Throughout the company’s 125 years of global operations, and since it established its presence in the Philippines in 1995, MSD has been delivering health solutions to Filipinos, backed by pioneering research to advance the prevention and treatment of various health diseases through vaccination against life-threatening infections like HPV, Pneumonia, Measles, and Rota-Virus; treatment for cancer, cardio-metabolic diseases, and anti-microbial resistance.

Maternal mortality is one of the many problems that MSD in the Philippines sees as a threat to the health and well-being not only of mothers, but also for their families and community. Through MSD for Mothers, the company engages in collaborative initiatives to improve maternal health. MSD for Mothers also partnered with the Zuellig Family Foundation (ZFF) to improve maternal care in 20 Geographically Isolated and Disadvantaged Areas (GIDAs) in Samar and Northern Samar provinces through the program dubbed “MSD for Mothers and ZFF Community Health Partnership: The Joint Initiative”.

The principle of “Inventing for Life” also takes into consideration the dignity and well-being of the patient. Through the Hope from Within (HFW), a multi-stakeholder cancer advocacy campaign, MSD aimed to raise awareness and strengthen the fight against the disease through education about early testing and new treatments such as Immunotherapy.“We are continually pushing the boundaries of science with the hope and expectation that the medicines and vaccines we invent will lead to better health for society for generations to come”, shared Dr. Beaver Tamesis, MSD in the Philippines President and Managing Director.

“We are constantly reinventing the way we reach out to patients, healthcare professionals and other stakeholders, as we aim to meet them where they are at the moment- the challenges and issues that matter.”

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MSD has been fully committed to developing an effective response to the COVID-19 pandemic since it was first recognized. Cognizant of the fact that success will require global collaboration among countries and companies and more, it has participated in the global effort against COVID-19. The company continues to explore multiple pathways to advance understanding of SARS-CoV-2 and develop vaccines and treatments, including an expansive internal research program, and an announcement of two COVID-19 vaccine development efforts – a collaboration with IAVI and plans to acquire Themis. MSD also announced collaboration with Ridgeback Bio to develop a novel antiviral candidate.

While research on COVID-19 vaccine becomes a priority, MSD has the unique expertise and capabilities to advance multiple development programs for COVID-19 while continuing to advance its research priorities in oncology, vaccines, diabetes management and other areas to address the continued threats from other diseases.

Having paved the way for innovative healthcare solutions to the Philippines in the last 25 years, MSD looks forward to the next chapter of stronger collaborations, innovations and delivery of healthcare solutions for the Filipino patients.

“Our hope, and we have expressed this as part of the industry, is for government to work closely with research-based pharmaceutical companies in planning for and securing sustainable strategies for future public health emergencies, beyond this pandemic”, remarked Dr. Tamesis. “We ask that we make it more enticing for innovators to actually be present in the Philippines through a more predictable and supportive business and policy environment.”

(This story was first published in the Malaya Business Insight on Jan. 7, 2021)

 

Willpower, meticulousness, strategic thinking, and community building come naturally to women. These qualities have not only endeared Mayor Nashiba Gandamra-Sumagayan to her constituents but also helped bring progress to Taraka in Lanao del Sur.

The proof of her hard work is the conferment of the 2020 Civil Service Commission Pagasa Award (Regional Winner for the Honors Program) for outstanding governance.

Sumagayan was credited for turning a fourth-class municipality into a progressive community. She has maintained the peace and order vital to the progress of every locality.

The mayor acknowledges her predecessor and husband, Amenodin, for initiating vital changes when he was the mayor. Amenodin settled long-standing family feuds which had intimidated the community. More police officers patrolled the neighborhoods, curbing crime and drug-related activities.

“Peace and order has always been our top priority. Our collective efforts have led to the various accomplishments of our security forces,” she says.

The Taraka-MPS (Metropolitan Police Service) was conferred the Medalya ng Papuri for arresting the top three most wanted suspects.

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More than a motherhood statement

Spending on infrastructure was likewise a priority. With the help of government organizations, farm-to-market roads, multi-purpose buildings, water systems, RHU (rural health unit) buildings, and a Municipal Disaster Risk Reduction and Management Office, among other structures, were built. The municipal hall was also expanded and the municipal gymnasium renovated.

The mayor enhanced the social services such as continuing education programs amid the pandemic. Every month, Sumagayan would meet with the local school board to discuss how the learners were faring and how the local government could improve the educational system. As a result, her LGU merited the Seal of Good Education Governance in 2019 from the Synergeia Foundation, a league of organizations espousing quality education, and the United States Agency for International Development.

Before she entered politics, Sumagayan was assistant professor in English and literature at the Mindanao State University. “I invested time in my work so that I would be able to equip my students with the essential skills needed to reach their goals,” she enthuses.

She admits her biggest challenge then was balancing her role as teacher, mother, and wife to her husband who was then Mayor and was girding for the bar exams. She did not allow the pressures of family life affect her work. Even if she felt under the weather, she continued to teach with enthusiasm.

Further, Sumagayan has made health services more accessible to her constituents. The RHU provides newborn screening kits, incentives for tuberculosis-cured children, and hygiene kits.

Dr. Bolawan Delawi, RHU head, and the Zuellig Family Foundation have implemented various health programs. With the police and other departments, Sumagayan has been conducting an awareness campaign on smoke-related health problems. The LGU has since been placed in the Hall of Fame of the Red Orchid Awards, the Department of Health’s incentive for tobacco-free environments.

Taraka has managed to control the COVID-19 pandemic through the Sangguniang Bayan, headed by Vice Mayor Amenodin Sumagayan.

Through a series of house-to-house relief operations, Sangguniang Bayan distributed hygiene kits and horticulture crops, and procured health materials for disinfection. Frontliners were given personal protective equipment and free meals. When the lockdowns put the livelihood of daily-wage earners on hold, the mayor provided cash assistance.

Sumagayan points out that her greatest achievement has been to empower her associates and her constituents by making them believe in their potential. Throughout her term, Taraka has received the seals from the Department of the Interior and Local Government for good governance, most gender responsive municipality, good financial housekeeping, disaster preparedness, business friendliness, and peace and order.

This year, Sumagayan plans to establish an agricultural and livelihood program with the vision of making Taraka an economic hub. She hopes to implement Mindanao Development Authority chairperson Emmanuel Piñol’s solar-powered irrigation system, an anti-poverty program that aims to provide water and improve crop production in isolated provinces.

“This will not only help our farmers but also our constituents who do not have enough to support themselves. We will be able to establish a local enterprise where everyone will benefit most especially our vulnerable sectors,” she says.

Aside from improvements in her municipality, her collaborative leadership style has also brought Muslim women to the forefront. “Muslim women leaders across the globe are proving that their biological makeup and their social stereotypes do not reflect their potential,” she emphasizes.

“Muslim women are independent and spiritual individuals in their own right. They are firm in their resolve and inclined to lead against odds. Despite living in patriarchal societies, they stand on their ground and let their voices be heard. They speak for other people and show immense compassion towards their communities. This is what fuels them to brave every challenge that comes their way. This is what makes Muslim women leaders special.

(This story was published in the Manila Standard on Jan. 6, 2021)

Located at the southern tip of Bataan Province, Mariveles is home to the Freeport Area of Bataan (FAB). In 2018, it was the second richest municipality in the Philippines, according to a Commission on the Audit report. Job-seekers from other provinces flock to the area.

A fifth of Bataan’s population lives in Mariveles, making it the most populous of the province’s 11 municipalities and one city. Yet health services for its residents used to be limited to those provided by the rural health unit, barangay health stations, private clinics, and the Mariveles Mental Health Hospital. The nearest hospital was over an hour’s drive away in Balanga City.

Ria (name withheld upon request), a long-time Mariveles resident and whose husband works in a FAB locator, recalls how she had to fight for space in a packed bus to get to the Bataan General Hospital and Medical Center (BGHMC) in Balanga City, where she gave birth to her first-born in 2019. Each two-way trip that included tricycle rides would cost her almost P200, which for Ria was “too much, especially since we’re on a tight budget.”

White elephant to white knight

Governor Albert Garcia acknowledged the deficiency, saying in a February 2018 interview with ZFF, “There are RHUs (rural health units), lying-in clinics but no hospital so when an accident occurs, they still need to bring the victim to Balanga. Plus, the Freeport is there, the workers, the population, so it needs a functioning hospital,” then he added, “That is why by hook or by crook this year (2018), the hospital will open” referring to the then-unused hospital, which had its roots to the vision of the governor’s late father.

As a congressman in 2011, Enrique Garcia introduced a bill to build a Mariveles hospital, which led to remodeling and then a retrofitting in 2017 of an existing building that stood idle since, earning it the monicker Mariveles Display Hospital.

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But the Mariveles District Hospital (MDH) would finally open in September 2018. It rendered out-patient and emergency services. And once it opened, its progress was fast.

In August 2019, it was licensed to operate as an infirmary. In March 2020, it was upgraded to a licensed Level 1 hospital just two weeks after it was designated a COVID-19 referral hospital.

It has discharged the province’s youngest COVID-19 patient (3 years old) and the oldest couple (80 years old).

Tracing infected and looking after their welfare

Ria was among MDH’s COVID-19 patients. She was exposed to a friend who had the virus. She was immediately tracked, tested in the RHU, and picked by MDH personnel after results showed she was positive. At the MDH emergency room, hospital personnel explained the tests and treatment she would be undergoing. For Ria, everything happened quickly, efficiently.

Thanks to ZFF’s interventions, the provincial government had the proper protocols in place.

“Our added knowledge because of our partnership helped us to cope better with the pandemic,” Garcia said during the governors’ learning forum last June 30.

For Ria, the two-week hospital stay was made easier by the health workers.

“I gained another family there,” said Ria, who praised her doctors and nurses for their patience, courtesy, and genuine service. “You can feel they were there to serve and not merely work.”

From her first day until her discharge, Ria did not have to shell out money. “I had my medicines. I was fed on time. They gave me masks and soap for handwashing. Upon my discharge, I did not have to pay for anything. Plus, when I was discharged, they gave me a set of easy-to-understand tips to avoid COVID-19.”

Fortunately, too for Ria, she did not suffer any discrimination when she returned home. The same cannot be said of MDH health staff, who were not welcome in their neighborhoods. So the Mariveles government and community responded. The local government opened a dormitory for the staff. Community members gave them meals and comfort food like milk tea. A FAB locator manufactured face masks for the health front-liners.

Service delivery network

Thankfully, too, its health service delivery network (SDN) has finally improved. MDH chief Dr. Hector Santos, who also oversees the Orani District Hospital, said the functional SDN has made it easier to refer and track all patients and not just those with COVID-19.

Governor Garcia said likewise, “There is that highly elusive service delivery network during normal times when it was a challenge for all LGUs to cooperate toward an efficient SDN. Because there was a crisis, and with help from our partners, we were able to integrate this health system that is now addressing our COVID response.”

Bataan’s proximity to Metro Manila contributed to its numerous COVID-19 cases. Acting swiftly and decisively to the crisis, however, has kept the pandemic manageable.

On his final term as the city’s chief executive, Tagum City Mayor Allan L. Rellon will pass on a legacy of championing nutrition to his successor. Under his leadership, Tagum was able to bring down stunting and wasting among children under 2 years even amid the pandemic.

Tagum is a long-time partner of the Zuellig Family Foundation (ZFF) from the Municipal Leadership and Governance Program in 2015. And while Tagum has already received a national award from the National Nutrition Council, Rellon still re-engaged with ZFF for the City Nutrition Governance Program (CNGP) to aid the implementation of the Republic Act. 11148 (Kalusugan at Nutrisyon ng Magnanay Act) focused on the health and nutrition of a child during the first 1,000 days (F1KD).

Three objectives
The first objective of the CNGP, a partnership program of ZFF with Nutrition International, is to lead integrated actions for F1KD. Rellon established a City Nutrition Committee (CNC) that included sectors not primarily involved in health and nutrition such as the city offices for social welfare and development, agriculture, youth division, and public employment and education.

Rellon also chaired an inter-department planning workshop that resulted in the formulation of the city’s vision of a city of healthy and productive people. This vision guided the city’s integrated response to nutrition challenges.

To address food insecurity amid the pandemic, those with malnourished family members and others experiencing food insecurity were engaged in backyard-container gardening and farming on city-leased land. They earn by selling the crops through the Agri Mobile Market. Tricycle drivers who were not allowed to take passengers because of the pandemic were tapped as delivery personnel under the Agri Runner program.

Through Rellon’s nutrition referral, having a malnourished member became part of the criteria for food, livelihood, housing, and employment assistance. In addition, households with malnourished members are prioritized for social protection programs such as PhilHealth city sponsorships.
The second objective of empowering front-line workers for the continuity of F1KD services amid the pandemic was fulfilled through the participation in a training course with practicum (Nutrition and Health Leadership program) and the City Nutrition System Strengthening Workshop. Mayor Rellon, together with other health and nutrition officials, also had a deep dive into the situation on the ground and learned how nutrition is affected by several other factors such as employment opportunities and quality of settlements.

As a result, Rellon and the CNC were able to come up with the distribution of food packs with rice, duck eggs, milk, and honey to nutritionally-at-risk (NAR) pregnant women and malnourished children.

The city offices for social welfare and development, agriculture, and public employment and education were tapped for employment; while the housing and land management, and youth division offices provided building materials and relocation for F1KD beneficiaries.

To fulfill the last objective of improving the F1KD information system for collaborative actions, the city government purchased laptops for the barangay nutrition scholars. Along with training and monitoring tools under CNGP, the city’s data management improved and a two-way flow of information between the nutrition department and other sectors was established. This led to the proper tracking and immediate rehabilitation of NAR pregnant women, among others.

Read more about Tagum and the other cities under CNGP in Case Stories on Nutrition Leadership and Governance.

ZFF president Ernesto Garilao’s acceptance speech during the 2019 XIHF Health Impact Award in China

Cagayan de Oro (CDO) City Mayor Oscar Moreno has prioritized health throughout his extensive political career. Even as congressman (1998-2004) and governor (2004-2013) of Misamis Oriental, he strived to improve health services, with the province’s enrolment in the Philippine Health Insurance Company (PhilHealth) among his achievements.

Under Moreno’s leadership, CDO became a partner in two cycles of the Zuellig Family Foundation’s (ZFF) partnership program with the United States Agency for International Development (2013-2020). Since then, ZFF’s interventions, including regular coaching, enhanced Moreno’s and the local health officers’ capacities to improve their health system and address priority health issues.

Despite a reduced budget, the mayor transformed the ill-equipped Justiniano R. Borja General Hospital (JRBGH) into a premier hospital on its way to a Level II hospital accreditation–meaning it will have specialists for gynecology and pediatric services and additional facilities such as intensive care unit. He also modernized 19 other urban health centers that needed PhilHealth accreditation as maternal and child care facilities or birthing homes.

In 2019, the DOH selected CDO as one of the pilot sites for Universal Health Care (UHC) integration because of its outstanding implementation of PhilHealth’s Sponsorship Program (SP). The city spent ₱160 million to enroll 80,000 individuals in PhilHealth’s SP that year. Moreno also pledged a ₱2-billion budget to improve the city’s health services, including plans to build four mega health centers.

Adolescent-friendly city
The city had a high adolescent birth rate—the highest in Northern Mindanao (Region 10) at 57.8% in 2019. In November 2020, Moreno committed to reducing teenage pregnancy in the city through The Challenge Initiative (TCI) in the Philippines. Co-funded and co-managed by ZFF and the Bill and Melinda Gates Institute for Population and Reproductive Health, TCI promotes positive health-seeking behavior and improves access to family planning programs. CDO allotted P6.5 million for TCI’s 2021 implementation.

Among the high-impact approaches adopted by TCI was the Youth Leadership and Governance Program (YLGP) of ZFF. Following this approach, Moreno formed the CDO’s Oro Youth Development Council (OYDC) with representatives from student bodies, out-of-school youths, faith-based and community-based sectors, and other advocacy groups. He also spearheaded the Technical Education, Skills Development, and Employment Committee to offer skills development and employment facilitation to fresh graduates, out-of-school youth, recovering drug dependents, and other disadvantaged groups.

By adopting various proven ways to address youth-related challenges, the adolescent birth rate in CDO decreased to 33% in 2021. The city will also have an adolescent and youth sexual and reproductive plan fully integrated with its UHC program.

By Jovito Dy

Electronic medical records, synchronized patient alerts via SMS, real-time health data from the field and inter-connectivity for reporting and consolidation of health data. These are the advantages of a health information system built through the support of several companies and organizations.

The Wireless Access for Health (WAH) Initiative is “aimed at improving healthcare service delivery through the use of information technology platforms like 3G connectivity technology and electronic medical record.”

Piloted in Tarlac, the recent partnership of the Zuellig Family Foundation with the WAH will bring the system to its six partner-local government units (LGU) of Dao (Capiz), Don Salvador Benedicto (Negros Occidental), Ipil (Zamboanga Sibugay) and the Romblon towns of Cajidiocan, Magdiwang and San Fernando. In 2013, the system will also be introduced to ten more ZFF partner-LGUs in the Autonomous Region in Muslim Mindanao.

The WAH Initiative has four main components. First is doing away with paper and having electronic medical records to promote real-time, data-driven planning for municipal health officers and local chief executives. Second is the sending of mobile text messages to remind patients of their scheduled consultations as well as to inform public about health promotion and programs.

The third component, “Mobile Midwife” aims to increase the productivity of rural health workers by capturing real-time data they gather from their field visits and synching it to the rural health unit central database using internet connectivity and smart phones.

The fourth component is the inter-connectivity of LGUs within a province for the electronic reporting and consolidation of health data. This allows having real-time and accurate health information.

Data in the WAH system can also be used for the DOH’s Field Health Service Information System. In the pipeline is enabling the use of WAH system information into the Philhealth system.

The partnership between ZFF and WAH was formalized with the signing of a Memorandum of Agreement last September 26 at the Holiday Inn Clark Pampanga during the North Luzon Health Information Systems Forum. Present during the signing were Tarlac Governor Victor Yap, Tarlac Provincial Health Officer (PHO) II and President PHO of the Philippines Ricardo Ramos M.D. and ZFF Vice President Ramon Derige.

The pioneering supporters of the WAH initiative are the United States Agency for International Development, Smart Communications Inc., Qualcomm Inc., RTI International, Department of Health (DOH)-Center for Health Development Region III, DOH-National Epidemiology Center, DOH-Information Management Service, Tarlac Provincial Government through its Provincial Health Office, University of the Philippines Manila-National Telehealth Center, and Tarlac State University.

Finally, barangay health workers (BHWs) in Sibuyan Island, Romblon get the protection and benefits they rightfully deserve.

In the inter-local health zone (ILHZ) of Sibuyan Island which is composed of the municipalities of Cajidiocan, Magdiwang and San Fernando, the mayors, BHW Federation presidents and barangay (village) captains formally agreed to measures that would prevent the arbitrary removal of BHWs from service.
The practice of replacing BHWs each time new barangay leaders were elected was so pervasive that it often disrupted the delivery of health services because new hires—allies of the leaders—were often inexperienced and untrained.

The Memorandum of Agreement (MOA) underscored the strict implementation of RA 7883 or the Barangay Health Workers’ Benefits and Incentives Act, where a BHW is defined as a person “who voluntarily renders primarily healthcare services in the community” following accreditation by the local health board (LHB). Thus, the MOA states that “all BHWs cannot be terminated, without justifiable reason, as their service in the community is done under the principle of volunteerism and that no certificate of appointment issued by the Barangay Local Government Unit (BLGU) is needed to allow any BHW to render healthcare services in the community.”

The MOA also puts in place a performance management system to monitor a BHW’s performance and code of ethics. Termination will be based on the rating and is subject to a review process to be conducted by the municipal LHB.

The signing of the MOA took place during the ILHZ’s Second BHW Summit last June 15 in Magdiwang. Present during the signing were Department of Health-Local Health Assistance Division Chief Anna Birtha Datinguinoo, Department of Interior and Local Government Provincial Director OIC Johnson Fopalan, Mayor Festo Galang of Cajidiocan, Mayor Ibarra Manzala of Magdiwang, Mayor Dindo Rios of San Fernando, barangay officials, rural health unit staff and over 400 BHWs.

The three towns of Sibuyan Island are partner-municipalities of the Zuellig Family Foundation under its Community Health Partnership Program where local health leaders undergo health leadership training to broaden their knowledge and appreciation for health; and make them pro-active in implementing health reforms. Since the start of the partnership, the health leadership teams of these LGUs have successfully influenced their barangay leaders to perform their roles in the local health system. The MOA was originally an initiative of Cajidiocan, which then merited the approval of all three municipal mayors. It underwent numerous consultations and dialogue sessions with barangay captains, BHWs, municipal health officers and other local officials.

This is the first innovative program that the Sibuyan ILHZ implemented since its re-activation last October. The three municipalities, which used to implement programs independently of each other, are now starting to work together towards a unified health system that would benefit residents of the whole island.

In support of this ILHZ initiative, ZFF will produce the BHW Manual that will serve as a guide to the implementation of the terms stated in the MOA. The manual will be distributed to BHWs, barangay captains and the local health boards of the municipalities.

For David Zuellig, trustee of the Zuellig Family Foundation, the decision to focus on health leadership and local governance to improve the health of the rural poor in the Philippines was logical yet counter-intuitive.

Zuellig spoke about the Foundation’s strategy in the session on innovative philanthropy during the Regional World Health Summit in Singapore, the first time the annual meeting was held outside Berlin since it started in 2009.
The summit’s theme, “Health for Sustainable Development in Asia,” underscored the challenge for governments and healthcare providers to meet the increasing demands for better healthcare at lower costs in the region. Amid Asia’s growing economy, public-private collaborations become more vital in coming up with sustainable strategies that will bring quality healthcare even to low-income populations.

According Zuellig, access of the Filipino rural poor is usually limited to those offered in the rural health units. So the Foundation focused on improving local health systems.

Zuellig said their strategy had the municipal mayor as the key element in improving the system. He said this was a logical move since mayors had the power to implement ordinances to improve rural health services. But Zuellig added that local politicians are generally perceived to be unresponsive to health and that is why their strategy also seemed counter-intuitive.

Yet, the Foundation proceeded to work with local chief executives, picking those who show genuine commitment for health reforms. In a relatively short time, their efforts paid off. Since piloting the strategy in 2009, 30 partner-municipalities have brought their maternal mortality ratio closer to the targeted Millennium Development Goal of 52. The MMR, accordingly, is a surrogate indicator of the quality of a health system.

To make sure gains are sustained, Zuellig emphasized the need to have a continuity protocol. “Policies that support the continuation of health programs must be in place. The motivation to improve health must come from leaders and the community itself, with or without external influencers.”

The rapid improvements in health outcomes in the municipalities came as a pleasant surprise to Zuellig himself. “I was pleasantly surprised to realize that health outcomes have improved faster than I thought was possible.” Such positive changes also caught the interest of other groups, including the Philippines’ lead agency in health. Partnership with the Department of Health will bring its health change strategy to 609 priority local government units. There are also existing partnerships with the United Nations Population Fund and global healthcare company Merck Sharp & Dohme.

For Zuellig, a number of lessons learned along the way also served as factors for their success. First, the Foundation focused on health because this was their area of expertise, further refining it to rural health because of serious inequities in rural areas. Then, there was the identification of a strategic intervention, which in this case was working with local health executives. Third lesson was the choice to have a systems approach over short-term interventions that do not address the root causes of problems. Lastly, Zuellig said they realized they had to take a long-term perspective because transforming systems take time.

In closing, Zuellig expressed optimism that for as long as the Foundation’s current crop of leaders hold public office, they will also continue to use its leadership and governance framework to address development challenges beyond health.