Press Release | 16 April 2024

As the DOH continues to work with local government units and the
Bangsamoro regional government to break the transmission of
Measles-Rubella (MR; Filipino: Tigdas) and Pertussis (Filipino: Ubong
Dalahit, o Tusperina), health officials have noted that procurements
of life-saving vaccines must strongly consider using framework
agreements for faster and more efficient delivery.

A Framework Agreement (FA) for procurement is used for repeatedly
needed goods that are seen to be necessary and desirable but, by its
nature, use, or characteristic, the quantity and/or exact time of need
cannot be accurately pre-determined, and are not advisable to be
carried in stock. The FA is in the nature of an option contract
between the procuring entity and the bidder(s), granting the procuring
entity the option to either place an order for any of the goods
identified in the FA List, or not to buy at all. It can be for a
minimum period of one year to maximum period of three years.
Procurement under a FA still follows the procedure for competitive
bidding as required by law, but it improves efficiency by allowing for
the benefits and advantages of lean and just-in-time procurements.

Measles Updates

Data from the start of the year to April 6, 2024 show that there have
been 1,627 cases of Measles-Rubella in the country, with 4 deaths
recorded. Children under ten years old are the most at risk for MR,
making up 82% of the total cases. Most are below five years old.

Close to half of the cases (787, 48%) are from the Bangsamoro
Autonomous Region in Muslim Mindanao (BARMM), where a nonselective
Measles Outbreak Response Immunization (MORI) is now in the second
week of its intensive phase. Almost 850,000 (849,728) children in
BARMM have been vaccinated for this MORI as of April 14, 2024. The top
three BARMM provinces with the highest percentage of target population
vaccinated are: Maguindanao del Norte (88.5%); Sulu (79.2%); and
Maguindanao del Sur (72.2%). Only 2.3% of those offered vaccines
either deferred or refused.

The national epidemic curve of new cases per week for Measles-Rubella
is showing signs of plateauing, which indicates that overall
transmission may be slowing down. The protective effects of the MORI
may not be seen in the epidemic curve until 4-6 weeks after it
started. Also, the DOH is cautious in interpreting trends as there may
either be late reports (i.e., underreported numbers) or cases
previously recorded as clinically compatible but later on shown to
have negative test results (i.e., overcounted cases).

Pertussis Updates

Pertussis cases are still on an upward trend. Data from January 1 to
April 6, 2024 show a total of 1,477 cases since the start of the year,
with 63 deaths recorded. The outbreak response immunization is
ongoing, and the DOH continues to await the arrival of the 3 million
pentavalent (“five-in-one”) vaccine doses by June or earlier, even as
it obtains DPT (“three-in-one”) doses to prevent the anticipated
shortfall in vaccines by May. The Philippine market continues to have
stocks of pentavalent and TDaP vaccines in the private sector.

In the past six weeks, the following regions showed a continuous
increase in the number of cases: Cagayan Valley, Central Luzon,
Zamboanga Peninsula, Northern Mindanao, Davao Region, and Bicol
Region. (For purposes of outbreak response, data on the growth rate of
cases is more pertinent to the DOH compared to the total number of
cases, per given area.) Of the total Pertussis cases thus far
recorded, 76% were less than 5 years old. Adults aged 20 and older
account for only around 4% of cases.

The DOH is cautious in interpreting trends. The number of cases may
still change as there may be late consultations and reports.
Furthermore, the effects of increasing immunization efforts to stem
the outbreak may not be seen in the data until 4-6 weeks after they
are started.

“Just like in the emergency room, the fast and focused pace of an
outbreak response highlights areas for improvement so we can save
lives better. We are looking at adopting processes like Framework
Agreements for procurement so that we can buy the vaccines faster.
This is the way forward, even as we exhaust all possible means now to
get what we need,” said Health Secretary Dr. Teodoro J. Herbosa.