“Natural versus Chemical”
“Natural versus Chemical”
By Ramon Ike Villareal Señeres, CESO, CSEE
Manufacturers of herbal products are always very careful in saying that they are selling food items, and not medicines. That is actually true, but many of their products actually have therapeutic effects, even if they are required by law to say that they have NO APPROVED THERAPEUTIC EFFECTS. Much more than that, some of their products could actually already qualify to be labelled as herbal medicines or simply as medicines, except that they do not have the means to go through the process of validation and registration, unlike the big pharmaceutical companies.
In a country that has a population of about 100 million and a poverty rate of about 40%, it would be fair to say that half of the number of poor people, or about 20 million of our citizens are sick of one ailment or another, conditions that they could not cure due to their lack of access to affordable medicines. Since free medical consultation is available in most public hospitals, we could say that medical attention is not the problem of the poor. Their problem on the other hand is the need to sustain their dosages of medicines, a challenge that is very difficult for them to face, because they have other basic needs to spend on, such as food.
Fortunately for some of the poor people, they are able to get assistance from the Philippine Charity Sweepstakes Office (PCSO) and the Local Government Units (LGUs), thus enabling them somehow to buy their medicines in order to stay alive, literally. Given the number of poor people who are in need of medicines however, it is very difficult for the PCSO and the LGUs to help everyone with all of the medicines that they need. Since we are short of money in the face of this problem, we should be long on ideas in order to find the solutions, and one idea that is worth exploring is to go towards the direction of alternative health, coupled with the idea of also promoting preventive health.
“Knowledge is power” it is said, and “Health is wealth”, it is also said. Guided by these two pieces of wisdom, we should already take the basic step of promoting health information in every way that we could, utilizing every means of media communications that we could get our hands on. The promotion of health information is of course not a new idea, but it appears that we as a nation is not doing enough, in relation to the number of sick people around us who could possibly be cured, or at least get better simply by gaining access to health information that could change their medical condition even if they would not incur big expenses in doing so.
To the credit of many media organizations, there are already several radio and television programs that are promoting health information. In the overall analysis however, there is still a great imbalance between health programming and the other types of media content programming, not to mention the overdose of song and dance shows in our airwaves. Add to that the fact that there are still many other media outlets that are still relatively untapped for purposes of promoting health information, for example, movie screens, cable television, video streaming, outdoor displays and mobile phones.
The Human Development Index (HDI) of the United Nations Organization (UNO) monitors the mortality rate of member countries as a way of tracking their progress in delivering basic health services to their citizens. This appears to be a very realistic and practical measure, because it would be logical to say that the better the system of health services delivery is, the lower the mortality rate is going to be. This is of course premised on the fact that every member country would have its own national strategy of delivery, and it does not discount the inclusion of alternative health and preventive health as part of the delivery process.
I do not know how the Philippine government is gathering the national mortality rate data, but as far as I am concerned, the best approach for data gathering is from the ground and up, from local data that should be consolidated into national data. Following this approach, I believe that it should be the LGUs that should be collecting the data that should in turn be submitted to the National Economic Development Authority (NEDA) for consolidation. Any other data that is coming from anywhere and gathered any other way should not be considered valid and should even be suspected of being fabricated.
In much the same way that “all politics is local”, I would also say that “all data are local”. This should give us a clue to the question of how and where we should get the data to find out the 20 million or so sick Filipinos who are among us. As I see it, our national government agencies (NGAs) have the tendency to macroeconomic data that are not based on microeconomic data that are coming from below. The bottom line issue here is not just the integrity of the data, but also the ownership of the data. If the data sets are not coming from below, there are no local sources that would own the data and vouch for its integrity. Add to that the fact that the local owners of the data should also be responsible for changing it to make it truthfully better.
“Dynamic data” is a concept that our NGAs should adopt. What this means is that these agencies should not allow the content of the data sets to be “static”, in the sense that these would not change. This is the meaning of data ownership, meaning that they should not just report the data; they should also take the necessary steps to improve the data values, it being their responsibility to do so. Going back to the subject of the local mortality rate, the data owners could really reasonably target the lowering of the mortality rates in their own areas of jurisdiction, assuming of course that they would actually know what the real data values are.
For every data set, there is a corresponding data set that would in effect be its “opposite” values. In the case of the mortality rate, there should be a corresponding measurement of the longevity rate for instance. As far as I know, there is no system or method of gathering longevity rate data now, both in the local levels and at the national level. Needless to say, the methods for measuring the mortality rate and the longevity rate should be harmonized with each other, because in the final analysis, these two data sets are really just two sides of the same coin. In other words, we should be able to see longevity rate data whenever and wherever we see mortality rate data, but that does not seem to be the case now.
Under ideal circumstances, a cabinet level department of a democratic government is really supposed to be more of a policy maker, rather than a project manager. To some extent, a cabinet level department could also be a program developer, but the actual program management should normally be assigned to, or delegated to the line units down below. In other words, a cabinet level department is supposed to be a staff unit, policy making being essentially a staff function.
Still on the subject of differentiating between staff and line functions, NGAs are supposed to perform mainly staff functions, and LGUs are supposed to perform mainly line functions. Based on this differentiation, it would appear that as far as the delivery of health services is concerned, the Department of Health (DOH) should be performing the staff functions on one hand, and the LGUs should be performing the line functions on the other hand. If this differentiation is acceptable, it would support my proposition that the LGUs should be the ones gathering the mortality rate data from below, and the NGAs should be the ones consolidating and analyzing these at the top.
The function of policy making is very much closely associated with the function of standards setting. This is where the value of reliable and accurate national data comes into play, because in theory, the definition of national standards should be based on measurable and verifiable data. At this point, it is important to note that the exercise of standards setting is supposed to be part of the function of policy making. This cycle should actually turn into a full circle, because with good data gathered, good policies could be formed.
All factors considered, it could be said that devolving the function of managing the public hospitals from DOH to the LGUs was the right thing to do. This was also supposed to be a good idea, except that the DOH appears to have failed in setting the standards in measuring the standards of these devolved hospitals, thus resulting in a widespread lack of compliance. More often than not, the LGUs would reason out that they do not have the funds to maintain these hospitals, but generally speaking, that does not seem to be a valid explanation, because many LGUs have succeeded in maintaining their local hospitals with acceptable quality, despite their lack of financial resources.
As far as I know, there appears to be no system of reporting deaths and their causes from the hospitals to the DOH or to any other central authority. Firstly, this is not good, because it does not help in gathering accurate data for the mortality rate. Secondly, it does not help in reporting timely data for the detection of contagious diseases which may already reach epidemic proportions at certain times. The data from the hospitals should be supplemented by the data coming from the funeral parlors, but it seems that this is not being done either. At some point, the data may reach the National Statistics Office (NSO), but that data may no longer be current.
The bottom line in all of these is our collective inability to gather and report the mortality rate accurately. It would be fair to assume that if our local and national officials are faithful to the task of gathering both the mortality rate data and the longevity rate data, they would be in a better position to plan and implement our health policies, a function that would eventually lead to the question of whether health services are sufficiently delivered or not. This will also eventually lead to the economics of the health delivery process, as well as the sustainability of this delivery process.
In a country where about one fourth of the population are prospectively sick and could not afford to access the means to become well, the issue of health economics is indeed a major challenge, and there should be an urgent search for solutions by our local and national officials, solutions that should include “out of the box” ideas that would drastically change the statistics of affordability and sustainability. At this point however, I would like to stress that we are still dealing mainly with this problem at the policy level and not yet at the program and project level, lest I be accused of advocating a welfare state.
Not unless we start looking at “out of the box” solutions, we would forever be limited to the western and conventional approaches to medicine and health care, approaches that are generally dependent on commercial medications that are usually supported by chemical formulations. Of course, it could also be said that with the right economies of scale, chemically based medicines could potentially become affordable, but this is still a potential option that has to be subjected to more studies. In the meantime, there are natural and organic food based products that could potentially supplement if not supplant the chemical based products.
What is good to know is that many privately owned Filipino companies have already developed and produced several natural and organic products that could potentially be considered as affordable alternatives to western chemical based products, even if these local innovations could not yet be considered as real medicines with proven therapeutic values. Since these Filipino companies have already done their part in developing their products, it is now incumbent upon the national government to find ways and means of supporting them, in the true spirit of private and public partnership.
If the government is looking for ways to help Filipino companies with their products, the best place for them to start is in the product development process. For many of these companies, the product development process might have already ended, at least in their minds, but that should not be the case. Generally speaking, most of the Filipino made natural and organic products in the market are still incomplete in terms of branding, packaging and labelling, among other needs. More than all of these however, there is a need for the scientific testing and validation of their therapeutic claims, and this is where the government could help them most.
Most of the Filipino made products that are in the market today are being sold on the basis of narrative testimonials of satisfied users who supposedly got cured or became better one way or the other after consuming these products. This may be good enough for local purposes, but for international purposes, these products should all be subjected to “double blind” tests, a scientific method that is generally accepted and required by most importing countries.
I do not know the actual costs of conducting “double blind” tests as of now, but whatever the costs are, it should now become the priority of the government to subsidize these costs, perhaps under the leadership of the DOH. I understand the fact that the Food and Drug Administration (FDA) under the DOH is more of a regulatory agency, but in the national interest, the FDA could perhaps double up as a research and development agency for these purposes.
According to the Science Daily, “the double blind method is an important part of the scientific method, used to prevent research outcomes from being influenced by the placebo effect or observer bias”. The same source adds that “blinding is a basic tool to prevent conscious and unconscious bias in research”. According to the Experiment Source, “the groups studied, including the control, should not be aware of in which group they are placed. In medicine, when researchers are testing a new medicine, they ensure that the placebo looks, and tastes, the same as the actual medicine”.
The author is a broadcast journalist, syndicated columnist, political economist and computer technologist. He was formerly Director General of the National Computer Center and Chairman of the National Crime Information System
By Ramon Ike Villareal Señeres, CESO, CSEE
Manufacturers of herbal products are always very careful in saying that they are selling food items, and not medicines. That is actually true, but many of their products actually have therapeutic effects, even if they are required by law to say that they have NO APPROVED THERAPEUTIC EFFECTS. Much more than that, some of their products could actually already qualify to be labelled as herbal medicines or simply as medicines, except that they do not have the means to go through the process of validation and registration, unlike the big pharmaceutical companies.
In a country that has a population of about 100 million and a poverty rate of about 40%, it would be fair to say that half of the number of poor people, or about 20 million of our citizens are sick of one ailment or another, conditions that they could not cure due to their lack of access to affordable medicines. Since free medical consultation is available in most public hospitals, we could say that medical attention is not the problem of the poor. Their problem on the other hand is the need to sustain their dosages of medicines, a challenge that is very difficult for them to face, because they have other basic needs to spend on, such as food.
Fortunately for some of the poor people, they are able to get assistance from the Philippine Charity Sweepstakes Office (PCSO) and the Local Government Units (LGUs), thus enabling them somehow to buy their medicines in order to stay alive, literally. Given the number of poor people who are in need of medicines however, it is very difficult for the PCSO and the LGUs to help everyone with all of the medicines that they need. Since we are short of money in the face of this problem, we should be long on ideas in order to find the solutions, and one idea that is worth exploring is to go towards the direction of alternative health, coupled with the idea of also promoting preventive health.
“Knowledge is power” it is said, and “Health is wealth”, it is also said. Guided by these two pieces of wisdom, we should already take the basic step of promoting health information in every way that we could, utilizing every means of media communications that we could get our hands on. The promotion of health information is of course not a new idea, but it appears that we as a nation is not doing enough, in relation to the number of sick people around us who could possibly be cured, or at least get better simply by gaining access to health information that could change their medical condition even if they would not incur big expenses in doing so.
To the credit of many media organizations, there are already several radio and television programs that are promoting health information. In the overall analysis however, there is still a great imbalance between health programming and the other types of media content programming, not to mention the overdose of song and dance shows in our airwaves. Add to that the fact that there are still many other media outlets that are still relatively untapped for purposes of promoting health information, for example, movie screens, cable television, video streaming, outdoor displays and mobile phones.
The Human Development Index (HDI) of the United Nations Organization (UNO) monitors the mortality rate of member countries as a way of tracking their progress in delivering basic health services to their citizens. This appears to be a very realistic and practical measure, because it would be logical to say that the better the system of health services delivery is, the lower the mortality rate is going to be. This is of course premised on the fact that every member country would have its own national strategy of delivery, and it does not discount the inclusion of alternative health and preventive health as part of the delivery process.
I do not know how the Philippine government is gathering the national mortality rate data, but as far as I am concerned, the best approach for data gathering is from the ground and up, from local data that should be consolidated into national data. Following this approach, I believe that it should be the LGUs that should be collecting the data that should in turn be submitted to the National Economic Development Authority (NEDA) for consolidation. Any other data that is coming from anywhere and gathered any other way should not be considered valid and should even be suspected of being fabricated.
In much the same way that “all politics is local”, I would also say that “all data are local”. This should give us a clue to the question of how and where we should get the data to find out the 20 million or so sick Filipinos who are among us. As I see it, our national government agencies (NGAs) have the tendency to macroeconomic data that are not based on microeconomic data that are coming from below. The bottom line issue here is not just the integrity of the data, but also the ownership of the data. If the data sets are not coming from below, there are no local sources that would own the data and vouch for its integrity. Add to that the fact that the local owners of the data should also be responsible for changing it to make it truthfully better.
“Dynamic data” is a concept that our NGAs should adopt. What this means is that these agencies should not allow the content of the data sets to be “static”, in the sense that these would not change. This is the meaning of data ownership, meaning that they should not just report the data; they should also take the necessary steps to improve the data values, it being their responsibility to do so. Going back to the subject of the local mortality rate, the data owners could really reasonably target the lowering of the mortality rates in their own areas of jurisdiction, assuming of course that they would actually know what the real data values are.
For every data set, there is a corresponding data set that would in effect be its “opposite” values. In the case of the mortality rate, there should be a corresponding measurement of the longevity rate for instance. As far as I know, there is no system or method of gathering longevity rate data now, both in the local levels and at the national level. Needless to say, the methods for measuring the mortality rate and the longevity rate should be harmonized with each other, because in the final analysis, these two data sets are really just two sides of the same coin. In other words, we should be able to see longevity rate data whenever and wherever we see mortality rate data, but that does not seem to be the case now.
Under ideal circumstances, a cabinet level department of a democratic government is really supposed to be more of a policy maker, rather than a project manager. To some extent, a cabinet level department could also be a program developer, but the actual program management should normally be assigned to, or delegated to the line units down below. In other words, a cabinet level department is supposed to be a staff unit, policy making being essentially a staff function.
Still on the subject of differentiating between staff and line functions, NGAs are supposed to perform mainly staff functions, and LGUs are supposed to perform mainly line functions. Based on this differentiation, it would appear that as far as the delivery of health services is concerned, the Department of Health (DOH) should be performing the staff functions on one hand, and the LGUs should be performing the line functions on the other hand. If this differentiation is acceptable, it would support my proposition that the LGUs should be the ones gathering the mortality rate data from below, and the NGAs should be the ones consolidating and analyzing these at the top.
The function of policy making is very much closely associated with the function of standards setting. This is where the value of reliable and accurate national data comes into play, because in theory, the definition of national standards should be based on measurable and verifiable data. At this point, it is important to note that the exercise of standards setting is supposed to be part of the function of policy making. This cycle should actually turn into a full circle, because with good data gathered, good policies could be formed.
All factors considered, it could be said that devolving the function of managing the public hospitals from DOH to the LGUs was the right thing to do. This was also supposed to be a good idea, except that the DOH appears to have failed in setting the standards in measuring the standards of these devolved hospitals, thus resulting in a widespread lack of compliance. More often than not, the LGUs would reason out that they do not have the funds to maintain these hospitals, but generally speaking, that does not seem to be a valid explanation, because many LGUs have succeeded in maintaining their local hospitals with acceptable quality, despite their lack of financial resources.
As far as I know, there appears to be no system of reporting deaths and their causes from the hospitals to the DOH or to any other central authority. Firstly, this is not good, because it does not help in gathering accurate data for the mortality rate. Secondly, it does not help in reporting timely data for the detection of contagious diseases which may already reach epidemic proportions at certain times. The data from the hospitals should be supplemented by the data coming from the funeral parlors, but it seems that this is not being done either. At some point, the data may reach the National Statistics Office (NSO), but that data may no longer be current.
The bottom line in all of these is our collective inability to gather and report the mortality rate accurately. It would be fair to assume that if our local and national officials are faithful to the task of gathering both the mortality rate data and the longevity rate data, they would be in a better position to plan and implement our health policies, a function that would eventually lead to the question of whether health services are sufficiently delivered or not. This will also eventually lead to the economics of the health delivery process, as well as the sustainability of this delivery process.
In a country where about one fourth of the population are prospectively sick and could not afford to access the means to become well, the issue of health economics is indeed a major challenge, and there should be an urgent search for solutions by our local and national officials, solutions that should include “out of the box” ideas that would drastically change the statistics of affordability and sustainability. At this point however, I would like to stress that we are still dealing mainly with this problem at the policy level and not yet at the program and project level, lest I be accused of advocating a welfare state.
Not unless we start looking at “out of the box” solutions, we would forever be limited to the western and conventional approaches to medicine and health care, approaches that are generally dependent on commercial medications that are usually supported by chemical formulations. Of course, it could also be said that with the right economies of scale, chemically based medicines could potentially become affordable, but this is still a potential option that has to be subjected to more studies. In the meantime, there are natural and organic food based products that could potentially supplement if not supplant the chemical based products.
What is good to know is that many privately owned Filipino companies have already developed and produced several natural and organic products that could potentially be considered as affordable alternatives to western chemical based products, even if these local innovations could not yet be considered as real medicines with proven therapeutic values. Since these Filipino companies have already done their part in developing their products, it is now incumbent upon the national government to find ways and means of supporting them, in the true spirit of private and public partnership.
If the government is looking for ways to help Filipino companies with their products, the best place for them to start is in the product development process. For many of these companies, the product development process might have already ended, at least in their minds, but that should not be the case. Generally speaking, most of the Filipino made natural and organic products in the market are still incomplete in terms of branding, packaging and labelling, among other needs. More than all of these however, there is a need for the scientific testing and validation of their therapeutic claims, and this is where the government could help them most.
Most of the Filipino made products that are in the market today are being sold on the basis of narrative testimonials of satisfied users who supposedly got cured or became better one way or the other after consuming these products. This may be good enough for local purposes, but for international purposes, these products should all be subjected to “double blind” tests, a scientific method that is generally accepted and required by most importing countries.
I do not know the actual costs of conducting “double blind” tests as of now, but whatever the costs are, it should now become the priority of the government to subsidize these costs, perhaps under the leadership of the DOH. I understand the fact that the Food and Drug Administration (FDA) under the DOH is more of a regulatory agency, but in the national interest, the FDA could perhaps double up as a research and development agency for these purposes.
According to the Science Daily, “the double blind method is an important part of the scientific method, used to prevent research outcomes from being influenced by the placebo effect or observer bias”. The same source adds that “blinding is a basic tool to prevent conscious and unconscious bias in research”. According to the Experiment Source, “the groups studied, including the control, should not be aware of in which group they are placed. In medicine, when researchers are testing a new medicine, they ensure that the placebo looks, and tastes, the same as the actual medicine”.
The author is a broadcast journalist, syndicated columnist, political economist and computer technologist. He was formerly Director General of the National Computer Center and Chairman of the National Crime Information System
posted by Ike Señeres at 5:39 PM
0 Comments:
Post a Comment
<< Home