Highlights of RH debates, Feb.8

Highlights of RH debates, Feb.8
Continuation of plenary discussions on the Reproductive Health Bill
Sponsor: Senator Pia S. Cayetano (SPSC)
Interpellator: Senator Loren Legarda (SLL)

Note: This article merely highlights the main points discussed in plenary and should not be treated as a transcript of the proceedings.

SPSC: [Starts by clarifying her responses to some questions raised by Sen. Legarda in the previous interpellation]

• On which Asian countries include contraceptives in their list of essential medicines…
Different countries have different listings. East Timor has a more expansive list than the Philippines. In the Philippines, our drug formulary only includes drugs. Therefore, our [committee’s] recommendation is to include some other kind of list. Condoms and other contraceptives cannot be included in the list because they are not drugs. But for the purpose of the bill, we will try to include other contraceptives that are not drugs in a comprehensive list.

• On the process of the World Health Organization (WHO) in determining the model list of essential medicines…
Every two years, the model list is updated by an expert committee made up of 8-12 members. They meet in private and stakeholders are invited to comment.

• On the process for drafting the Philippine National Drug Formulary (PNDF)…
It is based on WHO reports and the members of the PNDF would agree on the lists and recognize various inputs from various stakeholders. They consult with experts and resource persons and finalize the lists and review and update these periodically.

SLL: There’s reference to National Drugs Information Center and the National Formulary Committee. May I know if these [bodies] exist under the new law?
SPSC: NDIC still exists but it is not part of the Philippine National Drug Formulary (PNDF) anymore.

SLL: What are the mandates of these agencies?
SPSC: The review and final decision belongs to the National Drug Formulary. NDIC is with UP [University of the Philippines]. Sole responsibility is now with National Formulary Committee.

SLL: So the NDIC is just one of the institutions being consulted. And NFC is not under the FDA?
SPSC: Yes.

SSL: Who appoints members of the NFC?
SPSC: Members are appointed by the Secretary of Health.

SLL: Who do they represent? Because the role of the NFC is important so we want to know the composition of the committee and how they are selected and appointed, and their term. May we know whether pharmaceutical companies, NGOs and civil society are consulted? Maybe next time, we will have an example of a drug that was delisted from the list of essential medicines? I would like to understand how they operate, how medicines are listed and delisted…
SPSC: Yes.

SLL: On health expenditures. The current level of health expenditure of our country, as opposed to WHO recommendation of health expenditure. WHO recommends at least 5% of GNP and we spend only about 3.2%. May we know how we [national government] spend compared to how other countries spend on health?
SPSC: Whole expenses in the country include even out-of-pocket expenses. The picture that WHO is looking at includes the entire spending, regardless of the source. [Reference was made on WHO figures on spending of different countries including the Philippines]. The 2007 data say out-of-pocket expenses for health was at 54%, local governments 13%, national government 13%, social health insurance 9%, others 11%.

SLL: How much is the funding requirement for 2012 for the purchase of family planning (FP) products and supplies?
SPSC: For 2012, there is partial funding for unmet FP needs for the poorest of the poor. This will address the needs of those in the poorest quintile. For commodities it is P300 million for 2012. But this doesn’t cover the needs of those in the other poor quintiles.

SLL: And this is under the Family Health and Responsible Parenting in the DOH budget? Why was it included together with vaccines for senior citizens?
SPSC: Senior citizen program is part of family health.

SLL: What are the other programs related to Reproductive Health?
SPSC: With respect to RH, this includes development of manuals for maternal and neonatal health; trainings; human resource development; development of newborn death reporting; advocacy training; capacity building; violence against women. These include programs and materials.

SLL: If oral contraceptives are the only ones listed in the essential medicines list, there wouldn’t be condoms and IUDs?
SPSC: Condoms are part of the program. Condoms and IUDs are considered devices so they are not included in the National Drug Formulary but they are part of the purchase of supplies and therefore funded by DOH. Natural family planning devices are also included.

SLL: Condoms and IUDs are purchased today even if they are not part of the essential medicines. And is it the intent of the bill to include condoms and IUDs in the list of essential medicines?
SPSC: The Philippine Drug Formulary can only include drugs. Those which are not drugs will form part of the list of family planning supplies that will be purchased. The importance of including certain drugs in the PNDF is that it becomes mandatory for LGUs to purchase. We will make it a point that these FP supplies will be mandatory for LGUs to purchase without being included in the list of essential medicines.

SLL: Are they included in other countries’ list of essential medicines?
SPSC: Yes.

SLL: Should condoms and IUDs compete for a share in the limited budget for all health concerns?
SPSC: Yes. Given that many of our people live below poverty line and can barely afford drugs, we should be conscious of the spending capacity of our families. Many of families can’t even feed their families and bring their children to hospitals. If we give parents to plan families wisely by choice, and we equip them, then they would be able to provide more for the health needs of their children. RH budgeting is just as important as other concerns for health.

The budget for RH includes expenses for hospitalization for abortion complications and childbirth complications. RH addresses these concerns because if FP is effective, we would not be spending this amount on effects of unintended pregnancy. #

* Interpellation suspended for next session. Expected to be discussed next are financing for RH program and other questions on the list of essential medicines.

Photo: Senators Pia Cayetano and Loren Legarda at the continuation of plenary discussions on Senate Bill No.2865, the proposed ‘National Reproductive Health Act.’

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