Highlights of the sponsorship of the DOH budget
Senator Pia S. Cayetano
Senior Vice Chairperson, Finance Committee

Note: responses to the questions of Sen. Risa Hontiveros

ON VACCINE INVENTORY, WASTAGE

On vaccine inventory, the total number of doses received is 250.38 million. The total number of doses administered is 171.20 million. And the reported wastage is... 31.3 million. And that is 12 percent of the total, which I will add is within the allowed percentage of wastage. But of course, this does not mean that just because this is in the allowed percentage, that DOH is not striving to improve that number, your honor.

XXX

One of the reasons for the expiration was because some of the COVAX-funded vaccines that we received really had a short lifespan, so totoong may ganun hong pangyayari.

And then, there were also those that were subjected to natural disasters; subjected to temperature excursion. And then there were those na hindi na pwede gamitin, hindi nagamit kasi nga temperature and discoloration and presence of particulate matter, and there is such a thing as underdosing and empty vials, because di ba multiple doses? So they try na sunod-sunod, but there will be instances na hindi nagagamit lahat yun. So all of that contributed to the wastage.

XXX

VACCINE WASTAGE THRESHOLD

For Covax, they have initially given a number which is 10 percent. But from experience, WHO found that the reality is, in low-income, middle-income, and even high-income countries, the wastage rates went up to 30%. So there was then a statement made by WHO that up to 25% is acceptable. I don't think it's meant to be an excuse. But it's just showing the trends and realities. And the reason why I want to put on record the reasons, it's partly because of the reality that there is vaccine hesitancy.

XXX

The 12% wastage cost is estimated. And the reason why I have to emphasize "estimated" is because even the DOH does not know the cost because these were procured through an NDA - non-disclosure agreement. So based on an estimate of P500 per dose, the cost is P15.6 billion.

XXX

HOW MANY EXPIRED VACCINES WERE REPLACED

Mr President, there are 300,000 doses of Covax vaccines that were requested to be exchanged and they have been exchanged.

XXX

Just for the record din, para fair lang din ang narrative natin, we also have a lot of donated vaccines. And as recipients, wala naman tayo control kung malapit na mag-expire yun but they will also fall under our inventory. So may ganun din. Especially in the early days, we didn't say no to donations. But I also recall, because I also received so many calls from businessmen volunteering to give to our city in Taguig and in fairness to my brother there, Mayor Lino Cayetano, very efficient ang rollout niya ng vaccine so talagang hindi na namin kailangan pero andami-daming nag-donate. So may ganun din tayong kasama sa figures. They did not order those vaccines naman but that forms part of the inventory, your honor.

XXX

PASSAGE OF THE CDC BILL, LIFTING OF STATE OF PUBLIC HEALTH EMERGENCY

The Secretary updates me that the CDC [Center for Disease Control and Prevention] bill has passed in the House of Representatives. As the Senate President acknowledged, this representation will handle the hearings and eventually the defense of the same bill when we finish our budget debates.

But what's important about that bill is it includes provisions that authorize DOH and CDC, which we will eventually create, despite the absence of the declaration of a state of calamity, to do what is necessary. This would include the purchase of vaccines, and whatever else is necessary to address the health needs. So that bill is very important.

PROCURING BIVALENT VACCINES

Obviously we still have inventory [of the current vaccines]. But proceeds of the loan worth P3.4 billion will be available to purchase 5 million doses of the bivalent vaccines already. And then COVAX committed for 2023 that they could give out bivalent vaccines also. There are also proceeds of loans that are available for ADB and World Bank for 2023. So they're pretty much set as the need arises.

XXX

They are confident that they have sufficient funding for the purchase of COVID vaccines, including the new bivalent vaccines. And I need to emphasize, because I was familiar with this information, during the last two years or so, precisely why Sec. Dominguez wanted to fund vaccines through loans because the interest rates were very low. These were very good terms. So I remember when I was defending the same budget, the concern was people need to see we funded it, but talaga hong maganda ang terms ng loan na ito kaya we are now able to use the proceeds of that loan.

XXX

The game plan is to purchase by tranches because again, they are very mindful of wastage. So we need to also see what is the uptake of the vaccines. So itong 5 million [bivalent vaccine doses] nila will cover health workers and senior citizens, maybe some immunocompromised people and from there, they will see. This is just my personal opinion. When people feel confident about it, hindi sila masyado excited magpa-vaccine. So probably nga ang tatlong sektor na binanggit natin, yan ang medyo masigasig na magpapabakuna.

XXX

To be clear, in terms of the budget, that number was a response to the budgetary question... They are quite confident that those are the sectors that will be interested in availing. And evidence-based, talagang sila naman ang tatamaan. As to the general plan, again it will be evidence-based. If there is a new variant that appears to affect the population. But based on the trends in the past, ganun pa rin... Ganun naman ho ang rollout nun. So evidence-based, they will update us and secure the vaccines as necessary.