MeTA 17: CHAT General Assembly, March 2014

Last March 14, 2014, the Coalition for Health Advocacy and Transparency (CHAT) held its General Assembly this year at Dolce Latte Restaurant, Quezon City. Minimal Government Thinkers is among the original charter members of CHAT when a Civil Society Mapping was held in January 2009 at Diamond Hotel in Manila, two days before the 3-days MeTA National Forum, same venue.

CHAT is an alliance of health-focused civil society organizations (CSOs), people's organizations and public policy research organizations or think tanks (including IBON Foundation and MG Thinkers) that works with the Medicines Transparency Alliance (MeTA) Philippines as its civil society partner. It is a big coalition as some member organizations are themselves alliances or coalitions of their own. Like AGAP (Ayos na Gamot sa Abot-kayang Presyo) and 3CPNet (Cut the Cost, Cut the Pain Network).

The first speaker was Dr. Virgie Ala, former DOH-NCPAM Director, and she gave a health situationer of the country. I came late that day and was lucky to catch perhaps the second half of her presentation. Second speaker was Atty. Paula "Pau" Tanqueing of AGAP and she discussed various activities that  CHAT and its member organizations have undertaken, 

Ms. Cecile Sison of Philippine HealthWatch Initiatives, also of MeTA Philippines, discussed the covenant of CHAT. Then nice lunch. 

It was a working lunch, participants were paired and we discussed and suggested steps the alliance can take to re-engage and strengthen its role and advocacies, facilitated by Dr. Elmer Soriano. I did not speak during the open foru, and I did not stay long, after lunch I headed to the airport to catch my flight for Cebu City. I was going to give a talk at the University of San Carlos (USC) the next day about government price control and mandatory discounts for medicines policies. See Drug Price Control 39: Presentation at USC, Cebu, March 2014.

Despite some disagreement on certain health policies with some key members of CHAT, I like the coalition. I am the "odd-man out" in most cases for advocating less government (but not zero government) intervention in many health policies, while majority of member-NGOs support more government involvement. Still, members learn to tolerate such divergence in ideas.

Photo credit: Ian Nuevo of MeTA Philippines Secretariat.

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See also:
Health Transparency 13: MeTA International Visit to Manila, April 16, 2013
Health Transparency 14: IMS-CHAT Meeting, April 18, 2013, Friday, July 12, 2013 
MeTA 15: Forum 2014 on Healthcare Ethics and Transparency, January 30, 2014 

MeTA 16: Day 1 of Conference 2014, February 11, 2014 

Drug Price Control 35: DOH Procurement Price and Lobbying for Another Price Coercion, June 29, 2013 

UHC 19: Health is a Right, Health is a Responsibility, September 19, 2013

Health Transparency 14: IMS-CHAT Meeting

The Coalition for Health Advocacy and Transparency (CHAT) is the umbrella organization of health and research NGOs and think tanks that gathered during the Medicines Transparency Alliance (MeTA)-sponsored CSOs Mapping in January 2009. Many of the health NGOs there are coalition themselves of other community and sectoral organizations. CHAT is affiliated with MeTA Philippines and is considered the civil society arm or partner of the latter.

Last week, April 12, 2013, the International MeTA Secretariat (IMS) had a half day meeting with NGO leaders that composed CHAT. About one-half of the organizations within CHAT were represented, good attendance. The IMS were composed of Tim Reed, Executive Director of Health Action International (HAI), Ms. Renee Vasbiner, Administrative Coordinator of MeTA Secretariat, also of HAI, and Ms. Deirdre Dimancesco. Technical Officer of Medicines, Access and Rational Use, Department of Essential Medicines and Health Products, WHO Geneva HQ. 

CHAT was led by former Bulacan Gov. Roberto "Obet" Pagdanganan and Cecile Sison of HealthWatch. Gov. Obet and Cecile are also the Chairman and Secretary General of MeTA Philippines, respectively. The big coalitions within CHAT are the Ayos na Gamot sa Abot-kayang Presyo (AGAP, or good medicines at affordable price), Cut the Cost Cut the Pain Network (3CPNet) and Medical Action Group (MAG), Woman Health, Health Action Information Network (HAIN) and COPAP, the organization of senior citizens. Everyone was given the floor to introduce themselves and the NGOs that they represent, what they do and who are their main constituency.

I introduced Minimal Government Thinkers, Inc. as an independent think tank advocating free market, less government, personal responsibility and rule of law. Our constituency are individuals and groups here and abroad, who read about any free market reforms in the country and in this case, in healthcare policies.

So we have some big NGOs and coalition of NGOs themselves that played very active roles in the enactment of the Cheaper Medicines Law of 2008 or RA 9502, groups and individuals that supported major amendments to the Intellectual Property Code (IPC) of the Philippines like institutionalizing compulsory licensing (CL) of certain patented medicines. And MG Thinkers that advocate respecting IPR as much as possible. So CHAT is a loose coalition and members recognize that.

One advantage, members say, is that there is wide range of discourse and policy options to choose when we discuss certain issues, so they benefit from such diversity of opinions and observations. But one disadvantage is that it is difficult to come up with a consensus stand or statement on some issues, like I advocate less government while many want more government involvement in healthcare. Or possible disagreement in the possible TRIPS Plus provision in the soon to be negotiated EU-Philippines Free Trade Agreement (FTA).

At this point, I spoke. I said that MG Thinkers' involvement in CHAT was a bit interesting. Many if not all of the groups that attended the CSO Mapping workshop were known groups in the IPR debate before RA 9502 was enacted into law. And I was not with them as I was writing many articles defending IPR and my articles were published in many countries like the US, UK, India, Malaysia, Singapore, Philippines, and even in some Arab countries, published in Arabic, courtesy of MG's international free market network.

That when Ms. Klara Tisocki, then of the EU and now with WHO Western Pacific Regional Office (WPRO) invited me to attend the CSO Mapping workshop in January 2009, she has read my name and my articles, and she must have wanted diversity, not monotony, of ideas among CSOs. Klara played a key role in the MeTA formation in the Philippines. And so CHAT was designed to have diversity, to allow some looseness in the umbrella organization. 

On the issue of IPR and medicines, Tim Reed of HAI showed a youtube video produced by HAI Global, about the "EU zoombies" as a result of EU insistence that stronger IPR protection on patented medicines be adopted in various EU negotiations for FTA with different countries.

Then some organization matters were discussed, like key activities for CHAT.

Last April 08, Monday or four days before the meeting with IMS, CHAT also held an internal meeting about issues to discuss. We devise a Strengths, Weaknesses, Opportunities, Threats (SWOT) analysis of CHAT. The matrix was shown and discussed by Atty. Paula "Pau" Tanguieng of AGAP. Good presentation, Pau.

It was a good meeting with the IMS, food was nice too.

I keep writing about these meetings and events as many CHAT and MeTA members tell me that although they may not agree with many of my ideas, they still look forward to my analysis, stories and photos. Just one proof that diversity is preferable to monotony. :-)

Cheers guys.
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See also:
Health Transparency 10: Depoliticizing Health, Corporatizing Government Hospitals, September 18, 2012
Health Transparency 11: MeTA Philippines and Multistakeholder Process, September 19, 2012 
Health Transparency 12: MeTA Philippines Dynamism, October 02, 2012 
Health Transparency 13: MeTA International Visit to Manila, April 16, 2013

Free Trade 27: Proposed EU-PH FTA and TRIPS Plus

Free trade and intellectual property rights (IPR), these are among my favorite topics to discuss and debate. Here are my latest papers on these subjects,

Free Trade 26: "Buy Local" and Protectionism, June 24, 2012
On IPR Abolition 17: Copyright by a Government Corporation, September 02, 2012
IPR and Medicines 24: Balancing Costly Innovation and Cheaper Drugs, March 20, 2012

The Department of Trade and Industry (DTI) called for a public consultation on “One Country One Voice” (OVOC) regarding the proposed EU-Philippines Free Trade Agreement (FTA) on September 20, 2012. I read about the invitation last September 13 and quickly confirmed my attendance.

Fearing that such proposed FTA might contradict certain provisions of the Cheaper Medicines Law of 2008 or RA 9502, a joint statement was released by MeTA Philippines, Coalition for Health Advocacy and Transparency (CHAT), Ayos na Gamot sa Abot-kayang Presyo (AGAP) and the Fair Trade Alliance (FTA). Below are screen shots of portions of the eight-pages position paper. I checked the websites/blog of AGAP, FTA and MeTA, it’s not posted there.

Below are the exchanges we have the past few days. Copy-pasting them with no alteration, so pardon our French and whatever typo errors, just showing the raw exchanges. I am adding some photos of the event that day.

A bit long, about 17 pages including images/photos, so grab your favorite snacky and enjoy the ride.

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September 20-21, 2012:

Hi Pau,

I am sorry that I did not read the attached paper on the joint position of Meta-CHAT-FTA on this issue. I saw this during the MeTA meeting yesterday as Gov Obet presented this. I spoke and commented that the conclusions seem to be an over-reaction to the IPR issue on medicines. Why?

I am not a lawyer but my understanding is that a national legislation like RA 9502 which deals with amending the IP Code on medicines has supremacy over whatever treaty that the Senate and the Executive branch may enter into any country or block of countries. In this case, should it be true that the proposed EU-PH FTA will have provisions extending  patents of drugs, I don't think it will have supremacy over RA 9502 and hence, can not be implemented.

My feeling is that whatever TRIPS Plus provisions will apply to other sectors -- patents on softwares and cell phone applications, see the fight between Samsung and Apple for instance; copyrights on music and movies, see the rampant counterfeiting of DVDs, albums, etc.; or trademark infringement on the brand and logo of huge companies. I read in some newspapers how some individuals caught stealing and using the trademark of other companies so they can sell their copycats at high price. Even Kumon, the tutorial school, its logo and trademark is being stolen by some entities and they too teach "kumon education" and charge the same rate but pay zero royalties to the original brand, and their style may just be a bogus and inferior.

I still have to see the actual document, even in its draft form, of the proposed PH-EU FTA pertaining to medicines. As Daisy Cembrano of GSK said yesterday, after RA 9502, the innovator companies have practically ceded many of their IPRs in the country.

Drug Price Control 28: On Cong. Biron and Sen. Villar Bills

Last June 29, 2012, the Coalition for Health Advocacy and Transparency (CHAT) held a meeting-discussion at the PRRM building, Quezon City, on three issues:

1. legislative bills amending the Cheaper Medicines Law (RA 9502) by creating a drug price regulations board,

2. update on the bill raising the excise tax on tobacco and alcohol products ("sin tax bill"),

3. discussions on the proposed Milk Code, other matters.

The meeting was moderated by Atty. Pau Tanquieng of the Ayos na Gamot sa Abot Kayang Presyo (AGAP), the biggest coalition within CHAT. She also presented the three bills creating the drug price regulations board, as well as Sen. Legarda's peculiar bill amending the amendments to the Intellectual Property Code (IPC) contained in RA 9502.

After the discussions, Pau as convenor/moderator, asked, "Anyone here supports drug price control?" Anyone supports the creation of a drug price control regulation board?"

None said Yes, meaning everyone who attended the meeting, including CHAT President, Gov. Obet Pagdanganan has NO as answer to the above questions by Pau. Since she has already written the AGAP position on the same subject, she begged off to write the draft position paper of CHAT. No one else volunteered to do it, so I did. Here's the draft that I wrote, posted in our googlegroups last July 03, 2012.
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Draft Statement by CHAT

On the Proposed Amendments to the Cheaper Medicines Law

The Cheaper Medicines Law of 2008 or RA 9502 is still a new law and there are several indicators that so far, it has succeeded not only in bringing down medicine prices but also in making more essential drugs become more available in more drug outlets nationwide. There are other provisions of the law that are not activated yet and which, when seriously implemented, will further bring down drug prices, The main challenge therefore, for the implementing agencies and various stakeholders in the Philippine healthcare sector, is how to carefully implement those provisions.

There are several bills in both the House of Representatives and the Senate though, that aim to amend certain sections of RA 9502, foremost of which is the creation of a new agency, the Drug Price Regulations (or Regulatory) Board (DPRB). These are HB 1386 by Cong. Ferjenel Biron, and SB 5 by Sen. Loren Legarda and SB 2960 by Sen. Manny Villar.

We believe that the proposed amendments of (a) expanding the drug price control policy made in August 2009, and (b) creating a new office or bureaucracy that will implement such expanded policy, are not necessary at the moment for the following reasons.

One, even before the drug price control policy was made in August 2009, average prices of essential medicines have been declining due to more competition among various drug manufacturers and among more drugstores and pharmacies.

Two, the policy benefited the rich and upper middle class patients who would be buying those branded innovator drugs whether their original price was retained or was slashed by half. Many of the 21 drug molecules that were covered by the policy have cheaper, off-patent competing drugs already available. The poor were patronizing the off-patent drugs which are still cheaper than branded innovator drugs even if their prices were slashed by half.

Three, the policy has contradicted the goals the Generics Act of 1988 or RA 6675. That law was successful in promoting cheaper generics, off-patent drugs to the public. The drug price control policy however, encouraged the people to shift back to the branded innovator drugs made by multinational pharmaceutical companies as their prices were made 50 percent cheaper.

Four, the policy has adversely affected many local generic manufacturers, some of which were forced to close, or pull out some of their drugs since their prices were already low enough. After the mandatory 50 percent price cut by the innovator drugs, they were forced to either make further price cuts which affected their profitability, or simply close shop even temporarily.

As a result, the policy has introduced business uncertainty especially among local generic drug manufacturers. The threat of being forced out of the market by the unfair price competition by the foreign pharmaceutical companies due to drug price control will remain.

Five, creating the DPRB will only add another layer of bureaucracy in the government, which will require another set of budgetary allocation each year. Right now, the DOH Advisory Council on RA 9502 is doing fine monitoring the implementation of the law including the drug price regulation or control policy.

Six, there is a danger that corrupt government officials who will head that board might use their powers to extort money from existing players, otherwise their profitable drug products will be put under price regulation list.

In lieu of those twin moves, we propose the following.