Folding to pressure

Except maybe for Viagra, very few drugs go beyond anecdotal lore when it comes to enhancing male performance. Indeed, the use of certain substances to change sexual behavior often owes much to superstition and urban legend.

Which is why it is sorely disappointing to learn that Health Secretary Janette Garin, a medical doctor, has succumbed to “misinterpretation and misinformation” from some quarters about the HPV vaccination program, and has decided to scrap the school-based preventive measure against cervical cancer.

The program involved making available for free to 300,000 public school children as young as 8 or 9 the expensive vaccine against HPV, the human papilloma virus linked to cervical cancer. But in the face of fears expressed by some quarters that the vaccine would promote promiscuity, the Department of Health abandoned the school-based program and will instead roll it out in the 20 poorest provinces of the country.

A laudable intention, certainly, but one pockmarked with questions on its premise, logic and consequences. For one, why should a woman of science fold under pressure from certain quarters that would overlook medically-proven health benefits for mere speculations on moral behavior? Of course, medical reports say that people get exposed to HPV through intimate or sexual contact. But to deliberately engage in risky promiscuous activities just because one is protected from HPV is to insult the moral character of the Filipino youth. And isn’t moral character more a function of upbringing, family values and environment, rather than complacency?

Yielding to pressure from certain quarters also feeds an insidious precedent: Lean hard enough and the government will likely fold, as Garin did. Wasn’t this how the bishops held the reproductive health bill hostage for 14 years, by dangling the unproven Catholic vote? Are the 2016 elections promoting compromise and turning spine to jelly?

The diversion of the vaccine program to the 20 poorest provinces also creates problems of logistics.

Will there be refrigeration in this often power-deprived provinces to keep the vaccines fresh and efficacious? The recent nationwide deworming program that landed some schoolchildren in hospital with abdominal pain, vomiting and diarrhea, is instructive. Proper dosage, storage practices and information on adverse effects might have been entirely absent, given the program’s sheer magnitude that makes monitoring and information dissemination difficult.

Authorities should consider as well the mindset of local officials in these underdeveloped areas. With the health and education secretaries themselves voicing reservations about the program despite their extensive exposure to science, why expect local officials and parents in these provinces to be more progressive and open-minded about it? The likelihood of greater resistance to the vaccines, fanned by moral fears from the Church, is all too real. What makes such resistance on moral grounds more tragic is the fact that girls and young women in these remote areas are more exposed to the possibility of rape and sexual abuse, often unreported for fear of lifelong stigma and loss of family honor. Why aren’t some quarters objecting to this type of violent sexual contact and promiscuity that are a harsh reality and everyday risk that girls and young women face in poor, unlighted provinces?

Targeting the 20 poorest provinces also presents unique challenges absent in a school-based setting. As Inquirer columnist Rina Jimenez-David noted, these include tracking the girls in their homes, getting their parents’ permission, bringing the girls to health centers (even more problematic if located in far-off areas), and keeping track of the subjects for their second and third shots.

Education Secretary Armin Luistro’s recent clarification that he “did not rule out the HPV vaccine program and had merely asked for more time to study it” provides scant comfort to the schoolgirls deprived of necessary protection from HPV. Luistro said some quarters, including medical groups, had raised questions on the efficacy of the vaccine, the expense involved (to be sourced from sin taxes) and whether other, more common diseases deserve greater attention and funding.

But consider the statistics: Next to breast cancer, cervical cancer is the most common cancer killer of Filipino women. As many as 12 women a day die from it, when it could have been prevented. How much more “common” and “deserving of attention and funding” should a disease be before the health and education departments take decisive action?