The ultimate vaccine: A resilient health care system

Source: The Philippine Star – Filipino Worldview | Author: Ambassador Roberto R. Romulo | Date: May 8, 2020

Former health secretary Dr. Esperanza Cabral compels us to think beyond today’s crisis. Scientists predict a second wave. The development of a cure and a vaccine for the coronavirus disease 2019 or COVID-19 is going to take time. Even then, new pandemics and disease transmission are going to be a fact of life in a globalized world. Dr. Cabral’s words are simple and challenges us to do the right thing.

“Since the crisis that has caused our economy to stop on its tracks is a health issue, maybe there are things to say on how developing a resilient health care system, able to deal with shocks like this, is the ultimate solution to similar health, turned socioeconomic disasters, that are really just around the corner, threatening our way of life the same way that coronavirus has done.

This makes the case for why increasing our health care system’s capacity should be part of the national stimulus strategy. If we do not, we will simply repeat the experience we are going through now, maybe next year, maybe two years from now, who knows? For sure, however, it will be sooner rather than later.

Let’s get ready by spending on improving our health care system. Spend on improving hard infrastructure, BUILD, build, build! The kind of hospital where you would want to be admitted if you ever have a serious illness. Spend on training, recruiting and retaining more human health resource, Employ, employ, employ! The kind of doctor you would want taking care of you and the kind of nurse who will provide expert assistance to your physician. Spend on research and development of medical equipment, drugs, vaccines, supplies and materials such as personal protective equipment. Spend on production and stockpiling of these so that we are not forever dependent on imports. In a global crisis, we are going to get what we need only after the needs of the producing countries and the richer buying countries are satisfied.

Let’s spend on our health. Invest in family planning, or we will have an extra four million people to take care of when the next contagion comes along. Invest in waste management or we will drown in a tsunami of used personal protective equipment (they are made of plastic) that will pollute the land forever. Invest in water so that we can at least have some to wash our hands with. Invest in housing so that when we call for social distancing and home isolation, they will have some space to do this properly. Invest in data technology so that we can know where we are and can plan our next steps confidently. Otherwise, we will repeat this cycle of spending trillions that we don’t have, to protect business and our workers and revive our economy. As we always say, an ounce of prevention is better than a pound of cure.”

“It’s the public health care system, stupid” is what former secretary Cabral is saying – a twist of James Carville’s campaign slogan for Bill Clinton. The key takeaway from what Dr. Cabral says is that a resilient health care system will prevent a health issue – and the next one is just around the corner – from becoming a socioeconomic disaster. A resilient health care system will spare our country the terrible dilemma of choosing between loss of life or loss of livelihood.

Digital response to COVID-19

To me, a key component of health and economic resilience is the application of digital technology to more effectively address the health challenges and its economic consequences.

With lockdowns and other social distancing measures in effect, more and more people are relying on the internet for information and advice and hence, deploying effective digital technologies can help contain the outbreak, meet the needs of people for accurate information and soften the impact of the crisis on their lives.

Data analytics and artificial intelligence (AI) can be used to give an accurate picture of infections, and allow government and business to react and plan accordingly. Digital applications can help trace and test people who have come into contact with an infected person. I understand IATF has issued a “rapid pass” with digital tracing potential. Digital communication channels can provide reliable information on global and national COVID-19 developments, information about the outbreak, travel restrictions, practical guidance on protection, and governmental response. A comprehensive supply chain data application can facilitate the movement of goods such as food and essential services in an optimal way and avoid long lines at checkpoints. Digital ID and digital signature can help ensure the effective delivery of unemployment assistance, food relief and other social benefits.

But before we can unlock the promise of digital technology, however, we have to feed it with baseline data. One of the most basic data is a unique lifetime ID number for each and every Filipino. I understand that the Philippines and six other countries are the only ones who do not have a national identity system in place. In other places like Singapore and Taiwan, a unique ID number is used for the various cards and permits for health services, social security, passports, tax ID, drivers’ license and many others. That way, data can be consolidated and be easily accessible, while balancing health and public service imperatives and privacy concerns.

As an aged veteran of technology, I can foresee the many uses of a National ID System. But I may have to wait a while. About a year and a half ago, I heard a presentation by NEDA on the planned National ID System to be implemented by multiple agencies such as the Philippine Statistics Authority, NEDA and DSWD.

Frankly, as the saying goes, too many cooks spoil the broth. Worse yet, as of today, the respective agencies are still in the bidding process. I would suggest that President Duterte light a fire under the relevant bureaucracies to give this the highest priority and get this completed at the soonest possible time. According to the timetable, trials are underway and targets to cover the entire population by 2025. Indonesia, with almost three times the population of the Philippines is set to complete their identity card issuance soon.

We fought so hard for a DICT since the time of FVR, Erap, GMA, and PNoy. DICT presence NOW is an imperative.

Quarantine extended

Source: The Philippine Star – Filipino Worldview | Author: Ambassador Roberto R. Romulo | Date: May 1, 2020

President Duterte has extended the enhanced community quarantine to May 15. Despite sentiments of some including LGUs and businessmen, he personally listened to experts, scientists, and former secretaries of health before he agreed with the IATF. In general, the public supported that decision, although many complained about not receiving the promised food and cash grants to help them tide over the quarantine period.

The appointment of former AFP chief of staff General Carlito Galvez and current presidential adviser on the peace process as chief implementer of the National Action Plan has been widely hailed. The National Resilience Council had a roundtable discussion via Zoom with 200 plus participants. Former Major General Restituto Padilla Jr., the spokesman of the National Action Plan (NAP) COVID-19, was the key note speaker. Padilla emphasized the need for a whole of society approach to addressing this crisis.  Of particular significance was the four measures of success that the NAP had set for itself in fulfilling its mandate: 1) Reduction of new COVID cases. 2) Reduction of deaths. 3) Increase in recovered patients. And finally, 4) Normalization of the economy. These are clear and implementable metrics that the general public can understand and appreciate.

Heavy handed?

However, at the ground level though, there have been instances where overzealous implementation of the quarantine has led to blatant disregard for legal rights and privacy.

There was an incident at the Pacific Plaza Towers. The PNP stormed the condominium complex at the Bonifacio Global City in Taguig City on Sunday, April 19, and accosted residents who were at the open area of the condo.

Retired Supreme Court Justice Antonio Carpio said it was illegal for policemen to barge into the premises of a condominium. “The police needs a search or arrest warrant issued by a judge to enter a residential condominium building.”

The Taguig City Police said it was Mayor Lino Cayetano who ordered cops to go to the condo citing reports that residents were not observing physical distancing. Even with the mayor’s order, Carpio said the police still had no legal basis.

Retired Court Chief Justice Artemio Panganiban opined: The armed intrusion by policemen into the Pacific Plaza Towers in Taguig City, the “house” of the residents therein, may have violated the constitutional “right of the people to be secure in their persons, houses, papers and effects,” unless it can be factually shown that their acts were made in conjunction with, or were necessary incidents of, a valid warrantless arrest and search.

I am sure there are many similar cases of such confrontation that have gone unreported particularly in those areas where residents do not have the means to use social media to air their grievances. There are reports of homeless people, vendors and people who needed to go to work being arrested and detained for as long as two days when they should have been released after being booked.

It has also been reported that the DOLE labor official assigned in Taichung in Taiwan had arranged for the “deportation” of a caregiver with her employer and recruiter because she was critical of the Duterte administration’s handling of the pandemic crisis in her social media posts. This is a clear case of overreach and worse, forced a foreign government, who of course would not be a party to such action without a legal process being undertaken, to speak out. MECO resident representative Angelito Banayo subsequently disavowed the labor official’s actuations.

One tragic incident highlights fears that law enforcers may have taken at face value the President’s statement made in a press conference to shoot violators of the quarantine. Corporal Winston Ragos, retired from the Army for PTSD (Post Traumatic Stress Disorder) was unfortunate to run afoul of police forces manning a checkpoint in Quezon City. According to eyewitnesses, Ragos was complying with the police officers’ instructions, when he was shot as he reached for his bag, which his family says contained a bottle of water and documents attesting to his impaired mental health.

All of these incidents of heavy handedness raised the specter of martial law when a leaked Air Force memo spoke of getting ready for a martial law type of lockdown. The President himself threatened to declare one, thus, exacerbating the public’s concern.

US helping hand

Although the conversation between the President and US President Donald Trump on bilateral COVID-19 cooperation captured the media’s attention, what has not been given enough prominence is direct US assistance to our efforts to fight the pandemic. The US has, thus, far provided more than P470 million to support the Philippine’s COVID-19 response, in addition to 1,300 cots donated to the Office of Civil Defense and Philippine General Hospital. US assistance is also strengthening the capacity to detect, treat and defeat the virus. This complements nearly P30 billion in assistance the US has provided over the past 20 years to improve health care in the Philippines. This does not count the invaluable role that Filipino alumni of US educational grant programs are playing at the forefront of the country’s  effort against the pandemic.

American companies in the Philippines are also doing their share in the fight against COVID. To cite a few examples, Ford is lending vehicles for medical use; UPS and FedEx are delivering critical supplies; Procter & Gamble and 3M are producing PPE; and Coca-Cola and Pepsi are supplying beverages for frontline workers. US companies CapitalOne, Marriot, Dow, Cargill, AIG, Google, Airbnb and Facebook are also providing assistance.


During WWII “Lebensraum” became the ideological principle of Germany providing justification for territorial expansion into Central and Eastern Europe. They justified it as necessary for their survival.  There is an amazing similarity to China’s actuations in the Spratleys.

NRC’s November 29 Board Meeting