOT be vaccinated.

In fact, Kate Marshall of the IFRC wrote that:

“Dr Bhanu Pratap, Health Coordinator for the International Federation of Red Cross and Red Crescent Societies (IFRC) in Philippines, says the introduction of the vaccine is a positive move, especially for those living in the worst affected areas and for children.

The IFRC plans to support Philippine Red Cross health teams and volunteers to spread awareness of the vaccine to health centres and communities as part of the overall Epidemic Preparation and Response Plan.

Through its donor network, the Philippine Red Cross provides 53% of the Philippines’ total blood supply. Some dengue sufferers require platelet transfusions to stop internal bleeding. Blood platelets are essential for normal blood clotting, but donation and extraction is a time-consuming process. According to Dr Pratap the vaccine would help reduce the burden on health and blood facilities, especially in areas that are already stretched to the limit, and on the donated blood supply.

The IFRC plans to support Philippine Red Cross health teams and volunteers to spread awareness of the vaccine to health centres and communities as part of the overall Epidemic Preparation and Response Plan.”

THAT is a categorical endorsement of the available dengue vaccine.

The article stressed the importance of the vaccine by stating the following:

In 2015, dengue affected some 400 million people (NOTE: That’s 5% of the estimated 7.2 billion world population).

However, two out of every three dengue cases were in Asia.

The Philippine government spends some US$336 million yearly to combat dengue. (NOTE: That’s roughly P16 billion based on the foreign exchange rate of P49 per US dollar. In contrast, dengvaxia cost the government P3.5 billion.)

In the year 2015, the number of dengue cases in the Philippines surged to 200,000 cases—or an increase of 80,000 cases in 2014, according to Marshall.

Curiously, her article stated that – “The World Health Organisation has declared dengue a global epidemic and will include vaccination as part of its global prevention and control strategy to contain the disease.”

The WHO now says it never gave a blanket endorsement of the vaccine in March 2016.

However, IFRC’s Kate Marshall seemed to be under the impression that WHO was all for the vaccine in March 2016 because she says WHO “will include vaccination as part of its global prevention and control strategy.”

Seeing that there was no other vaccine commercially available at that time except for dengvaxia in the Philippines, the WHO’s alleged intention to “include vaccination as part of its global prevention and control strategy” can only be referring to dengvaxia at that time.

You can read a copy of the IFRC news release in the IFRC website by clicking here.

I believe writer Manolo Quezon also mentioned the same news release in his opinion piece entitled last December “Contrasting official reactions“.

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The search for a dengue vaccine has been going on for decades without success.

The gravity of the disease, also according to Kate Marshall of IFRC, was tackled in an ASEAN Dengue Summit in Angeles City, Pampanga in June 2014.

The summit underscored that “the 10 member countries have the highest number of dengue cases in the Asia-Pacific, which accounts for 75 per cent of all infections worldwide.”

Economic losses were cited:

“Speaking at the conference, Professor Donald Shepard of the Schneider Institutes for Health Policy at Brandeis University, US, said dengue outbreaks in Southeast Asia were responsible for economic losses of $950 million US dollars each year.”

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I believe we should not lose this context in the ongoing dengvaxia probe.

Dengue is a very serious and expensive disease to have. There has been a long and pressing need for an effective vaccine.

Given the 2014 ASEAN Dengue Summit and the seeming March 2016 backing of the International Federation of the Red Cross and the Philippine Red Cross for a vaccine program, the few voices who had expressed caution in injecting dengvaxia were all but drowned out.

Disclaimer: The views in this blog are those of the blogger and do not necessarily reflect the views of ABS-CBN Corp.