Philippines ‘exporting’ measles?

Science01 090819
File photo: Health Secretary Francisco T. Duque III leads the ceremonial vaccination during the recent school-based immunization kickoff launch held at Signal National High School in Taguig City.

A part from various commodities and skilled labor, the Philippines also exports diseases, such as measles.

In a recent presentation at the launch of the Development Policy Research Month (DPRM), Department of Health (DOH) National Immunization Program Manager Maria Wilda Silva said the decline in the immunization rate and affordability of travel has made the country a “vector” for the disease.

When the Philippines encountered a major measles outbreak in 2014, the Philippines was cited by the World Health Organization (WHO) as a factor for the spread of the disease to other parts of the world.

Given that the Philippines has not yet been able to quell the spread of the measles outbreak that started in the first two months of 2019, spreading the disease to various parts of the world is again a threat.

“We are still in outbreak or epidemic level, up to now, for measles. We haven’t fully controlled the transmission of measles. [This] despite the effort of the government to give the second dose of measles containing vaccine not just to infants but we have extended this to school children up to Grade 7,” Silva said.

Data that Silva presented showed that in 2018, there were around 200 people per million population affected by measles. This has increased to almost 300 people per million population in 2019.

Silva’s data also showed that between 2004 and 2019, the highest incidence per million population was recorded in 2014, when there were over 500 per million population that was affected by the disease.

Apart from measles, Silva said, the DOH has already informed the public of the “recirculation” of polio.

While the Philippines recorded its last polio case in 1993 in Cebu and has already eliminated the disease in 2000, the danger of the return of the debilitating disease is ominous.

Silva said one of the major factors is the declining trend in immunization among children. She said since 2011, the proportion of children that have received complete sets of vaccination against various diseases, such as measles and polio, have been on a decline.

However, Silva said the DOH recently found samples of “polio-like” viruses, or “vaccine-derived polio virus.” This has already been disclosed by the DOH in the past few days to alert the public.

“The risk for polio recirculation is real,” Silva said. “We are now on high alert for polio recirculation, thus, we are doing some campaigns to arrest or to stop the transmission of polio.”

The spread of diseases across borders or cross-border public-health threats is among the most important challenges under Globalization 4.0.

Philippine Institute of Development Studies (PIDS) President Celia M. Reyes said these challenges also include trade wars, environmental degradation, worsening inequality, erosion of social cohesion and trust, and the proliferation of disinformation.

Reyes expressed concern that if these challenges are not managed well, they could pose a threat to the ability of the country to attain a higher level of economic growth and meet its development targets.

These development targets are identified under the AmBisyon Natin 2040, which is the long-term vision of Filipinos for themselves and the country.

Further, as a signatory to Agenda 2030, the Philippines must also meet the targets set under the 17 Sustainable Development Goals (SDGs).

“We would like to encourage all sectors to get involved and support the government in addressing the challenges posed by the new globalization. The government cannot do it alone,” Reyes said. “Each of us can do something to mitigate the risk and harness the opportunities that come along with the new globalization.”

In terms of the spread of diseases, such as measles and the recirculation of polio, are rooted in the decline in children’s immunization rate.

Silva said immunization is being used not only to control the spread of diseases like measles and polio but also congenital rubella, Japanese encephalitis and hepatitis B.

Data presented by Silva showed in 2011, around 75 percent of children have been fully immunized. This was a decline of 11 percentage points from 86 percent recorded in 2010.

The trend continued and in 2018, the proportion of fully immunized children in the Philippines declined to 66 percent. Between 2004 and 2018, the highest immunization rate among children was recorded in 2009 when 89 percent of Filipino children were fully immunized.

This declining trend, Silva said, was mainly due to the plunge in Filipino’s vaccine confidence. Vaccine confidence became a major concern after the Dengvaxia vaccine scare that made parents think twice about making their children avail of the vaccinations available in school.

“The vaccine confidence issue came about after the announcement of one company about the dengue vaccination that we [Philippine government] have implemented in 2016 and before we can come up with a statement of the safety of the vaccine, actually the social media was very active because I think this was announced in Europe, in France, one day before we had the official communication from WHO,” Silva said.

BusinessMirror last year reported that the Dengvaxia vaccine scare caused many parents to doubt the efficacy of vaccines and how these can prevent their children from falling ill from the diseases these vaccines aim to ward off.

This low confidence in vaccines was observed in the results of a survey conducted by the London School of Hygiene and Tropical Medicine which was conducted during the Dengvaxia scare.

The data, Silva showed, only 32 percent of those surveyed thought vaccines were important.

Further, Silva said 79 percent of respondents did not consider vaccines safe. She added that the results also showed the confidence level of respondents to vaccines dropped to 22 percent, from 82 percent.

“This is actually the very big challenge of how to bring back vaccine confidence or trust of the public to vaccine safety and efficacy,” Silva said.

In order to address these concerns, the DOH has identified key strategies under its expanded immunization program. These strategies involve strengthening the cold chain to support the immunization program and capacity-building for health workers for the introduction of new vaccines.

The DOH also intends to push for the financial sustainability for the newly introduced vaccines for expansion and develop a comprehensive multiyear plan for immunization program.

The health agency has also conducted vaccination activities against measles, such as the Outbreak Immunization Responses (ORI) in several regions.

This was followed by a nationwide Supplemental Immunization Activity (SIA) for children aged six to 59 months old which was conducted in two phases—in April 2018 (NCR and Mindanao) and in September 2018 (other parts of Luzon and Visayas).

However, the DOH lamented that despite the efforts of health workers, the SIA campaign had achieved a coverage of 69 percent during Phase 1 of implementation and 29 percent in Phase 2.

“I appeal to the public to rebuild your trust and confidence in vaccines that were long proven to be effective, and I am quite sure that all of us sometime in our lives have been recipients of these vaccines which had protected us from various diseases,” Health Secretary Francisco T. Duque III earlier said.

Image credits: Nonoy Lacza


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