MANILA, Philippines – Former Department of Health (DOH) secretary Janette Garin took a swipe at several public health experts who have been staunchly criticizing her for launching the now-suspended dengue vaccination program.

In a Rappler talk interview on Saturday, December 16, Garin said she would listen more to the opinions of the DOH’s program directors and the positions of medical societies they consult rather than the stand of individual doctors.

“Kaya nga ang ginawa naming polisiya, we cannot rely on individual doctors. We rely on specialty societies. Kung ito ay sakit sa puso, cardiologist ang papakinggan namin, pero hindi isa. Tatawagan namin ‘yung association nila and ask the association, ‘Who will be your representative?'” said Garin.

(That’s why our policy is that we cannot rely on individual doctors. We rely on specialty societies. If we’re talking about heart ailments, we listen to cardiologists, but not just one. We will call the association and ask them, “Who will be your representative?”)

“As secretary of health, I would rely on the director kasi sila ang kaharap ng mga pasyente at mga regional directors. Mahirap kasi para sa amin na pagka may isang magaling na doktor, siya lang ang pakikinggan namin. It would be better pagka society,” she added.

(As secretary of health, I would rely on my directors because they are the ones who face the patients and the regional directors. It’s hard to listen to just one good doctor. It would be better if we listen to societies.)

The DOH under Garin had launched the dengue vaccination program in April 2016 by administering Sanofi Pasteur’s Dengvaxia vaccine to public school students aged 9 and above in the National Capital Region, Central Luzon, and Calabarzon. (READ: TIMELINE: Dengue immunization program for public school students)

At the time, public health experts had warned Garin it was too early to allow mass use of the vaccine, as clinical studies on its safety, efficacy, and cost-effectiveness had not yet been completed.

These Filipino doctors include Antonio Dans, Anthony Leachon, and Susan Pineda-Mercado. (READ: ‘Bad science, wrong info’ root of Dengvaxia problem – health experts) 

Leachon was part of the dengue expert panel that Garin’s successor Paulyn Ubial formed, while Mercado was DOH undersecretary during the time of Juan Flavier and later served as director for noncommunicable diseases at the World Health Organization.

Two years after Garin launched the dengue vaccination program, Sanofi released an advisory saying Dengvaxia may cause a vaccinated individual to develop severe dengue symptoms if he or she had not been infected by the virus before immunization. 

More than 833,000 Filipino schoolchildren got the risky vaccine before current DOH Secretary Francisco Duque III suspended the program.

In a Senate probe into the Dengvaxia controversy last week, Garin said her program directors, the Philippine Society for Microbiology and Infectious Diseases, and the Philippine Pediatric Society Incorporated advised her to push through with the immunization program as the vaccine may lead to an “80.8% reduction in hospitalization and 93.2% reduction in severity.”

But Dans, Leachon, and Mercado were not the only doctors who were against the vaccination program. 

FEC designed to ‘protect’ DOH 

The Formulary Executive Council (FEC) – composed of top Filipino experts who determine which drugs and vaccines the government may use and buy – also did not want mass use of Dengvaxia. The FEC was formed through an administrative order signed by former president Fidel Ramos.

Still, Garin said she would give less weight to the FEC’s recommendation as “they are consultants [and] not full-time [employees]” of the DOH. (READ: Conflict between Garin and FEC emerges in Dengvaxia probe)

She said “miscommunication” often happens whenever the DOH’s program directors explain the needs on the ground to the FEC’s secretariat, who then relays the message to the FEC members.

“The feedback to me was that sometimes the Philippine National Formulary Secretariat does not properly convey the message of the program directors to the FEC. It’s not a perfect system… The administrative order should be reviewed,” said Garin.

Duque, however, told Rappler that he considers the FEC’s views as crucial, as it was formed to “protect” the DOH chief.

“They are a recommendatory body, but it’s not something that you can ignore as secretary of health because they are your protection!” said Duque. 

Duque already spent 5 years as DOH chief under former president Gloria Macapagal-Arroyo before being reappointed to the department again in October by President Rodrigo Duterte.  

Garin, meanwhile, had only been DOH secretary from February 2015 to June 2016. – Rappler.com