The Philippines has the most Covid-19 cases in Southeast Asia. Why is Duterte backing under-fire health secretary Duque?
The Senate of the Philippines is at loggerheads with President Rodrigo Duterte over his continued endorsement of health secretary Francisco Duque III, whom the upper chamber has accused of criminal negligence and gross mismanagement of the Covid-19 pandemic.
Twenty of the body's 24 senators recommended Duque's sacking in a 93-page report on September 1 that detailed his lapses as chairman of the board for Philippine Health Insurance Corporation (PhilHealth), the state agency paying for medical care and Covid-19 testing.
The Senate had initially called for his immediate resignation on April 16 after a month-long extreme lockdown of the country failed to stop a spike in cases. As of Friday, the Philippines had more than 252,000 confirmed cases of Covid-19, the most in Southeast Asia, along with over 4,100 related deaths.
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The most recent controversy surrounding Duque is the controversial disbursal of 45 million pesos (US$925,500) from PhilHealth to a private dialysis clinic, B. Braun Avitum, that had no patients suffering from Covid-19 - despite the funds being earmarked for the pandemic.
Duque admitted the payment was illegal at an online Senate hearing on August 18, during which he was grilled for nine hours. However, he argued that he was not liable because as a "non-voting chair", he did not sign the board resolution that advanced 14 billion pesos (US$288 million) of PhilHealth funds through the interim reimbursement mechanism (IRM) that saw even hospitals and clinics with no Covid-19 patients get cash advances, while other medical centres treating patients with the disease missed out.
Duque, who later told reporters he did not know how much each hospital received through the IRM, declined to be interviewed on the matter.
Despite the charges against him, the health secretary has retained Duterte's backing. "By the way, Secretary Duque, this is not the time for you to resign," the president said in a pre-recorded briefing on September 7 in which he exonerated the health secretary of corruption over PhilHealth. "I have heard stories about you going to resign. I have full trust in you."
Presidential spokesman Harry Roque said Duterte was personally "very close" to Duque's brother Gonzalo, and that he trusted the family.
The president also made light of the Senate's accusations of criminal negligence against Duque, saying that people in positions of responsibility are prone to such charges. "We are in the same boat, actually," he said, though he mentioned that the Department of Justice was conducting a separate investigation into PhilHealth. Its findings will be presented on September 14, according to justice secretary Menardo Guevarra.
Senate president Vicente Sotto III, who led the body's probe, expressed confidence that their findings on PhilHealth would change Duterte's mind.
"If [Duque] claims he did not know about it, he is practically admitting guilt to negligence. As a friend, I will advise him to get a good lawyer," he told This Week in Asia. "He is chairman of the board. He governs PhilHealth as mandated by law. The IRM releases of 14 billion pesos were illegal, and the board violated rules of procedure in the distribution of funds. Then he wants us to recommend charges against everybody else except him?"
There are more than 252,000 confirmed Covid-19 cases in the Philippines, the most in Southeast Asia. Photo: AP
Besides Duque, the Senate also recommended charges of malversation, negligence and corrupt practices against PhilHealth chief executive and president Ricardo Morales, and at least five vice-presidents.
For infectious disease specialist Dr Benjamin Co, head of the paediatric infectious disease section at the University of Santo Tomas Hospital in Manila, the issue is no longer whether Duque was at fault. "With so many issues hounding the secretary, he needs to resign," he said. "If I were him, I would resign so that whoever replaces him can focus on the pandemic. That's probably why we are where we are, because there are too many things that he is not concentrating on."
Duque has come in for much criticism for his handling of the pandemic. On April 16, when the Senate first called for his resignation, 16 of the 24 senators signed a resolution accusing him of "failure of leadership, negligence, lack of foresight, and inefficiency" resulting in "flip-flopping policies and measures" that had led to Filipinos, including frontline medical personnel, losing their lives.
At the time, the senators said Duque had failed to order adequate contact tracing after two tourists from Wuhan, the original epicentre of the Covid-19 pandemic, tested positive for the disease. One of them died in the Philippines on February 1, the first recorded death from Covid-19 outside China.
The team of Chinese doctors sent to the Philippines poses for a photograph before their departure on April 19. Photo: Xinhua
They also deplored his "dismal failure" to provide frontline medical workers with sufficient personal protective equipment, and to alert them that dozens of patients exhibiting Covid-19 symptoms had already been admitted to hospitals. By August 1, more than 5,000 of these medical workers had been infected, and 38 had died.
Duque's reversal on mask wearing also came under fire. As late as April 2, amid Metro Manila's lockdown, Duque told the public that "people in good health do not need to use face masks".
On May 20, the Senate summoned Duque for an investigation into his handling of the pandemic, during which he promised to widen testing and increase the number of quarantine centres. However, mild and asymptomatic cases were still allowed to self-quarantine if their homes were big enough, contrary to the advice of Chinese doctors who had flown from Wuhan to Manila in April to share their expertise.
As a result, Philippine General Hospital spokesman Dr. Jonas del Rosario told This Week in Asia, walk-in patients during this period were routinely told to self-quarantine at home without informing city governments of their status.
During the Senate's August 18 online hearing, minority leader Franklin Drilon told Duque he had "moved too slowly, too late", and hoped he would show responsibility. The health secretary's response was that he had.
"There was never a time that I never tried my best," he said. "But if my best is not enough, I'll just have to do some more reflection and soul searching, and I will be the first to let everyone know that we need to learn."
This article originally appeared on the South China Morning Post (SCMP).
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