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By Joy Aceron and Victoria Maglanque*
In a health emergency, entitlements of citizens that ensure their health, safety and security are most crucial. Not only that it ascertains individual welfare and rights, it also avoids over-burdening the health system with patients that require intensive care.
In this pandemic, the government has passed policies that guarantees entitlements of citizens to health services. G-Watch’s COVID-19 Citizen Entitlement Map lists down the following:
For suspected coronavirus patients:
For all citizens:
For Senior Citizens and PWDs:
For public and private health workers/ medical staff and other frontliners:
For families of patients who died from COVID-19:
The question is whether the government is observing these entitlements guaranteed in their policies.
Health: Not the Biggest Budget Allocation
In reviewing the reports of the Executive to Congress under the Bayanihan to Heal as One Act, it is clear that despite the ongoing health crisis, health still does not get the biggest chunk of the budget for COVID-19 response.
The Executive’s 5th Bayanihan report dated April 27, 2020 shows that only PhP1.9 billion out of PhP245 billion was allotted to the Department of Health. This is not even 1% of the total budget.
We earlier wrote a piece that shows how the weak public health response to COVID-19 is an indication of the failed revenue generation for health, including the well-celebrated sin tax law (See: https://www.rappler.com/views/imho/254245-analysis-where-sin-tax-funds-coronavirus).
Our organization, G-Watch (www.g-watch.org), has very early on called for a strengthened health response to COVID-19 by increasing the budget allocation for health (See: https://g-watch.org/think-piece/prioritize-support-public-health-system-pass-supplemental-budget-public-health-response). We see this as crucial to ensuring the success of the country’s COVID-19 response.
In this Pandemic, Testing is a Citizen Entitlement
Mass testing to us means testing a significant number of people in a population, prioritizing the prospective cases, to lower the chance that any positive case is left undetected, causing wide uncontrollable community transmission in a given country.
This definition clarifies the use of the term ‘mass’ and why is it central in a country’s effort to control and stop COVID-19, especially as the lockdown eases.
This also clarifies when and how is testing for COVID-19 is an entitlement of citizens that are not only crucial for a particular citizen’s health, but also critical to public health and safety. The best post-lockdown scenario is that where there is a reliable system for mass testing, containment and treatment.
In the first week of April, the IATF, headed by the Department of Health announced that it is gearing up for mass testing[1]. However, to date, the DoH has reported missed targets. The government aimed to conduct 30,000 tests per day by end of May but in May 27 alone, the number of tests conducted was only at 7,589.[2]
In addition to this, there is also the issue of backlogs. As of May 27, 2020, there is still a testing backlog of 3,683 with only 42 laboratories capable of processing samples.[3] The DOH also has backlogs on validation of positive cases--while there are already more than 19,000 who have tested positive, there are only 13,000 confirmed COVID-19 cases.[4]
With the easing up of lockdown, the national government has expressed its reliance on the private sector to conduct tests for their employees. This was heavily criticized by the public and was deemed as a “recipe for disaster.”[5]
Contact tracing also proves to be one of the challenges faced by the government as 95,000 more contact tracers are needed to be hired in order to attain the ideal ratio set by the WHO, which is one contact tracer for every 800 individuals.[6]
Messed up Priorities on Health Performance Targets
Indeed, access to quarantine centers and treatment facilities is one crucial service that citizens must be entitled to.
In the Report of the Executive to Congress under the Bayanihan to Heal as One Law, we couldn't help but notice the mushrooming of quarantine facilities. The report does not give the exact amount spent for this (conversion, equipment, facilities, rents, etc.), but we can imagine it’s a lot.
The report also is not clear about how much of these facilities are currently being used. There are a lot of data missing. But we would hazard a guess. The utilization/ occupancy is likely low. These numerous facilities are not being utilized. Why? Three words: No mass testing.
In performance evaluation metrics, not all metrics are created equal. And in many occasion, one performance metric only makes sense if the other metrics are accomplished. This is the case here. Those quarantine centers (we suppose the metric is bed-population ratio) only makes sense if we are actually testing. The testing will be the source of the people who will use the quarantine centers. No testing, no positive people to contain, underutilized quarantine centers. So in this case, testing performance is the more important performance metrics than quarantine centers. Yet, the government says it doesn't have money for testing, while it's spent/ spending a lot of money for quarantine centers.
Who are getting tested first is also an indication of problematic prioritization of the government. There were reports of VIP testing for government officials and their family members. This was heavily criticized by the public especially since there are reports that regular citizens are dying even before the release of their test results or even without being tested. There are also reports that Chinese workers in the Philippines were tested for COVID-19 and got their results faster than some OFWs who had to wait for weeks or even months.[7]
Local Governments Seem to be Doing Better
In the meantime, there are local governments who have take it upon themselves to do testing.
As early as March, for example, the LGU of Marikina has applied for a license from the DOH to operate a COVID-19 testing center.[8] In Taguig, a drive-through testing site was established.[9] The LGUs of Valenzuela[10] and Pasig[11] have also ramped up their mass testing in partnership with DOH-approved testing centers.
Outside Metro Manila, the Bacolod LGU has launched the first COVID-19 Swab Mobile in the Philippines,[12] and Dagupan City has started its risk-based testing for its frontliners.[13]
From G-Watch’s Citizen Entitlement Monitoring, core G-Watchers in different localities all over the country have noted some positive news:
However, while guaranteed health services during COVID-19 are being made available by local governments, some G-Watchers noted the lack of information dissemination about these services. For example, in Tacloban, the availability of services of Level 2 and Level 3 hospitals for those seeking treatment/consultations on COVID-19 is not being communicated to citizens. Available assistance from PhilHealth is also not well-communicated. There are also entitlements that are not availed, such as being allowed to use an electronic prescription of drugs, because pharmacies are not informed of the policy, such as noted in Tacloban.
The most crucial entitlements in a health emergency are health services that will not only protect citizens, but will also ensure an effective and responsive public health system. Almost three months of COVID-19 coordinated response by the government, its prioritization of health entitlements of citizens remains highly questionable.
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*Joy Aceron is convenor-director of G-Watch (www.g-watch.org) and research fellow-adviser at Accountability Research Center (www.accountabilityresearch.org).
*Victoria Maglanque is Program Officer of G-Watch.
[1] Tomacruz, S. (April 7, 2020) ‘PH aims to test 20,000 per day by April 27’. Rappler. https://www.rappler.com/nation/257242-philippines-aims-massive-testing-april-2020.
[2] Beat COVID-19 Situationer No. 30. https://drive.google.com/file/d/1I7tTVG0Bg1hWBx0zzT4uYbo7tW52of2K/view?u....
[3] Cabico, G.K. (May 28, 2020). ‘DOH aiming to eliminate COVID-19 testing backlog by Thursday night.’ Philippine Star. https://www.philstar.com/headlines/2020/05/28/2017138/doh-aiming-eliminate-covid-19-testing-backlog-thursday-night.
[4] Sabillo, K. (May 22, 2020) ‘Only 13,000 are confirmed COVID-19 cases in PH but more than 19,000 tested positive.’ ABS-CBN News. https://news.abs-cbn.com/spotlight/05/22/20/only-13000-are-confirmed-covid-19-patients-in-ph-but-more-than-19000-tested-positive
[5] Lalu, G.P. (May 20, 2020). ‘Govt’s reliance on private sector for mass testing a recipe for disaster--Group.’ Inquirer.net. https://newsinfo.inquirer.net/1278366/govts-reliance-on-private-sector-for-mass-testing-a-recipe-for-disaster-group.
[6] Cabico, ibid.
[7] Gotinga, J. (May 28, 2020). ‘Fontana Chinese get coronavirus test results faster than some OFWs.’ Rappler. https://www.rappler.com/nation/262157-fontana-chinese-get-coronavirus-test-results-faster-some-overseas-filipinos.
[8] CNN Philippines (April 30, 2020). ‘Marikina COVID-19 testing lab gets DOH approval.’ https://www.cnnphilippines.com/news/2020/4/30/marikina-covid-laboratory-approved.html.
[9] Cator, Currie (April 22, 2020). ‘Taguig rolls out drive-thru COVID-19 testing.’ CNN Philippines. https://www.cnnphilippines.com/news/2020/4/22/taguig-city-drive-thru-testing-this-weekend.html.
[10] Alindogan, J. (April 12, 2020). ‘Philippines: Valenzuela city begins mass localized testing.’ AL Jazeera. https://www.aljazeera.com/news/2020/04/philippines-valenzuela-city-begins-mass-localised-testing-200411203022883.html.
[11] Cator, C. (April 12, 2020). ‘Pasig City, Cavite to conduct mass testing.’ CNN Philippines. https://www.cnnphilippines.com/news/2020/4/12/mayor-vico-sotto-governor-jonvic-remulla-pasig-city-cavite-conduct-mass-testing-covid-19.html.
[12] Masculino, G. (May 8, 2020) ‘Bacolod Launches First COVID-19 Swab Mobile in the PH.’ Manila Bulletin. https://news.mb.com.ph/2020/05/08/bacolod-launches-first-covid-19-swab-mobile-in-ph/
[13] Rappler (May 28, 2020). ‘Dagupan CIty begins risk-based coronavirus testing for 600 frontliners.’ https://www.rappler.com/nation/262173-dagupan-city-risk-based-coronavirus-testing-frontlines.
