Just do it at DOH

You must forgive this scientific-amateur, deadline-frazzled journalist. There was an error in yesterday’s column on the purported “dengue/malaria” cure that is but the latest issue being raised against Health Secretary Enrique Ona.

In that column on the withdrawal of authorization for the clinical trials being conducted on human test subjects on the efficacy of “ActRx TriAct,” a drug that combines three herbal concoctions to reportedly fight both dengue and malaria, I said that malaria “is caused by bacteria.”

In reaction, Dr. Tony Leachon, who is an internist and cardiologist by training but who is a former “P1 a year” consultant to the Department of Health on noncommunicable diseases (and as such was one of the leading lights in the campaign for the passage of the Sin Tax Law), writes that I got the cause of malaria wrong. “Malaria is caused by a parasite—a protozoa known as plasmodium with species carried by a vector known as Anopheles mosquito,” Leachon says, adding that dengue, on the other hand, is caused by a virus carried by a mosquito known as Aedes egypti.

When I brought up this contrast between the two diseases that ActRx TriAct purports to cure, Dr. Jovencio Ordonia, an authority on herbal medications, said there is no contradiction since the combination of the three ingredients—berberine, artemether and artesunate—“has both anti-viral and anti-bacterial qualities.” Ordonia disclaims any direct link to Preferred and Proven Therapies Inc., the company behind the new medicine, but he once headed (before retirement from the Department of Health) the Philippine Institute of Traditional and Alternative Healthcare. He is thus a “champion” of alternative and traditional (that is to say, indigenous and ancient) therapies, which he claims are still resorted to by ordinary Filipinos, and quite common in many areas of the Philippines, including “the immediate area surrounding the Philippine General Hospital.”

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WHAT current DOH officials, including Acting Health Secretary Janette Garin, are apparently alarmed about in the ActRx TriAct controversy is the speed with which it was approved for human trials, which usually begin only after clearing extensive lab tests and testing on animals.

But Ordonia says that in testing done among 288 human test subjects in San Lazaro Hospital, the 288 patients all recovered from dengue.

As Ordonia tells it, the manufacturers of ActRx TriAct, based in the United States, were thinking of starting human trials in Latin America when a friend of theirs, former senator Heherson Alvarez, heard about it. It was Alvarez who convinced the manufacturers to move the human trials to the Philippines, says Ordonia, arguing that dengue and malaria are major diseases in the country. (Dengue is counted among the top 10 causes of death in the Philippines, with more than 62,000 cases recorded from January to August in 2010.)

It’s not quite clear how Preferred and Proven Therapies Inc., the local company overseeing the trials of ActRx TriAct and headed by Alvarez’s son, managed to win DOH support for its trials, conducted earlier in Palawan (for malaria) before the studies were transferred to San Lazaro and, reportedly, other public hospitals. Secretary Ona has yet to formally issue an explanation after the story was carried by the media.

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THE ActRx TriAct controversy is but one of many other issues being raised against Secretary Ona, who is on “extended leave” from the DOH.

The explanation first given to the public for Ona’s temporary departure from the Cabinet was that he needed time to recover from an allergy to hair dye. (When I met him recently and asked about his allergy, Ona merely snorted in reply.)

Then Malacañang itself came up with a more cogent explanation: Ona was allowed to go on leave to find the time to come up with an explanation for his role in the controversial choice of a pneumococcal vaccine from two types currently available. Recently, that leave was extended, which perhaps means Ona needed more time to pull his data together.

Reportedly, the ambassadors of the countries where the biggest suppliers of the two competing pneumococcal vaccines come from (GSK from the United Kingdom which manufactures PCV7, and Pfizer from the United States which manufactures PCV13) made approaches to Malacañang protesting the waffling and fence-sitting among health authorities who should decide what type of pneumococcal vaccine to purchase. The National Bureau of Investigation is looking into the case.

Already, so we’re told, DOH officials have been either transferred from the department or their authority severely curtailed. Among the casualties: Dr. Eric Tayag, the “dancing” official who used his high-media profile to promote health awareness on communicable diseases, who reportedly simply “went back” to his old status of director, although he has also lost his media-celebrity status; and Undersecretary Dr. Teodoro Herbosa, who has been ordered to “return” to UP Manila from where he was plucked by Secretary Ona to assist at the DOH.

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AS A “wallflower” at this dance of power and authority at the DOH, one can only watch in wonder as accusations and recriminations fly thick and fast.

Meanwhile, we are facing many serious health issues, the people’s vulnerability to disasters—and the many health problems that arise from them, from malnutrition to depression, maternal health to respiratory infections—being only a part of the overall challenge.

The President, we are told, had long been aware of the problems among his people at the DOH, but one must ask what took him so long to finally act on them. As the late health secretary and senator Johnny Flavier put it, “Let’s DOH it!”