Mistrust in a broken health system

In light of the measles outbreak, the Department of Health (DOH) should stop blaming the parents for the now-declared epidemic. The DOH should instead be honest about its failures in the government’s vaccination programs over the past few years, as pointed out by civil society groups and international organizations such as the Unicef.

Repeated warnings over low vaccination rates and poor health service delivery show that this public health failure was waiting to happen, perhaps regardless of Dengvaxia.

The problem with the DOH’s attempt at public relations is that, to allay fears about Dengvaxia in the light of the measles epidemic, one has to restore the eroded trust not just in vaccination but in the broken health system.

And that involves three important things: (1) grounded and sensitive health education in all communities; (2) health services that are available, accessible, free, comprehensive and progressive; and, just as importantly, (3) accountability for failed policies—namely, the Dengvaxia fiasco in itself, as well as the shortcomings in vaccinations way before 2016.

The matter of vaccination should be a given in a society that promotes health as a right, meaning it should be readily available and free to those who need it the most, regardless of politics or economic standing.

Meanwhile, the health care workers, especially those in the front lines facing the brunt of the epidemic, and the DOH must help in adopting a stance that meets the people where they are, with acceptable and sensitive advice that does not disregard genuine concerns and fears as mere superstition or ignorance. Health workers should start where the community is, in order to begin mending the mistrust.

We must shy away from blaming parents for what may be legitimate grievances that stemmed from the inefficient and faulty mass vaccination program of Dengvaxia.

The risks that the vaccine may have in children not previously infected with dengue (seronegatives) are clear, yet the government remains mum on its responsibility toward the children who should not have been inoculated. The fear stoked by a lack of accountability cannot be quelled by diverting the issue away from the root cause of the alleged hysteria, especially when there have been gaps in achieving vaccine targets for several years.

Ultimately, servants of the people must ever be ready to accept criticism and be sincere in correcting past mistakes. We simultaneously continue our efforts in bringing health services to the communities, while calling on our health leaders to be more transparent and accountable in order to prevent yet another public health disaster.

JOSHUA L. SAN PEDRO, MD, coconvener, Coalition for People’s Right to Health, [email protected]