Transcript of Sen. Nancy Binay Q&A, Senate COW Hearing on Vaccines

Senator Nancy Binay-Angeles (SNBA): ...may mga available na tayong syringes, PPEs, ilan, good for ilan na po yung ready na?

Sec. Francisco Duque: Ma'am, kukunin ko lang po sa staff ko kung ilan, hindi ko po memoryado yung actual figures. I'll just submit it to you, madam Senator.

SNBA: Ok. Thank you Secretary. And then for yung augmentation mo, more or less, ano yung (figures) and nasaan na tayo sa proseso for the augmentation? Are we bidding it out already, or binibilang pa natin kung ano yung need natin?

Sec. Duque: Yung atin pong procurement sa kasalukuyan ay ongoing, madam Senator. Lahat po ng ancillary supplies gaya po ng aking nabanggit, yung mga karagdagan na PPEs, pero hindi naman po full PPEs ito, mga masks, face shield, alcohol, sanitation chemicals, disinfectants, so yan po ay mabubuo na natin sa lalong madaling panahon.

SNBA: So Secretary, ano ho yan, na bid out na?

Sec. Duque: Ongoing pa po, so pati yung bidding nyan ay kasama sa proseso ng procurement, at tutulungan din po tayo nito ng PS-DBM para mas madali po nating makuha o makamit itong mga kinakailangang sapat na volume ng mga peripherals para po sa ating ancillary services.

SNBA: Secretary, for 50,000 doses we have sufficient supply like syringes, bulak, meron naman po?

Sec. Duque: Yes, ma'am. We have about 30 million na syringes ma'am, 27 auto-discharge syringes, and about 3 million (unintelligible). Ito ma'am, we can just submit it to you, (or) would you want me to read it out?

SNBA: No Secretary, just for submission.

Sec. Duque: Yes, we would just submit ma'am, narito na po sa akin ma'am.

SNBA: Ok. Thank you po. And then, pagdating naman po sa distribution and deployment, meron na ho ba tayong kinausap for the supply cold chain management?

Sec. Duque: Meron na po. In fact, of the 18 companies that the DOH supply chain management team, andito po si Usec. Carol Taiño, labingwalo na po yung nakausap at apat po dito ang may kakayahan na mag, as a third-party logistics provider. Kaya po nila yung iba-ibang temperature requirements kasi iba-ibang bakuna iba-iba po ang temperature requirement, may iba po plus two to plus eight degrees centigrade, yung iba naman po negative twenty degrees centrigrade, at may isa naman po diyan, ay negative seventy degrees centigrade. So apat ang kumpanya ang naghayag na sila po ay kaya po nila, maa-accommodate itong mga iba't-ibang klase ng bakuna. So meron po tayong apat na companies na sa kasalukuyan ay atin pong kinakausap.

SNBA: But at the moment Secretary, may padating na ho tayo by February. At the moment, wala pa ho tayong kinakausap, wala pa tayong inaawardan (award) for the supply cold chain management?

Sec. Duque: Madam Senator, meron ho tayong available na, up to, I think, July. So kakayanin po ito, at ito naman pong, for our negative, plus two to plus eight, yun pong RITM natin andyan na po, yung mga regional warehouses and cold storage facilities po natin. Naka-imbentaryo na po tayo lahat madam Senator. So kung anuman yung kulang, bandang mga July-August na ho, pero aagahan po natin. Tama po kayo, na dapat ay we have to be ten steps ahead.

Sec. Carlito Galvez: Madam, I'll just add. Sa next week po madam we will inspect the cold chain facilities in Metro Manila, including yung mga cold chain facilities natin sa mga major hospitals just to check if yung preparedness ng ating mga LGUs at the same time yung ating mga healthcare facilities. So bibisitahin po natin yung RITM, based on the report ni Sec. Duque, meron po tayong cold freezer na nabili na ng DOH. And we will inspect it this coming week. So yun po ma'am, rest assured na yung supply chain na requirements, particularly sa mga ultra cold, we have been negotiating since December 16, nagkaroon po tayo ng logistic workshop with Zuellig Pharma, saka Unilab, and also the different cold chain supply consortium, with the different private companies. And we have already assured that the President, we can manage the supply chain, even the negative eighty, seventy, negative twenty ultra cold facilities.

SNBA: Pero Sec. Galvez, I saw sa news yung presidente ng cold chain group, parang wala pa raw sa kanilang nakikipag-usap from government. And I think invited ho ata natin sila ngayon, can they confirm this?

Sec. Galvez: Narito po ang Zuellig at ang Unilab.

SNBA: The group...

Sec. Duque: Madam Senator meron po kaming listahan ng mga nakausap na po, labingwalo na nga po ito. We will just submit to you the list madam senator.

Sen. Francis Pangilinan: Madam chairperson, with the permission of Senator Binay, just very quickly.

SNBA: Go ahead.

Sen. Pangilinan: Yes, thank you Mr. President, thank you Sen. Binay. Can the inventory of all these cold chain equipment, itong mga, mai-submit din sa atin so we know exactly the situation is. Thank you.

Sec. Duque: Yes, Your Honor, we will do immediately Your Honor.

SNBA: Ok, I think invited ho ata natin Mr. President si Mr. Dizon, is part of the association of cold chain, tama po ba?

Sen. Sotto: Yes, he's online. Would you like him to respond?

SNBA: Yes please, Mr. President.

Anthony Dizon, Cold Chain Assoc. of the Phils. President: Yes, good morning Mr. President, good morning madam senator and all the other members of the committee. Maraming salamat po sa pagkakataon na makilahok sa hearing na ito. Gusto lang po naming i-manifest at this point, na makailang ulit na po kaming nakipag-usap sa gobyerno para ilahad ang aming kakayahan, ang aming capability, and our willingness to participate in this vaccine distribution program, if we are called upon. Ko-confirm ko lang po yung binanggit ni Senador Nancy na nasa diyaryo po ngayon, yung sinabi ko kahapon na hindi pa po nakikipag-usap sa amin ang gobyerno. Kaya hindi rin po namin masimulan ang paggawa ng plano, ng action plans, ng aming maaring ilagay, ipatupad, dahil hanggang ngayon po ay wala kaming naririnig na malinaw na direksyon. Ang masakit pa po nito, as of yesterday, we have received unofficial information that the participation in the vaccine distribution program will also be subject to guidelines, restrictions, terms of reference that may be provided by regulatory agencies. E lalo po kaming hindi makakakilos dahil hindi po namin alam kung ano yung mga guidelines na yun. Nevertheless, ang amin pong posisyon sa ngayon, ay handa pa rin po kaming tumulong because we have been operating this industry for so many years under the guidelines of regulatory agencies that pertain to cold supply chain. Sa palagay naman po namin ay hindi naman napakalayo sa magiging guidelines for the handling of vaccines, kailangan lang po naming malaman kung kami ay kasali o hindi.

Sec. Duque: Maraming salamat po, kailangan po natin dito ay yung pharma grade cold chain. At gusto ko lang pong basahin ang mga kumpanyang amin na pong nakausap Your Honor, Mr. Chairman. Yun pong Orca, Royal Cargo, Maersk, Jatcor (?), Diamond, Pharmaserve (?), Vantas (?), (unintelligible) Inc., LBC, Distriphil (?), Metropak, Royal Cold Storage, Cool Air, Country Force (?), Fast Logistics, and Zuellig. Hindi po kami, tama po kayo, ang kinakausap namin diretso na doon sa providers, pero ready naman po kaming makipag-ugnayan dun sa inyong asosasyon. Kung meron pa po kayong pwedeng i-rekomenda, we will promptly look into this Your Honor, Mr. Chairman.

SNBA: Siguro Sec. Duque, mas maganda kung marami yung magagamit nating cold chain, kasi ang naririnig ko, based dun sa mga interviews sa inyo, kumbaga, nakakahon tayo sa isang klase ng bakuna kasi ang limitation ay yung storage, yung cold storage, pero kung mas maraming makakaprovide, mas marami tayong mapagpipilian na mas maiging bakuna, hindi po ba?

Sec. Galvez: Madam Senator, actually ma'am, ang pag-ano po namin ng pharma grade, pharma grade po kasi ang...Dalawahin po natin, dalawa po kasi ang cold storage, yung agricultural cold storage at ang pharma. Ang kinakausap po natin ay yung pharma grade, kasi kailangan po ng training diyan, at ng extensive experience kasi balita po natin ay talagang very sensitive po yung paghandle ng cold chain. So ang kinakausap po namin ma'am, together with the LGU, actually sinabihan din po namin ang LGU that they can connect directly with the cold chain pharma operator. And many LGU already are connecting with them, especially Manila - gumagawa nga siya ng cold chain niya that can accommodate the negative seventy, negative twenty. So yun po ang mga preparation po natin, na yung ginagawa po natin ngayon, by areas, and even we are connecting with other big companies that can accommodate millions of dosage of vaccine. Sa negative twenty, negative seventy dito sa Manila at sa major hubs sa Visayas at sa Mindanao like in Cebu City and also in Davao. So we are also exploring this spoke and hub strategy wherein this ultra cold storage can also be deployed in different areas so that other people in rural areas can also have access to our safe and effective vaccines. So yun po, para wala pong discrimination sa atin pong pagbabakuna.

SNBA: Yes, kaya nga Sec. Galvez, napakahalaga na kinakausap na natin itong grupo ng cold chain di ba, kasi what if meron sa kanila na willing naman to shift to pharma grade. Kaya kailangan ngayon pa lang nag-uusap na, dahil base doon sa statement nyo during the Monday hearing, kumbaga, eto na naman, mas may mas may access yung dito sa NCR or sa mga cities kasi sila lang ang may facility dun sa mas ok na bakuna tapos ibibigay natin dun sa probinsya yung hindi ganoon kataas ang efficacy kasi yung handling niya eh mas kaya nila. SO parang meron nanamang inequality pagdating sa distribution. Yun lang naman po Sec. Galvez. Siguro maganda po na pagusapan at tignan natin kung papaano pa natin maeexpand itong pharma grade cold chain supply management natin. Moving on to another topic sa distribution and deployment, meron na ho ba tayong IT program na gagamitin para dito sa vaccination program?

Sec. Duque: May IT support para dito halimbawa yung QR code system for registration pero syempre ito po ay combination pa rin ng IT and in areas na medyo mahina ang internet connectivity ay hindi maiiwasan na gagamit pa rin tayo ng manual system.

SNBA: Secretary ang sunasabi ko pong IT program is if we have a war room kung saan, siguro may call center doon at may software tayo na pag kunyare may nagkaroon ng adverse effects sa Cebu, itatype lang nila yung code o whatever, magaappear na yung batch na yan, dito galing yan, yung nagdistribute niyan ganito, yung handling nyan. For me napakaimportante po ng paggamit natin ng technology. This is such a massive operation. Hindi po pupuwede dito yung di kamay at isusulat natin ang recoding natin sa papel. Kailangan po may pagka high tech yung operation din po natin. So meron ho ba tayong ganoong platform?

Sec. Duque: Yes ma'am. Sa kasalukuyan pinauunlad natin ang COVID electronic immunization registry kasama ang DICT tsaka po ang Knowledge Management Information Technology Service ng DOH.

SNBA: So meron na po pag tinanong namin sa inyo kung saan dinala yung Sinovac, san dinala yung Pfizer, ilan ang nabakunahan, tapos na ba ang per shot nila, due na ba sila sa second shot, maaaccess niyo ba lahat yan through th IT program?

Sec. Duque: Mayroon po tayong dashboard na isesetup para mamonitor naitn lahat from the entire distribution, yung end to end supply chain system at yung pong mga babakunahan from registration, counselling, screening, to actual vaccination and post vaccination monitoring and reporting. This will all be supported by an existing IT capacity bt we will continue to enhance.

SNBA: But at the moment secretary that setup is not yet available. Am I correct?

Sec. Duque: Yes ma'am

SNBA: So wala pa po. Magddry run tayo next week na hindi natin matetest yung setup in terms of technology?

Sec. Duque: Meron na po tayo next week. Maybe Sec. Galvez can do a more detailed...

Sec. Galvez: Yung command control system po natin, yung war room has been established since November 16. Nasa Aguinaldo po iyan. We setup the command system there, at nakacascade po yan sa regional and also the provincial. Yung atin pong national task force on COVID-19 nakasetup na po yan since March. Yun po ang gagamitin natin na communicaiton structure. Nandoon na po iyong mga dashboard at iyong tinatawag na communication lines para mas mabilis po ang reaction natin. The whole first floor of AFP Clubhose is occupied by NTIA so we have an extensive comman control war room sa Aguinaldo.

SNBA: So sa dry run niyo po, may computer na, tapos iinput niyo yung database? Ganoon po ba ang setup natin or sulat muna?

Sec. Galvez: Yes ma'am papakita po namin next week.

SNBA: Ok Secretary we will just wait for that. Balikan ko po yung vaccine procurement, at the moment lahat po ng vaccines worldwide EUA pa lang ang permit tama po ba?

Sec. Galvez: Yes ma'am

SNBA: Meron na po bang nagapply for commercial in other countries? Maybe DG Domingo would know.

Dir. Gen. Domingo: Wala pa po. Lahat po on going trials pa and all EUAs

SNBA: More or less kailan po natin makikita ang commercial authorization for the vaccines?

Dir. Gen. Domingo: Yung full completion po kasi ng trials is 1 to 2 years. Sa ngayon medyo matatapos na po yung first year. Ang pinakamaaga po siguro end of 2021 or middle of 2022.

SNBA: Thank you. Balik po tayo kay Sec. Galvez, sa isang interview niyo po nabanggit niyo na mukhang masmauuna ang Pfizer kesa sa Sinovac. Tama po ba?

Sec. Galvez: Kung ma aprubahan po ang aming appeal with COVAX there is a possibility ma'am and we are also negotiating diplomatically with AstraZeneca.

SNBA: And when will we know that?

Sec. Galvez: In February po

SNBA: Pero kailan nyo po makoconfirm na padating na yung Pfizer?

Sec. Galvez: There will be an evaluation this coming 18th to 29th this January. So the result of that will indicate when COVAX will be ready to deploy. Sa ngayon po ma'am hindi po natin alam kung anong time yung sa GAVI. Maybe we could ask sir Jimmy...

Dr. Jaime Montoya: The vaccines are being evaluated as the period was specified by secretary Galvez. We predict that after jan 29, it will be issuing the approval to the countries who applied and who complied with the requirements set by the COVAX facility. This would be incumbent with the... Of course the EUA has already been issued by the Philippine FDA so that has already been satisfied so we expect that the process would be fast and once the permits has been issued and the vaccine arrived through the normal process of inspection, this will be available to the target populations as perscribed by the DOH.

SNBA: More or less ilan po yung darating by February and sure na ho ba na Pfizer yung dadating kasi di ba sa COVAX facility its a mix of different vaccines.

Montoya: Your Honor, Doctora ____ who is part of the negotiating team can answer that question.

Dr. __: Mr. Chair the available vaccines available for the Philippines are Pfizer vaccines.

SNBA: More or less po ilang doses ang dadating initial by Feb?

Dr. __: Wala pong commitment ang COVAX at the moment pero they can only ship at the moment probably up to 50,000 in one shipping.

SNBA: Kunwari po maapprove na itong sa COVAX facility, may listahan na po ba tayo ng mga bibigyan natin? Do we have 50,000 names?

Sec. Galvez: Yung uunahin po muna is yung mga hospitals po natin.

SNBA: Nainform na po sila na they will be receiving the Pfizer vaccines?

Sec. Galvez: Yung last presentation po natin, we indicated na the possible COVAX vaccine will be Pfizer. And based on our priority, it would be the hospital institution.

SNBA: At ilan po yung macocover? More or less ilan po itong frontliners na ito?

Sec. Galvez: More or less 25,000 po if the first shipment is 50,000 because of 2 doses.

SNBA: So 25,000 frontliners po ang mabibigyan?

Sec. Galvez: I have to clarify that on going pa ang negotiations natin and it is not yet ano so we cannot speculate how much because...

SNBA: Pero secretary nabanggit ni doktora na they can only ship 50,000 doses at a given time.

Sec. Galvez: Yes. We have to wait for the decision of COVAX and GAVI on what the volume would be coming in and from there we will look at our prioritization matrix and we will see how many will be given with the vaccine. But for now we do not have the figures and the indicative date. There is still uncertainty.

SNBA: Pero kasi secretary hindi ba ho dapat, I think sa UK nagsesend out na sila ng primer about the vaccine na ituturok sa kanila. Wala ho ba tayong ganoong programa na iinform natin yung mga healthworkers natin na ito yung mga possible vaccines na iinjection sa inyo Pfizer, Sinovac, Novovac, and may preference ba kayo kung ano iinject sa inyo. Wala ho ba tayong ganoong information dissemination lalong lalo na sa ating mga frontliners? Ngayon pa lang kahit wala pa po yung bakuna?

Sec. Galvez: Actually, Ma'am, I believe last week nagkaroon po ng meeting si (DOH) Usec. Cabotaje with the different hospitals in NCR, and also our regional directors, I believe Ma'am na we already have the prioritization.

SNBA: Hindi po actually Secretary about prioritization eh. It's about informing them kung ano ang ituturok natin sa kanila. Mayroon po bang ganoong effort? I think, Mr. President, mayroon yata tayong invited from the Nurses Association, mayroon na ho bang ganoong effort on the part of the government to inform our frontliners kung ano ba ang vaccine na pwedeng iturok sa kanila.

Sec. Galvez: Yes, Ma'am, we have town-hall meetings with the doctors' associations and nurses. I've talked with them, and we have an information guide during our meeting yesterday. I already informed them what are the vaccines that will be coming in. Even our vaccine expert panel specified the different characteristics of these vaccines. And tomorrow, we will be having a town-hall meeting with the Philippine Nurses Association.

SNBA: And Secretary, ano po ang mga pine-present ninyong bakuna na pwedeng igamit sa kanila?

Sec. Galvez: We have the seven portfolio. We informed them that we have a portfolio of seven vaccines, and I presented that the first—the indicative date of the probability that Pfizer and also Sinovac, and maybe AstraZeneca, will be the first three vaccines that will be coming in in the Philippines.

SNBA: And what is the feedback? Kasi naririnig natin Secretary 'di ba, lalo na sa Sinovac, may dadating na 50,000 pero kung wala namang magpapaturok masasayang ang vaccine. Hindi po ba we want to avoid that?

Sec. Galvez: There are many feedbacks that many of our health workers are averse on some vaccine. But we told them that the selection we are making is based on science and the recommendation of vaccine experts. And I believe that because of some sort of perceptions and also coming from the media that there are certain misconceptions on certain products.

SNBA: Secretary Galvez, kayo na mismo nagsabi, 'di ba, based on science. Paano naman kayo nakapag-desisyon na bilhin ang Sinovac kung based on science when technically wala pa pong publication itong Sinovac?

Sec. Galvez: Ma'am, i've heard the vaccine expert ranking during our initial preparation for the evaluation and selection and also the negotiation. They submitted to me the list of the different vaccines, with different platforms. So they listed that the inactivated platform, which has been used for almost 260 years, is the safest among all the platforms, and next is the protein sub-unit, and after that, the virus...

SNBA: Pero Secretary Galvez, 'di ba in terms of use and advanced stage, hindi po ba mas logical na dapat AstraZeneca ang pinrioritize natin sa pag-procure ng bakuna?

Sec. Galvez: Actually, Ma'am, sila nga po ang una nating sinign-an. If you will remember that we have a tripartite agreement

SNBA: Pero that was not government money. That was private sector money.

Sec. Galvez: Yes. Actually, Ma'am, nauna naming ni-negotiate is Pfizer and AstraZeneca.

SNBA: Pero iyong Pfizer nga po through Covax pa eh, hindi pa diretso sa Pfizer, 'di ba?

Sec. Galvez: No, no. Our financing is our financing. Para maintindihan po ng mga tao, dalawang klase ng financing po ang Covax. Tinatawag nating Covax financing at saka iyong tinatawag na full financing at saka self-financing. What we are doing is a bilateral self-financing. So basically ang arrangement natin is a bilateral arrangement with the vaccine company.

SNBA: Pero Secretary, balikan lang natin iyong sa Sinovac at AstraZeneca. Well technically sa AstraZeneca po, walang national government funds ang ginamit natin to procure the 17 million, tama po ba?

Sec. Galvez: Ang arrangement po natin sa AstraZeneca is the vaccine will be procured by the business and LGUs.

SNBA: Secretary simple lang naman ang tanong ko eh. Was national government money used to procure AstraZeneca vaccine? Yes or no?

Sec. Galvez: No.

SNBA: None. Unlike sa Sinovac po na kahapon lang or the other day lang nag-apply ng EUA, we are using national government money, tama po ba?

Sec. Galvez: Ma'am, we have to look at the perspective of our portfolio. Nine-negotiate po natin iyan...

SNBA: Pero Secretary, 'di ba in the interest of speed, kasi nga ang gusto natin mabakunahan agad 'di ba, iyong AstraZeneca ang tagal na, nag-apply na 'to I think last December pa ng EUA nila, maraming bansa na ang gumagamit nitong AstraZeneca, pero hindi natin ito ginastusan ng national government money. Unlike iyong Sinovac po na wala pang, kaka-apply lang ng EUA, mababa ang efficacy rate kasi nga technically hindi pa tapos ang ano nila kaya wala pang publication about the vaccine, ito ginastusan na natin ng pera ng national government.

Sec. Galvez: Wala pa po, Ma'am, wala pa po tayong ginagastos sa lahat ng vaccines.

SNBA: May commitment na kayo.

Sec. Galvez: Market commitment.

SNBA: Pero Secretary, iyang commitment ba na yan pwede n'yo pang tanggalin?

Sec. Galvez: Ma'am the model now on the procurement of all vaccines is advanced market commitment.

SNBA: Iyon na nga. Hindi po ba ang advanced market commitment is considered goods sold already? Kumbaga done deal na yan, wala nang atrasan.

Sec. Galvez: No. Ma'am ito, para po malaman ninyo sa kontrata, may tatlong parte po iyan. Una, iyon pong tinatawag nating CDA. Iyong CDA is an agreement na kumbaga it's the non-disclosure of the secrets of the trade. Second is iyong tinatawag na term-sheet. Iyong term-sheet is iyong general terms, parang print-works to lock the supply. And then iyong supply agreement, nandoon po ang terms of payment at saka terms of ano po tayo. So sa atin pa lang po ngayon, we are dealing with the term-sheet, considering we have to lock so that they can already make production. So wala pa pong government fund tayong naibibigay.

SNBA: So technically, Secretary, pwedeng hindi pa rin tayo bumili ng Sinovac?

Sec. Galvez: Yes.

SNBA: And shift that fund to another vaccine?

Sec. Dizon: Madam Senator, if I may just try to summarize po the process of selection.

SNBA: Senate President, can the resource person just answer kung pwede pa bang hindi natin bilhin ang Sinovac? Iyon lang naman po ang tanong ko.

Sec. Dizon: The answer to that is yes, if the vaccine expert panel does not recommend a certain vaccine, then the Philippine government will not purchase and will not administer the vaccine. The choice of vaccine is heavily reliant on what the vaccine expert panel recommends. What Secretary Galvez is trying to say is that in the initial review of the vaccine expert panel, they recommended seven vaccines. This is why the vaccine cluster has included them in the portfolio for possible purchase and to administer the vaccine. These are the vaccines enumerated by Secretary Galvez earlier which initially includes Sinovac. Pero hindi pa po final ito. So hihintayin pa po natin ang vaccine expert panel final recommendation based on the phase 3 clinical trials and also the FDA issuance of the Emergency Use Authority.

SNBA: Siguro to wrap up lang, Mr. President. Ang apela ko lang naman po kina Sec. Galvez at sa decision-makers natin when it comes to the use, kung anong bakuna ang gagamitin, sana po isipin ninyo na magulang kayo ng bayan. Kasi 'di ba ho, Secretary, kapag isa kang magulang, you would always pick what's best for your children, lalong lalo na pagdating sa health nila. Sana ganoon ang mindset natin sa pipiliin natin, kung ano ang ituturok natin sa ating mga kababayan. Iyon lang naman Mr. President, maraming salamat.

Sec. Galvez: To answer the question of the Madam Senator, Ma'am, kung ano po ang recommendation ng vaccine expert natin —science-based— and it will be passed to the FDA. Kung ano po ang vaccine na unang mapupunta dito, I'm willing to have that and my family.