THE CHILDREN IN OUR MIDST

There is a running debate in many development countries whether access to health services should be considered as a “right” or as a “benefit” that should be only optionally provided by the government. I think that the basis for answering this question would vary from country to country, but here in the Philippines, I think that this question should be answered locally and not nationally, because just like in the global scene, the answer would depend on each locality, to “give or not to give”. As you might have guessed by now, there is no universal rule that governs the answer to the given question, and that is why the policies would vary even in countries that are located close to each other, such as the United States and Canada.

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Notwithstanding the diversity in the making of health policies everywhere however, I think that a specific exception should be made in the case of child vaccination, since the impact or side effects to them would extend to their entire lifetimes if and when they are not vaccinated in their youth. In other words, this is not an option, because in the long run, it could be a matter of life and death for these children as they grow older. As usual, the discussion about this, as in any other development issue will turn to the question of money, and this is where I am going to offer some suggestions.

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According to the General Appropriations Act (GAA), 20% of the Internal Revenue Allocations (IRAs) and health is listed as one of the priorities. Understandably, there are other priorities, such as education. In the case of education however, some Local Government Units (LGUs) are able to generate additional funding through the Educational Support Fund (ESF), since the law allows them to allocate a portion of their earnings from real property taxes for educational purposes. With or without the ESF however, health competes with education when it comes to the allocation of scarce resources, along with other expense areas such as infrastructure and public safety (police, jail and fire services).

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First things first, I think that the first thing that our government should do is to benchmark the overall challenge of vaccination, defining early on what types of vaccines should be included in the first place. As part of benchmarking, the government (both local and national) should build databases for this specific purpose, i.e. for the purpose of vaccinating children from birth up to a certain age limit. Not that I am trying to pre-judge the government for what it can do and what it could not do, but as a sign of good faith, it should already start building the databases.

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In theory, the health and social work functions have already been devolved to the LGUs. What this means is that the Department of Health (DOH) and the Department of Social Work & Development (DSWD) are now supposed to be just policy makers and capability builders only as far as these two functions are concerned. Between the DOH and the DSWD however, which of them are ultimately responsible and accountable for achieving vaccination targets? If neither of them is directly accountable, should it be the LGUs then that should pledge to these targets?

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Once these benchmarks and targets are set, the next step that these LGUs should take is to set their sustainable targets, considering their available resources and known limitations. Nowadays, the issue of sustainability always seems to be taken for granted. Actually, the first logical step towards sustainability is attainability. If it could not be attained, it could not be sustained. It goes without saying that before it could be attained, it should be “afforded”. If the LGUs could not afford it, then they could not even attain it. It’s just as simple as that. In real terms, affordability and sustainability should really go in hand, because the LGUs should only set the volume targets that they could achieve in the short run, and eventually sustain in the long run.

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In the English language, a jail is a jail, but strictly speaking, an “inmate” in a city jail is not a prisoner. Only the “inmates” in the national jails are the real prisoners, because they are the ones who have already been convicted. With this in mind, I wonder why our LGUs could not put up dormitories that would house child offenders, instead of mixing them in with the adults. Why does it have to take a CNN story to wake up our LGU officials about this problem? Is this problem not in our national consciousness, so much so that we would need a foreign news network to push us to move? In Makati City, the city government immediately takes custody of “accused” children, so that they will no longer be detained. This is a very practical approach that should be copied by all the other LGUs, to protect the children in our midst