NBIprobingDOHsP800-Mpneumoniavaccinepurchase

by Leandro DD Coronel
November 10, 2014
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President Aquino has ordered the Department of Justice (DOJ) to look into the alleged
anomalous procurement of over P800-million pneumonia vaccine by the Department of Health
in 2012, which was approved by on-leave Health Secretary Enrique Ona.
Justice Secretary Leila de Lima yesterday confirmed that the DOJ, through the National Bureau
of Investigation (NBI), has been conducting a discreet probe since June, immediately after
President Aquino ordered her to investigate the reports of concerned stakeholders over the
questionable purchases of pneumoccocal conjugate vaccine (PCV 10) in 2012.
The vaccine was intended for the pulmonary diseases of the poor children.
But De Lima admitted that the NBIs investigation has been hampered by the refusal of some
DOH officials to cooperate.
They were given a run around [by the DOH officials]. So I told them, you better do an open
investigation already so they can officially issue subpoenas to shed light on the matter, the
Justice Secretary said. I think certain sectors went straight to the president and complain about
it, and the president assigned it to me.
Among those who were placed under NBI investigation were Ona and DOH Assistant Secretary
Eric Tayag.
De Lima said the NBI- Anti Graft Division is set to subpoena Ona, Tayag, and several other
DOH officials to shed light on the matter.
In the complaint, the stakeholders alleged that the DOH approved the purchase of 1 million
pieces of PCV 10 vaccine in 2012 despite the recommendation of the National Center for
Pharmaceutical Access and Management (NCPAM), the Formulary Executive Council (FEC)
and the World Health Organization (WHO) which recommended PCV 13 which is said to be
more cost-effective.
Based on the 2012 annual procurement plan of the DOH, the total cost of the vaccine bought by
the Health Department through the United Nations Childrens Fund (UNICEF) was P833, 670,
642. 20.
According to the information we received, the BAC (bids and awards committee) of the DOH
has already prepared for the procurement of PCV 13 and they already have the certificate of
provisional exemption because that is a requirement but all of a sudden, the stakeholders
claimed that Asec. Tayag instead ordered the procurement of PCV 10, De Lima said.
De Lima added that the stakeholders were wondering why Sec. Ona issued a certificate of
exemption for PCV 10 instead for the cost-effective PCV 13.
Ona was earlier forced to go on leave after President Aquino ordered him to fully explain some
questions pertaining to the DOHs vaccination program.
Aquino said he has questions for Ona, specifically about the governments vaccination
campaign, and the balance between preventive and curative aspects of public health.
But, Ona said he asked for a four week leave that started October 28 for personal and health
reasons.
Undersecretary Janette Garin has been designated as officer-in-charge of the department.
Garin said Ona had to go on sick leave because prescription medication has been ineffective in
controlling his severe reaction to hair dye.

NOT TRUE that PCV13 is more cost effective than PCV10.

Consider these:
1. For invasive diseases like meningitis & bacteremia both are 94% effective
2. For all causes of pneumonia - PCV10 = 23% ::: PCV13 = 25%
3. For all causes of Acute Otitis Media - PCV10 = 34% ::: PCV13 = 8%
It becomes obvious then, since >95% of those who will receive vaccination will be
children, that the superior effectiveness of PCV10 for all causes of Acute Otitis Media
(very common ear infection in children) will make PCV10 more cost effective contrary to
what the bulong-bulong con sipsip brigade is telling PNoy. The brigade apparently wants
these 2 health officials out, especially Dr. Eric Tayag who has made enemies by his
streamlining the procurement process. Nako ha!! pati ba naman yang vaccine
hinahaluan pa nang bulong-bulong con sipsip. Pwede bah, let us for a moment think
about health without politics!

http://www.mb.com.ph/nbi-probing-dohs-p800-m-pneumonia-vaccine-purchase/

NBI probes Ona, DOH over vaccine procurement

Justice Secretary Leila de Lima cites reports that the initially discreet investigation being
conducted by her agency is one of the reasons Health Secretary Enrique Ona has gone on
leave
Rappler.com
Published 4:48 PM, Nov 10, 2014
Updated 4:48 PM, Nov 10, 2014

File/Rappler
MANILA, Philippines The National Bureau of Investigation (NBI) is conducting an investigation
into the procurement by the Department of Health (DOH) of vaccines in 2012, Justice Secretary
Leila de Lima said Monday, November 10.

The case involves the procurement of 1 million units of Pneumococcal Conjugate Vaccine 10
(PCV 10) a vaccine used for immunization of infants and children against pulmonary diseases
worth over P833 million.

The investigation stemmed from complaints from "certain sectors" who went straight to the
Office of the President, De Lima said.

The complainants alleged that the DOH procured PCV 10 vaccines instead of a "more costeffective" vaccine, the PCV 13.

The procurement was said to have been "directed" by Assistant Secretary Eric Tayag, and
"made possible by a certificate of exemption issued" by Secretary Enrique Ona in 2012.

It was made "contrary to the recommendation of the National Center for Pharmaceutical Access
and Management (NCPAM), the Formulary Executive Council (FEC) and the World Health
Organization (WHO)," De Lima quoted the complainants.

She said the President assigned the case to the Department of Justic last June, and the NBI
was instructed to do a "discreet investigation" into the matter. This, however, proved tricky, after
the investigating team wasn't able to access documents and were given the runaround by some
DOH offices.

The investigation, the justice chief said, is now an "open investigation" so that subpoenas can
be issued. The NBI's Anti Graft Division is set to issue subpoenas to Ona, Tayag, and other
DOH officials.

A progress report on the discreet probe was given to her office Friday, November 7, she said.

Those involved in the anomalous transaction could face both criminal and administrative cases,
De Lima said.

"We are fast-tracking [the probe] because, based on reports, that's one of the reasons for
Secretary Ona being on leave now," she added.

Ona is currently on leave, initially reported as a "sick leave," which fueled speculation that he is
on his way out as health secretary.

President Aquino later said that his top health official went on leave so Ona could "prepare"
answers to questions on the government's vaccination program, and the balance between
preventive and curative aspects of public health.

Undersecretary Janette Garin is currently officer-in-charge of the Department. Rappler.com

http://www.rappler.com/nation/74597-nbi-probe-ona-doh-vaccines

Pinabulaanan ng Malakanyang na hinusgahan na ni Pangulong Noynoy Aquino si Health

Secretary Enrique Ona sa harap ng iniutos nitong imbestigasyon sa umano'y
maanomalyang programa sa bakuna ng kagawaran.
Paliwanag ni Deputy Presidential Spokesperson Abigail Valte, hindi porke't
pinaiimbestigahan ng Pangulo ang proyekto ay duda na ang Pangulo sa kaniyang
kalihim.
Pagkakataon aniya ang imbestigasyon para ihanda ni Ona ang tugon nito sa mga
alegasyon.
"If you recall, this is not the first time that the President has asked an investigation not
specifically on the person but on a particular incident. Remember, the President also
gave instructions for the MRT incident and the President does this just to ascertain the
facts at hand," sabi pa ni Valte.
Nakadepende aniya sa mga magiging sagot ni Ona kung aalisin ba ito ng Pangulo sa
pwesto.
Isang buwan ang hiningi ng kalihim para makapagpaliwanag.
Batay sa pahayag ni Justice Secretary Leila De Lima, mas pinili ng DOH ang pagbili ng
Pneumococcal Conjugate Vaccine 10 (PCV 10) na bakuna lang para sa bata imbes na
PCV13 na siyang inirekomenda ng National Center for Pharmaceutical Access and
Management (NCPAM), Formulary Executive Council (FEC) at World Health
Organization (WHO) dahil puwede ito sa bata at sa matatanda.
Sinasabing nabahiran ng katiwalian ang pagbili ng pambakuna.
Pero sa pahayag na inilabas ni Ona, sinabi nitong nagkakahalaga ng US$15.40 PCV 10
noong 2012 habang ang US$16.34 naman ang PCV 13.
Hirit ni Ona: paanong magkakaroon ng graft kung US$1 lang naman ang pagkakaiba ng
presyo ng dalawa.
"We assure the public of the DOH's strict adherence to transparency, integrity, and
honesty to all government transactions especially to the motto of 'Daang Matuwid.' Our

review committee will leave no stone unturned," dagdag pa ng kalihim sa kaniyang

pahayag.
http://dzmm.abscbnnews.com/news/National/Palasyo,_itinangging_hinusgahan_na_si_Ona_sa_vaccine
_anomaly.html

Iniimbestigahan na ng NBI at DOH ang umanoy anomalya sa pagbili ng Pneumoccal

Conjugate Vaccine 10 o PCV 10 noong 2012.
Sinabi ni Justice Secretary Leila de Lima na mismong ang Pangulong Noynoy Aquino
ang nag-utos na imbestigahan ang nasabing usapin.
Ayon kay De Lima, may basbas ni Assistant Secretary Eric Tayag ang naturang
pagbili ng DOH ng PCV 10 at nagpalabas pa si Secretary Enrique Ona ng certificate
of exemption para sa nasabing procurement.
Taliwas aniya ang kinalabasan ng procurement sa rekomendasyon ng National
Center for Pharmaceutical Access and Management, Formulary Executive Council at
World Health Organization na PCV 13 ang bilhin dahil mas mabisa ito.
Ipinabatid ni De Lima na nagkaroon na sila ng discreet investigation sa usapin na
tila mabagal dahil sa pagtanggi ng mga kinauukulang tanggapan na maglabas ng
dokumento at November 7 pa aniya sila nakapagsumite ng progress report hinggil
dito.
http://www.dwiz882.com/2/news/national/36287/imbestigasyon-sa-umanoyvaccine-anomaly-ng-doh-gumugulong-na/?
PHPSESSID=fdc31cb3023b2e914ee5943b65db2879
MANILA, Philippines - Health Secretary Enrique Ona on Tuesday broke his silence on
the controversial issue surrounding the multi-million-peso procurement of the PCV10 or
pneumococcal vaccine by the Department of Health.
In a statement, Ona said he had formed a technical working group to investigate the
issue even before he went on leave on October 28.
He said the technical working group, composed of four current and former employees of
the DOH, is expected to finish its investigation before November 28, or when his leave
expires.
Ona said that apart from the recommendation of the World Health Organization and the
DOHs National Pharmaceutical Access and Management, the technical working group
was tasked with recording the chronology of events regarding the procurement of the
vaccine.

The vaccine, worth P833.6 million, was part of the expanded vaccination program of the
DOH.
Explaining the need to buy the vaccine, he said that 13 out of 100,000 children aged one
to five years old are dying because of pneumonia.
In parting, he said they will abide by the findings of the National Bureau of Investigation
and the Department of Justice.
Meanwhile, DOH spokesman Dr. Lyndon Lee-Suy said it is normal in the procurement
process for the Health secretary, as vested with the authority, to revise the specifications
of medicines the DOH will procure if he sees that it will be advantageous to more people.
Lee-Suy appealed to the public not to pre-judge Ona as well as DOH Assistant Secretary
Erik Tayag before the investigation is finished.
Tayag is still the Assistant Secretary, but the DOH may permit him to go on leave, in
case he asks for one.
Lee-Suy said this will be the last statement of the DOH regarding the anomalies it is
allegedly involved in.
http://www.interaksyon.com/article/99022/doh-chief-breaks-silence-on-controversialvaccine-procurement

DOH conducts internal probe over anomalous P833-M med

purchase
MANILA, PhilippinesThe Department of Health (DOH) formed an
independent review committee to probe the allegedly anomalous procurement
of pneumococcal vaccines in 2012 which involved health secretary Enrique
Ona and Assistant secretary Enrique Tayag.
In a statement released Tuesday, Ona said that the department adheres to the
Aquino administrations Daang Matuwid.
We assure the public of the DOHs strict adherence to transparency, integrity,
and honesty to all government transactions especially to the motto of Daang
Matuwid. Our review committee will leave no stone unturned, Ona said.
The health secretary explained that the first-time procurement of the
pneumococcal conjugate vaccine (PCV) 10 in 2012 cost P833.6 million under
the Expanded Vaccination Program of the DOH. The nationwide vaccination
program is said to benefit 330,000 children.

Health Secretary Enrique Ona. AFP FILE PHOTO

Ona said that the PCV 10 vaccines which the department procured are
cheaper over PCV 13 vaccines, which was recommended by the National
Center for Pharmaceutical Access and Management (NCPAM), the
Formulatory Executive Council (FEC), and the World Health Organization
(WHO).
In 2012, the unit cost for PCV-10 was US$ 15.40, while that of PCV-13 was
US$16.34, or a cost difference of almost $ 1.00, the health secretary added.
Meanwhile, the health secretary lamented that the usual medical discussion
on the two vaccines was marred with allegations of graft.
It is in the appreciation of the cost effectiveness of these two competing
vaccines for Filipino children that usual medical discussion and differences is
being presumed to have been tinged with graft, Ona said.
The NCPAM, FEC, and WHO lodged a complaint before the Office of the
President over the health departments decision to purchase PCV 10 over
PCV 13.
The complainants assailed DOH for choosing PCV 10 which has a limited
coverage of diseases that could be treated.
The Department of Justice and the National Bureau of Investigation are at the
helm of the investigation on the alleged anomalous medicine purchase.
The vaccines were targeted for children afflicted with pneumonia, meningitis,
sinusitis, bronchitis, among other pulmonary diseases.

Read more: http://newsinfo.inquirer.net/650126/doh-conducts-

internal-probe-over-anomalous-p833-m-medpurchase#ixzz3IrTmVZRB
Ona, Tayag probed over vaccine mess
The Philippine Star
1 day ago
Provided by The Philippine Star
Officially on leave and rumored to be on the way out of the Cabinet, Health
Secretary Enrique Ona is under investigation for a questionable procurement
of vaccines worth P833 million in 2012. Also being investigated for the same
possible anomaly is Assistant Secretary Eric Tayag.
This was confirmed yesterday by Justice Secretary Leila de Lima, who said
that President Aquino ordered the probe after receiving complaints from
concerned stakeholders and relevant bodies.
She did not identify the groups that reported the alleged irregularity to the
President.
The National Bureau of Investigation (NBI) has started the probe, De Lima
said.
Ona is on a month-long leave, supposedly while recuperating from an allergic
reaction to hair dye.
The STAR could not reach Ona and Tayag for comment.
We will cooperate fully with the NBI by providing all the documents that
they need, Department of Health (DOH) spokesman Lyndon Lee Suy said in
an interview.
He declined to comment further, saying they have not yet received official
communication from the NBI.
At Malacaang, deputy presidential spokesperson Abigail Valte said Ona
would have enough time to explain his side.
Secretary Ona was given time to answer questions that were propounded
by the President. He was given a month. Lets allow him the time to put the
answers being asked of him, Valte said in an interview. Lets give him time
to come up with explanations about the questions that were propounded to
him.
De Lima said the complaints against Ona and Tayag stemmed from their
approval of the purchase of Pneumococcal Conjugate Vaccine 10 (PCV 10) a

vaccine for pulmonary diseases for children despite recommendations from

the National Center for Pharmaceutical Access and Management, Formulary
Executive Council and the World Health Organization (WHO) that PCV 13 was
more suitable and cost effective.
Cost effective in the sense that PCV 13 covers more diseases unlike PCV 10,
which has limited coverage, she explained.
A check with the DOH website showed that the project was worth over P833
million.
De Lima said the Bids and Awards Committee was prepared to procure PCV
13, but all of a sudden, as alleged, the procurement of PCV 10 was instead
ordered by Asec. Tayag.
It also appears that the certificate of exemption a requirement for the
procurement was issued by Sec. Ona for PCV 10. That was what the
relevant bodies questioned, De Lima pointed out.
She said the bureau might look into both administrative and criminal aspects
of the questionable transaction.
Administratively, the President has disciplinary authority over presidential
appointees. In the criminal aspect, if there is violation or irregularity that can
fall under the Anti-Graft and Corrupt Practices Act and within the jurisdiction
of the ombudsman, she said.
The justice secretary said the NBI actually started a discreet probe last June,
but encountered difficulty in gathering information reportedly due to lack of
cooperation from certain health officials.
They were given a runaround, so I told them to better open the
investigation so they could officially issue subpoena on DOH officials to
further shed light on the issue, she added.
Ona has reportedly displeased President Aquino over several other issues,
including the officials requests for P600 million for the rehabilitation and
renovation of the Research Institute of Tropical Medicine, and P1 billion for
the same work on the state-run Dr. Jose Fabella Memorial Hospital.
The President had also frowned upon Onas request that he and an
undersecretary be issued a P3-million Toyota Land Cruiser and a Toyota Hilux.
The official was also said to have earned the ire of Aquino after he pushed
through with the inauguration of a medical facility in northern Luzon despite

the Chief Executives canceling the event at the last minute. Sheila
Crisostomo, Alexis Romero

12
WHO position paper on pneumococcal vaccines 2012
Summary
The current WHO position paper, which focuses mainly on the 10valent and 13-valent pneumococcal conjugate vaccines (PCVs),
replaces the 2007 position paper on 7-valent PCV.
The position paper on 23-valent pneumococcal polysaccharide
vaccine published in 2008 remains valid in the absence of any new
evidence that would require a change in recommendations. (Some
still valid key recommendations on the use of PPV23 are included
in the current document).
Infections caused by Streptococcus pneumoniae (the
pneumococcus) include serious diseases such as meningitis,
bacteremia, and pneumonia as well as less severe conditions such
as sinusitis and otitis media. Pneumococci are usually transmitted
through respiratory droplets from the nasopharynx, particularly
from infants and young children. S. pneumoniae includes >90
serotypes. In the pre-vaccination era, 6 11 of these serotypes
accounted for 70% of all invasive pneumococcal disease
worldwide. The WHO estimates that in 2008, out of the about 8.8
million global annual deaths amongst children aged <5 years, 476
000 (333 000 529 000) were caused by pneumococcal infections.
In developing countries case-fatality rates among younger infants
may reach 20% for pneumococcal septicemia and 50% for
meningitis. Currently marketed pneumococcal vaccines include
one polysaccharide vaccine (PPV23) and two conjugate vaccines
(PCV10 and PCV13). The 7-valent conjugate vaccine (PCV7) is
gradually being removed from the market. Pneumococcal
polysaccharide vaccines are safe, but poorly immunogenicity in
infants <24 months of age and fail to induce an anamnestic
antibody response. To enhance immune esponses selected
polysaccharide serotype-antigens are conjugated with various
protein carriers; PCV10 includes serotypes 1, 4, 5, 6B, 7F, 9V, 14,
18C, 19F and 23F, whereas PCV13 in addition includes serotypes 3,

6A, and 19A. Licensure both of PCV10 and PCV13 was based on
non-inferiority trials as compared to the well documented
protective efficacy of PCV7 and a related PCV9-formulation. PCV10
and PCV13 are licensed for the prevention of invasive disease,
pneumonia and acute otitis media caused by the respective
vaccine serotypes in children from 6 weeks to 5 years of age. In
addition, PCV13 is licensed for the prevention of pnumococcal
disease in adults aged 50 years. Recent reviews of randomized,
controlled trials of PCV7 and PCV9 have shown vaccine efficacies
(VEs) against invasive pneumococcal disease of 71% and 93%,
respectively, following 3 primary doses or 3 primary plus a booster
dose. For radiologically confirmed pneumonia (first episode), the
estimated VE for 3 primary doses was 24%. Based on the
immunogenicity data, PCV10 and PCV13 show comparable VEs for
serotypes contained in the vaccines. The immunogenicity and
reactogenicity of the involved antigens are shown not