Manila — After two years of constant probing and pressure from civil society organizations, the Department of Health (DoH) has finally disbursed (1) the allocation for purchase of non-mercurial thermometers and sphygmomanometers for DoH- and Local Government Unit (LGU) controlled health facilities. The DoH, however, has yet to disclose the exact amount used.
Health Care Without Harm-Southeast Asia (HCWH-SEA), a member of the Alternative Budget Initiative for Health (2), who lobbied for the inclusion of the 13.2 M allocation in the 2009 national budget and tracked down its release said that this is a very welcome move from the government.
“Health care facilities patiently awaited the release of this budget which was originally intended to jump-start the hospitals’ switch to mercury-free thermometers and sphygmomanometers,” said Merci Ferrer, HCWH-SEA Executive Director.
The 13.2 M was intended for purchase of mercury alternatives for hospitals run by the DoH. After receiving reports that majority of health facilities (rural and barangay health facilities) run by the local government have not yet started with the phase-out of mercury devices, the DoH extended the grant to them. The regional Center for Health Devices (CHD) will be responsible in identifying recipient rural and barangay health units based on the facility’s needs.
In 2009, the 13.2 M allocation for non-mercurial alternatives was impounded by former President Gloria Macapagal-Arroyo, along with the 100 M allocation for the purchase of autoclaves for medical waste treatment of DoH-controlled hospitals. The following year, in the General Appropriations Act (GAA), the budgets for both the non-mercurial alternatives and autoclaves were combined and brought down to 50 M. However, it again failed to materialize. In a communication with the DoH, the release of the budget was disallowed following the President’s Veto Message of the 2010 GAA requiring that the release of the increased items of appropriations be subject to the identification by Congress of new revenue measures in support thereof. It further required that all allowable increase in appropriations should carry with it a corresponding increase in the respective outputs and improved outcomes of the agencies concerned.
“With so many twists and turns to have the money included in the national budget to its eventual release, we are pleased that the budget for mercury alternatives is finally obligated and disbursed,” said Ferrer. “We still need to follow-up on the budget for autoclaves (3) since in the 2010 GAA, the budget for mercury alternatives and autoclaves were merged under one line item which is the Health Facilities Enhancement Program.”
According to a correspondence with the DoH, the non-mercurial alternatives, like thermometers, sphygmomanometers or BP apparatus and calibrators are now being prepared for freight to respective DoH-controlled hospitals and regional CHDs.
“Health facilities run by the LGUs are among the first to raise the issue of non-availability of funds to purchase mercury alternatives despite orders from both the DoH (4) and the Department of Interior and Local Government (DILG) (5) to phase-out mercury devices,” said Ferrer. “Now that the budget is extended to some of them, it will fast track the implementation of mercury phase-out in LGUs who will receive the devices.”
HCWH-SEA will continue to monitor the delivery and allocation of the devices to the hospitals and LGU facilities. “We want to make sure that the hospitals and other facilities actually received the devices and that the devices are properly working,” said Ferrer. For the rural and barangay health units, we need to be sure that those who will receive the devices are those who actually need them.
HCWH-SEA is also calling on other LGUs who have not yet appropriated budget for the switch to mercury alternatives, to prioritize this.
Likewise, the group raised concern on the temporary storage of phased-out devices. “Since we will be replacing old mercury devices, DOH and the respective CHD officials should train each recipient health care facility on the proper temporary storage of phased-out devices.”
According to the DoH Administrative Order 21 which mandated the phase-out of mercury devices, phased-out devices must be properly stored in the health care facility while waiting for a more centralized storage. “The UNDP-Global Environment Facility Global Healthcare Waste Project released a guideline (6) on proper storage of mercury waste. "We encourage the DOH to disseminate the guidelines and for all healthcare facilities to implement it.”
View the lists for 2011 DoH mercurial alternatives allocation and2011 LGU mercurial alternatives allocation
Footnotes:
(1) Disbursed means the items have already been purchased and the money/allocation has been paid out.
(2) The Alternative Budget Initiative is a consortium of 60 non-government organizations that has been actively engaging the government in the budget process for the past six years.
(3) HCWH-SEA and ABI-Health have also been lobbying for the release of 100 M allocation for autoclave for medical waste treatment. It was included in the 2008 General Appropriations Act but was later vetoed by the President. In 2010 GAA, the budget for mercurial alternatives and autoclaves were merged under one line item which is the Health Facilities Enhancement Program. The allocation remains unreleased to date.
(4) In 2008, the DoH issued Administrative Order 21 mandating the gradual phase-out of mercury-containing devices in all Philippine health care facilities and institutions by September 2010.
(5) In December 2010, the DILG issued Memorandum Circular 2010-140 enjoining all provincial governors, city mayors, municipal mayors, DILG regional directors and others concerned to ensure compliance to the Department of Health (DoH) Administrative Order 21 (AO21).
(6) Guidance on Cleanup, Temporary Storage or Intermediate Storage and Transport of Mercury Waste from Healthcare Facilities was released by the UNDP-Global Environment Facility Global Healthcare Waste Project.