MANILA, Philippines — The Healthcare Professionals Alliance Against Covid-19 (HPAAC) strongly thumbed down a bill seeking to allow local government units (LGUs) to directly purchase Covid-19 vaccines, saying it could lead to “maldistribution” and higher jab prices.
During a Senate finance committee hearing Thursday, Dr. Antonio Dans of the HPAAC cited three reasons why the healthcare workers’ group is opposing the said measure.
Senate Bill No. 2042 seeks to exempt LGUs from certain procurement requirements under the Republic Act No. 9184 or the Government Procurement Reform Act and other related laws during the period of the state of calamity due to the pandemic.
“The [HPAAC] strongly opposes the passage of [Senate Bill] 2042 which expedites the purchase of vaccines against Covid-19 by exempting LGUs from procurement laws,” Dans said.
“We oppose this bill because allowing local government units, or ever private corporations, to purchase directly from manufacturers will cost big problems,” he added.
Allowing LGUs to directly purchase vaccines can lead to “maldistribution of vaccines,” according to Dans.
At present, LGUs may buy Covid-19 vaccines but only through tripartite agreements with the drug manufacturers and the national government.
“The EUA (emergency use authorization) issued by FDA (Food and Drug Administration) is based on the declaration of a national emergency. The Covid-19 pandemic is not a local problem,” he said.
Vaccines “are not a local resource” and “prioritization and distribution requires centralized orchestration,” he added.
This requirement, Dans said, becomes “even more intense” when supplies are scarce, as in the case of vaccines against Covid-19.
“When LGUs…are allowed to procure on their own, then priorities will be defined by capacity to pay rather than need for the vaccine” he pointed out.
“If this were to happen, we would not be able to achieve twin goals of the vaccine program which is reduction in mortality and maintenance of healthcare capacity,” he said.
Further, Dans told the Senate committee that vaccine prices can shoot up should LGUs be allowed to purchase vaccines from suppliers.
“The country will lose the scale or volume that one buyer has, at the same time, the central government’s monopsony power as a single buyer is also diminished, likewise, resulting in higher prices,” he added.
“We point out in this statement that the national government has offered to pay for most of the country’s vaccine needs and we need to rationalize not duplicate the use of these funds,” he also said.
Dans pointed out that 30 to 50 percent of the cost of immunization programs is due to implementation.
He underscored the need for LGUs ensure make sure they are able to cover this counterpart cost, which he noted includes profiling, data clean-up, hiring and training of vaccinators, conduct of simulations, transportation of patients, cold chain logistics, among others.
“LGUs have a huge and ever important role in implementing the vaccine program, but we believe procuring vaccines is not one of those roles,” he said.
Dans also said that allowing LGUs to procure vaccines on their own could bypass the required recommendation of leading health technology assessment experts.
“In the past year, a new study on Covid-19 has come up every 3 minutes. Never has science seen such an explosion of information. This means that the balance between benefit, harm and cost may shift very quickly, even overnight and to evaluate the benefit against risk, complex skills are required in assessing efficacy and price also cost effectiveness, budget impact, feasibility, applicability to the Filipino population,” he explained.
“The [Universal Health Care] Law puts the mandate to review this science on the shoulders of skilled scientists of the independent Health Technology Assessment Council (HTAC). Bypassing recommendations of this council will expose the people to possible dangers of inappropriate technology, and may make local policy makers liable for wrong decisions,” he added.
Tripartite agreement
Dr. Jaime Montoya, executive director of the Philippine Council for Health Research and Development recommended to the Senate committee to include in the measure a “stipulation emphasizing that LGUs will only be allowed to procure their own Covid-19 vaccines through a tripartite agreement with the national government and the manufacturing companies.”
“In the international scenario on markets, vaccine developers usually do not engage with LGUs for supply of products that have not yet been finished clinical trials and/or just under EUA use,” he said.
“They only do so usually there is a special arrangement made through the national government and the vaccine developer agrees to do so,” he added.
Vaccine czar Carlito Galvez Jr. agreed with Montoya’s recommendation, saying that the policy on the tripartite agreement should still be followed to “provide safety to the LGUs that it is the government that will indemnify for any adverse effect.”
The Senate bill, according to its author Senate Majority Leader Juan Miguel Zubiri, seeks to aid LGUs in expediting their purchase.
“If local government units and private entities have the funds to procure vaccines for their constituents and employees, and the manufacturers are willing to deal with them, then let us give them the authority to do so,” Zubiri said at the beginning of the hearing.
“We hope to spare the purchase of COVID-19 vaccines from the tedious and circuitous procurement process. With this exemption, we also hope to avoid adverse COA findings from being issued and graft cases from being filed against local government units and their officials,” he added.