National Policy Framework on Trade and Health

January 28, 2020

DOH ADMINISTRATIVE ORDER NO. 2020-0004

 

I. BACKGROUND

Trade and health have historically operated as separate policy spheres. The two fields however, have increasingly become intertwined with the rise of trade in health goods and services. Increasing trade in health creates many new opportunities for the sector and other related activities but there are potential risks to public health and the national health system. Liberalization of health services can contribute to enhancing quality and efficiency as well as offer new services previously unavailable domestically, including access to medical expertise located overseas through electronic means. It could also provide employment opportunities for health professionals who might otherwise choose to work overseas. However, the entry of more service suppliers, whether local or foreign, and the introduction of new services will require enhanced regulatory frameworks and capacities. For trade in goods, greater market openness generally leads to lower prices, greater product variety, and improves access but the lack of health goods/products testing and/or proper safeguards in the supply chain may compromise the quality of cosmetics, processed food products, medicines and medical devices, and other related health products. Stronger patent protection for drugs rewards innovation but may delay access to affordable medicines. Indeed, there are numerous possible risks and benefits from increased trade in health goods and services. HTcADC

Thus, deliberate strategies are needed to mitigate the risks and realize the gains of trade and health. In view of this, the World Health Assembly 2006 adopted WHA Resolution 59.26 urging Member States to ensure that the interests of trade and health are appropriately balanced and coordinated. Furthermore, the DOH must take the lead in ensuring that international trade and trade agreements do not undermine the attainment of national health objectives but rather contribute to the enhancement of the national health system.

II. GOAL AND OBJECTIVES

1. Policy Goal

To maximize the benefits from trade in health goods and services while minimizing the risks to public health and the national health system.

2. Policy Framework Objectives

General Objectives

The national policy framework aims to establish the overall direction for the integration of trade in health policies. It sets out the guiding principles and strategic priorities that will be pursued to achieve the policy goal as stated above.

Specific Objectives

An overarching framework is necessary to ensure policy coherence in trade and health. The policy framework shall:

a. Facilitate the adoption of trade and related policies that contribute to, rather than hinder the achievement of national health objectives;

b. Guide the country's engagement in trade agreements and international cooperation, as appropriate; and

c. Establish the basis for a national program on trade and health within the DOH and the allocation of corresponding budget and funding.

III. COVERAGE/SCOPE

This issuance shall apply to all units of the DOH, including its attached agencies. It shall also involve other concerned government agencies at the national and local levels, non-governmental organizations (including regional and international NGOs), industry, professional organizations, academic institutions, intergovernmental organizations and other relevant stakeholders and partners.

IV. GENERAL GUIDELINES

1. Health shall take primacy over trade

The protection and the promotion of the health and welfare of Filipinos shall be the primary consideration of the health sector in government when pursuing its trade and economic objectives.

Given that the right to health is recognized in the Philippine Constitution and given the mandate of the DOH as inscribed in the Administrative Code of 1987, the DOH has the responsibility to ensure that international trade objectives are not pursued at the expense of national health objectives.

2. Equitable access in healthcare products and services shall be ensured

The government shall ensure that equitable access in healthcare products and services shall not be diminished in taking advantage of the opportunities that international trade may bring. Safety nets shall be in place so that Filipinos especially the marginalized and vulnerable groups are equitably served.

3. Alignment with national health priorities and thrusts as defined in the Philippine Development Plan shall be ensured

Consistency and integration of the trade and health policy with the broader national development and health agenda, such as the Universal Health Care and the Fourmula One Plus strategy, shall be ensured to realize the country's vision of uplifting the lives of the Filipino people.

4. Adoption of a holistic or whole of government approaches

Collaboration and institutional mechanisms shall be fostered and institutional mechanisms strengthened, to ensure that complementary measures are developed to mitigate possible adverse trade and health effects.

5. Reliance on Evidence-based Decision Making and Innovation

The assessment of benefits and risks shall be based on sound analysis using the best available evidence from a wide range of sources to enable decision-makers to make informed choices by balancing various interests and views.

Monitoring and analysis of the potential opportunities and challenges of trade and trade agreements on health sector performance and health outcomes shall be undertaken. Informed predictions of social, political, economic and cultural trends as well as technological changes which may affect risk factors and market opportunities shall always be taken into account.

V. SPECIFIC GUIDELINES/IMPLEMENTING MECHANISMS

1. Strategic Priorities

Measures to advance the trade and health objectives of the country shall be formulated with the following strategic priorities: aScITE

a. Improving access to medicines, medical products and technologies

Greater market openness generally leads to lower prices, greater product variety, and improved access. This should be complemented by proper safeguards in the supply chain to avoid compromising the quality of medicines, medical device, and other health products. Thus, the regulatory system shall continuously be strengthened by adopting good regulatory practices. The use of flexibilities under the Trade-related Aspects of Intellectual Property Rights (TRIPS) shall be utilized to improve access especially on essential medicines. Moreover, necessary measures shall be adopted to promote and ensure access to affordable quality drugs and medicines for all Filipinos and also to support local production or manufacture of these drugs and medicines as well as health and health-related goods in the country.

b. Safeguarding trade in goods

The lowering or elimination of tariffs and non-tariff barriers as a result of trade agreements increased the cross-border flow of goods and commodities. The trade of goods and commodities that have a direct or indirect impact to health because of the nutritive value and quality of production must be properly safeguarded so that health is not imperiled. This is especially true with certain products in the market such as tobacco and alcohol. Both have direct and indirect effects to the health of consumers.

c. Ensuring availability of competent human resources for health

The increasing local demand for health services as health facilities expand highlights critical need for sustainable health human resources. In addition to effect on supply of health workforce, the mobility of health professionals as part of trade in services poses challenges relating to mutual recognition, ethical recruitment and migrant welfare and protection. The government is accountable for ensuring that the country's health system is maintained by adequate health workforce and in mitigating negative effects of migration on health outcomes and its social costs.

d. Strengthening medical travel and wellness tourism

Medical Tourism in the country has been noted to have very high potential for economic growth. Our medical personnel are competent and highly skilled. Filipino nurses are also regarded as competent, compassionate and caring healthcare providers. A number of private hospitals in the country are delivering high quality medical care and are accredited according to international standards. The DOH shall lead the sector to prepare the country to become the destination for medical travel and wellness tourism not only in the ASEAN region but also globally.

e. Promoting eHealth

As articulated in the Philippines eHealth Strategic Framework and Plan 2014-2020, it is envisioned that, "By 2020, eHealth will enable widespread access to health care services, health information, and securely share and exchange patients' information in support to a safer, quality health care, more equitable and responsive health system for all the Filipino people by transforming the way information is used to plan, manage, deliver and monitor health services." This Plan will ensure that access to health through tele-medicine and other technology-driven health interventions is facilitated, especially in geographically isolated and disadvantaged areas (GIDA), and increased access to vital health information is made available to planners and decision makers.

2. Institutional Framework

a. Trade and Health Unit

The DOH shall establish a Trade and Health Unit, which shall be placed under the Bureau of International Health Cooperation (BIHC). The Trade and Health Unit shall serve as the focal point for all trade and health matters.

The functions of the Trade and Health Unit shall include the following:

i. Lead in the development of the National Strategic Plan for Trade and Health and the corresponding action plans, programs and activities;

ii. Provide technical assistance to stakeholders on Trade and Health matters;

iii. Maintain a database of relevant Trade and Health-related global/regional/national treaties, laws, policies and agreements;

iv. Participate in inter-agency meetings and international fora as designated by the Secretary of Health;

v. Coordinate or convene meetings with international partners and other government agencies on all matters concerning trade and health;

vi. Provide updates to the Office of the Secretary through the Cluster Head; and

vii. Facilitate the conduct of capacity building on trade and health.

b. Technical Working Group on Trade and Health

A Technical Working Group on Trade and Health shall be created through the issuance of a Department Personnel Order. The TWG shall be composed of different DOH technical offices and shall be chaired by the Undersecretary in charge of the BIHC. Other government agencies may also be invited to provide technical advice on trade matters.

The functions of the TWG shall include the following:

a. Participate in the development of the National Strategic Plan for Trade and Health and the corresponding action plans, programs and activities;

b. Ensure implementation and monitoring of action plans, programs and activities on Trade and Health;

c. Develop DOH positions on trade and health-related matters and make recommendations to the Secretary of Health;

d. Participate in inter-agency meetings and international fora as designated by the Secretary of Health; and

e. Convene meetings/coordinate with relevant stakeholders.

VI. BUDGET

The DOH through the BIHC shall allocate budget and funding for the implementation of the planned activities and programs concerning Trade and Health. Moreover, other planned activities to be identified and implemented under specific Strategic Priorities in Section V.1., shall be charged against the funds of the concerned implementing Office or Bureau.

VII. SEPARABILITY

In the event that any provision or part of this Order is declared unauthorized or rendered invalid by any court of law or competent authority, those provisions not affected by such declaration shall remain valid and in effect.

VIII. REPEALING CLAUSE

This policy repeals DPO No. 2006-1134, as amended, dated May 2, 2006 "Creation of Technical Working Group on General Agreement on Trade in Services (GATS), Trade Related Intellectual Property Rights (TRIPS) and other trade relates issues," and DPO No. 2011-2876 dated May 13, 2011 "Reconstitution of a Technical Working Group on Trade in Health Goods and Services."

IX. EFFECTIVITY

This Order shall take effect immediately. aDSIHc

 

(SGD.) FRANCISCO T. DUQUE III, M.D., MSc.Secretary of Health