ON THE FRINGES OF DESPAIR: Why Quality Affordable Medicines are out of Reach to Millions of Filipinos

In a slum area in Caloocan City, Mang Luisito*, sitting by the door of their decrepit shanty, watches the alley ahead for any sign of the arrival of his eldest son Reggie, 10. This was his routine for 6 months now, whenever evening came. His frail, almost skin-and-bone frame belied the fact that he was only 39 years old. Nowadays, he could barely stand or walk. He lost his breath with each painful step.

“It is hard to believe I was once a strong carpenter,” said the soft-spoken father of four, as he wiped a tear with the back of his hand.

One morning, he collapsed on his way to work. When he woke up in a crowded hospital ward, the doctor told him both his kidneys have stopped functioning. He needed to undergo regular dialysis to survive. The high cost of medicines coupled with expensive dialysis treatments made Luisito give up any hope of surviving barely a week after hearing the diagnosis.

Finally, Reggie arrives--the family breadwinner, apparently. No expression of affection was made between father and son, but the boy dutifully pulls out two twenty peso bills from his pocket and hands them to his father. The child’s daily wage as a coffee pot carrier for an ambulant food vendor living next door. The child is illiterate, his father says. Reggie had stopped his schooling at the age of seven and has worked at several odd jobs ever since.

Juan sends off a smaller child to buy the family’s meal for the night. He looks at this reporter and says point blank, he is just waiting for death.

“I’d rather not be cured at all than let my children die of hunger.” The eerie acceptance shone in his eyes. “It is better not to buy medicines than to watch your children starve.”

There are thousands, perhaps even millions of Filipinos in the country trapped in similarly hopeless situations. The high cost of medicines and exorbitant health services have made the matter of survival a privilege and not a right. Everyday, an ill Filipino would be forced to choose between pulling the plug on his family’s meager lifeblood of resources or to cling on to dear life.

As bleak as the future seems to be for the country’s healthcare system, a ray of hope now shines through with the expected passage of Senate Bill 2263, a law aimed at providing quality affordable medicines for all.

The proponent, Senator Mar Roxas, hopes that the bill would finally address the high cost of medicines in the country.

“When someone you love dies, it’s not political or economic, it’s personal. But for the poorest of the poor—those who could have saved their loved one if they had the money to do so—it goes beyond what is personal. It goes straight to the question of social justice.”

He said prior efforts to address the problem have not made substantial headway because of poor implementation, inhospitable circumstances or even venal collusion. The impending bill "aims to give life to the public health provisions of the Constitution and promote the people’s welfare."

Roxas also cited three major obstacles to the people’s access to affordable, quality medicines.
First is the extreme concentration of market power in only a handful of players in the country’s pharmaceutical industry. He said that due to its monopolistic or oligopolistic structure, there is lack of competition--resulting to the high cost of medicines.

“Here (in the country), there is only one manufacturer and contract manufacturer of medicines. We need to loosen the monopolistic or oligopolistic power that some multinational pharmaceutical companies have long enjoyed to the detriment of all Filipinos. "

The second has to do with the behavioral orientation of the consumers, doctors and public institutions. Roxas stressed there must be a continuing education of the Generics Law.

“Our doctors and public health institutions must not negate the spirit of this law by failing to live up to their duty to inform their parents, particularly the poor, about generic substitutes,” he said.

The third obstacle is the protectionist provisions in the Intellectual Property Code. He said that due to the highly technical and abstruse nature of the intellectual property system, the multinational pharmaceutical companies have dominated the application of the IP law to the detriment of public welfare.

Several proposed amendments to the IP law also include: the parallel importation of medicines, so that any Filipino can shop beyond the country for better prices; an exception to the application of trademarks and tradename restrictions with regard to parallel imports; disallowing the issuance of another patent for new uses of an existing patented substance; and the removal of the requirement for the government to undergo long and compulsory licensing processes.

The bill also intends to adopt internationally accepted best practices that have made medicines more affordable and accessible in so many countries around the world. At present, support has poured in from various sectors for the passage of the bill into law and expectation is high that it will soon make lives better for millions of Filipinos.