Partnering for the People
Practical Partnerships for the Pandemic Series
by Kaitlyn Magtoto and Lea Molina
As the pandemic ravages on, there is a continued need for discourse on how to advance efforts to beat the COVID-19 pandemic and its consequences. In partnership with Optum-UnitedHealth Group, Asia Society Philippines launched “Practical Partnerships for the Pandemic,” a series of online conversations on how the public and private sectors can join forces to deal with the global crisis. Panels were composed of guests from the private and public sectors, who shared their on-the-ground experiences on what works in various aspects. Most importantly, they provided insights on what can be done better to hasten our public health and socioeconomic recovery.
For Large-Scale Vaccination: Government and the Private Sector Together (26 May 2021)
The first episode “For Large-Scale Vaccination: Government and the Private Sector Together,” moderated by Health Systems specialist Dr. Albert Domingo, gathered a panel with Mayor Marcelino "Marcy" Teodoro of Marikina City; Dr. Beverly “Bev” Lorraine Ho, MD, MPH, concurrent Director IV of the Health Promotion Bureau at the Department of Health; Rommel T. Juan, President and Chief Executive Officer of Binalot Fiesta Foods; and Rebecca "Bec" Richmond, Director of Optum UK Advisory Services.
Dr. Domingo opened the discussion by posing questions to Dr. Ho, Mayor Teodoro, and Rommel Juan, regarding the progress of the vaccination program in their areas of work and circles of influence. “We recognize the way the structure of the government is: National government-enabled, LGU-led, people-centric response,” said Dr. Ho, as she asserted that much of the work lies with the Local Government Units (LGU). She also highlighted an often overlooked factor in the program. “The operations and implementation of the vaccination program is what’s really costing money: HR costs, Operations costs for the likes of water, electricity, supplies, etc.” Mayor Marcy pointed out that the process of vaccination needs to be simplified. “The solution is already present in the system, we should simply remind ourselves to exercise the process. It’s a question of logistics, of having the capacity for a number of people to be vaccinated. The problem of the LGUs is also in the availability of the vaccines.” In the case of the private sector, Juan shared his experiences from dealing with his employees, “I did a survey for our people, siguro mga 30-40% lang are willing to be vaccinated.” To dispel some fears and apprehensions, he shared, “What I did was I made a personal campaign, I got my vaccine early, and made a video for our people why they should get vaccinated.”
In order to move forward, Mayor Teodoro asserted the need for a whole-community approach, “We need to be commonsensical and pragmatic in our approach. We should listen to our people. In the case of Marikina for example, it’s not a case of wanting to be vaccinated, as there is an abundant number of people who are willing. The problem is in the regulation on the prioritization of inoculation.” He boldly suggested simplifying the categorization to two: those who want to be vaccinated, and those who don’t want to be vaccinated. With this, more people will be vaccinated, and herd immunity will be achieved in the earliest possible time. Juan agreed with his sentiments and said, “If the people are willing to get vaccinated already, let’s make it as easy as possible for them-- the vaccination centers should be everywhere per barangay, not just in one mega vaccination center where it piles up.” However, Dr. Ho pointed out that equity and fairness must also be valued, simultaneously with the value of wanting to reach faster herd immunity. Bec Richmond agreed, “I think segmentation has to be the key. There are going to be groups who are at risk, much more significantly than others. I think looking at age demographics is an easy way to segment data. It’s not perfect, but I’m mindful that some data or analytics isn’t always consistent to the point in terms of supply chain as well.”
The key takeaway in this episode was Richmond's sharing of some factors on how a successful public campaign can be achieved if the government and private sectors bridge the gap between them. “I would summarize it as one thing: a willingness to break barriers in three key areas. First, sharing risk to enable innovation. There must be a willingness to push forward, have a shared level of comfort with one another, to enable things like overlapping trials. Second, there must be a willingness to share data to allow us to paint a more accurate picture of the community, to understand those who might be reluctant, and those who need to be protected. Third, a willingness to share infrastructure, sites, and even manufacturing capabilities.” Indeed, there is a great need to break down barriers between the public and private sectors, to hasten the response to public health and put a stop to this global crisis.
Watch Episode 1 below:
Hurdles to Large-Scale Vaccination by Local Governments (2 June 2021)
The logistics of vaccine rollout adds a significant layer to the COVID-19 response in the Philippines. Cities and localities in the country greatly vary in terms of access to technology, infrastructure, and even cold storage. This was the main focus of the second episode of this PPP series, entitled “Hurdles to Large Scale Vaccinations in Local Governments,” in collaboration with Synergeia Foundation, with the local governments sharing how they are responding to the crisis. The main speaker was Rebecca “Bec” Richmond, Director of Optum UK Advisory Services; and it was moderated by Atty. Darwin Mariano, UnitedHealth Group’s Vice President for External Affairs in the Philippines, and an Asia Society Asia 21 Fellow.
They were joined by Dr. Christia Padolina, City Health Officer of Navotas City and shared the best practices of Navotas City regarding their COVID-19 pandemic response. She enumerated the process they employed in the city in combating mis- and disinformation, as well as how they divided the team. Mayor Ralph Lantion of Bayombong, Nueva Vizcaya also came live on screen, as he happily shared how his municipality managed to have zero COVID cases over the Christmas holiday season. Both city officials pointed out that the LGUs have systems in place and are ready to inoculate the population, but the problem, they say, is in the availability of vaccines.
Richmond's presented on the various hurdles faced by government units, as studied and researched by Optum. She identified a total of 10 hurdles that need to be addressed, with 3 main categories. Namely, Local Coordination Hurdles, Resource Constraint Hurdles, and Community Willingness Hurdles. Each of the 10 points had corresponding questions that aimed to be points for reflection and catapults for action. One of the striking things she mentioned was how the UK has been successful in their COVID-19 response, “I think the major cause has been the success of the vaccination program in combination with the lockdowns. But also, it was making sure that the most vulnerable had support available to them, that they had the things they needed to be able to stay at home. Nonetheless, I think the defining factor was the speed of the vaccination program.”
Watch Episode 2 below:
The Digital Dose Needed for Vaccination (16 June 2021)
The final session of the PPP series “The Digital Dose Needed for Vaccination,” included distinguished guests: Hon. Risa Hontiveros, Senator of the Republic of the Philippines; Dr. Ted Herbosa, Special Adviser, National Task Force against COVID-19; Richard Bon Moya, National Technology Officer, Microsoft Philippines; Dr. John Hitt, Evidence-based Medicine Implementation and Senior National Director, OptumCare; and Dr. La Shonda Cobbs, Director of COVID-19 Services, OptumServe. Dr. Albert Domingo was back to moderate this final episode, which focused on lessons learned from vaccine service delivery and rollout.
The conversation began with Dr. Herbosa providing the current vaccination rollout status of the Philippines - with 10 million doses delivered since the start of the rollout in March. The vaccination has ramped up by seeing a million doses, on average, per week administered; and further plans to administer 140 million doses by the end of November. Notably, he adds that stalled projects and programs such as the Vaccine Self- Sufficiency Project and e-Health Framework Strategy and Plan, both initiated during his time as Health Secretary but was impeded by succeeding administrations, would have greatly helped in the current challenge in database management for the vaccine rollout.
Corollary, Sen. Hontiveros reported that the Senate has set up policy frameworks considering the urgency in the short term to equip the executive branch in swiftly and effectively responding to the pandemic. One of these is Republic Act 11525, An Act Establishing the Coronavirus Disease Vaccination Program which provides for a national COVID-19 roadmap, and national deployment and vaccination plan for COVID-19 vaccines. She echoes Dr. Herbosa that programs that enable biological production service that manufactures vaccines locally would help the vaccine rollout in its supply chain. As such, she ensures that during the sunset review of the pandemic strategy, such programs will be revisited, revived, and get its necessary funding.
There has been a general perception that the vaccine rollout has been slow, Dr. Herbosa shares that “[Only] the people who want to paint the perception that we are really slow are saying that.” He also explains that the pace has improved and will continue to improve. Sen. Hontiveros politely responded that she saw no problem in perceiving the vaccination rollout as slow, especially considering their oversight function in the Senate which requires them to take into account actual and existing on ground conditions. She however, reaffirms Dr. Herbosa’s assurance of the commitment of ramping up vaccine rollout until the end of the year.
The slow rollout has also been attributed to the vaccine hesitancy of priority groups and the general population - because of information, or its lack thereof; concerns on vaccine efficacy; and, on a broader scale of implementation, logistics.
Dr. Hitt notes that this can be addressed by addressing layers of information for people. People must appreciate the disease and its severity considering that COVID-19 is invisible to the majority of the population. This means that information of knowns and not knowns should be transparent including the severity of the disease and the risks for the population of healthy people and those with comorbid conditions.
On measuring vaccine efficacy, Dr. Hitt shares that vaccines are tested in different playing fields in clinical trials; and this playing field has also changed because of the variants of COVID-19 that have been found.
Dr. Hitt highlights that a great consideration for the Philippines must also be in its logistical planning considering its geography - being an archipelago. Thus, it’s supply chain must accommodate this fact and a consideration of the supply chain requirements of vaccines must be made. Such that certain vaccines like Pfizer require a cold chain.
Dr. Cobbs adds that a requisite for bridging the government and the private sector is always partnership. This comes hand in hand with Availability of vaccines, supplementary supplies, other resources, and human resources; Accessibility; Acceptability; Affordability; and Communication.
Lastly, adding to the programs digital dose Mr. Moya notes that a framework for a system or implementation, whether or not centralized, must be established that allows for interoperability. Where he says “at the very minimum the data can be centralized.”
Mr. Moya highlights that while there are missing pieces in policy infrastructure to support digital solutions, its implementation is not impossible. First, data standards must be agreed by all stakeholders and need to be implemented; and a structural and institutional approach must be established. The establishment of a strong digital platform will allow a more efficient response for future health disasters or crises such as the COVID-19 pandemic.
Watch Episode 3 below: