Tragic abandonment

"Studies have also shown that cancer patients who get COVID-19 are 16 times more likely to be in the severe and critical categories, the Cancer Coalition of the Philippines said."

In Wednesday’s Pre-Budget Briefing on the Department of Health’s (DOH) proposed 2021 budget conducted by the House of Representatives Committee on Health, Chairperson Rep. Angelina ‘Helen’ Tan exercised the committee’s oversight function and probed into the implementation and funding of the Universal Health Care Act, the National Integrated Cancer Control Act (NICCA) and other health legislation.

Responding to a query on the highest cause of deaths in the country, Health Secretary Francisco Duque III said that heart related disease was number one and the second is cancer. Yes, cancer is a leading cause of death and disability in the country that according to the University of the Philippines’ Institute of Human Genetics, National Institutes of Health kills four Filipinos every hour—96 lives lost every day!

Compare that with the country’s total death from COVID 19 which by DOH update as of this writing is at 4,108. In the same number of months, there would already have been 17,200 cancer deaths. Global figures are just as alarming.

When President Duterte signed into the law Republic Act 11218 (NICCA) in February last year, millions of cancer stakeholders were looking forward to an end to decades of struggle and frustration of the government’s neglect in addressing this disease. Thanks to great advances in innovative medicines, cancers of certain types should not be fatal with early detection and proper treatment.

NICCA is landmark health legislation that was virtually unanimously supported by both Houses of Congress, crafted through the collaboration of all cancer stakeholders to comprehensively address strategic gaps in the country’s cancer control program. Its programs will make quality cancer care and treatment more accessible and affordable. It aims to increase survivorship, reduce incidence, lessen mortality, morbidity and disabilities, and improve the well-being of patients, survivors, and their families.

This is another piece of great legislation, but so far, since the Implementing Rules and Regulations (IRR) were approved 12 months ago, there has been slow progress in its implementation. The all-important National Cancer Council mandated by the law to lead the implementation of its core programs has not even been organized.

This pandemic is most cruel to cancer patients. According to the recent statement of Cancer Coalition of the Philippines, cancer screening, cancer care and treatment has been disrupted due to non-availability of facilities or for fear of COVID-19 exposure. For the majority of cancer patients who lack financial capacity, treatments were discontinued because funding assistance were also halted. Another alarming development is a report of the Philippine Society of Medical Oncology that almost 74 percent of its members had cancer patients who either deteriorated or died because they were unable to seek urgent care in the hospital.

CCPh further stated: “This situation is now viewed by public health practitioners, oncologists and the cancer community both here and abroad, as a ‘ticking time bomb’ or a ‘shadow curve’ that has not yet been recognized, but could well lead to large increases in diagnosis of advanced cancers, progression of disease, deaths, unnecessary complications, and disabilities. Studies have also shown that patients with cancer who get COVID-19, are 16x more likely to be in the severe and critical categories.”

As convenor of CitizenWatch Philippines, we strongly support the call of CCPh’s appeal to legislators, “as mandated in the law, that a budgetary line item and adequate funding for the implementation of the programs under the NICCA be institutionalized in the Government Appropriations Act.”

The cancer stakeholders are asking for starter funds for the Cancer Assistance Fund (CAF) as the NICCA mandates and needs fast action now that the traditional sources of medical assistance for cancer patients such as the PCSO was discontinued.

Cognizant of the government’s priority to overcome this virus from Wuhan, this petition sensibly but urgently seeks support so that cancer patients can catch-up with urgent life-saving procedures and treatments.

Based on the proposed DOH budget, cancer stakeholders have reason to worry and the impetus to call out what I feel is a tragic abandonment of cancer patients and their families. There is no line item for the Cancer Assistance Fund, the DOH proposed budget for cancer access program is P137 million which would help only a nominal number of breast and childhood cancer patients.

In solidarity with the CCPh, we call our representatives in Congress, now exercising their power of the purse, to “again show your compassion and concern for cancer patients by ensuring that there are adequate funds allocated for full implementation of all the critical components of this law.”

DOH 2018 data reported 110,000 new cases diagnosed yearly and the death toll from cancer for both adults and children is about 66,000 Filipinos per year. We know that we must win this virus war first but at the very least, the appropriations for NICCA should be institutionalized in the GAA.