Republic of the Philippines
HOUSE OF REPRESENTATIVES
QUEZON CITY

Sixteenth Regular Congress
First regular Session

HOUSE BILL no,_ 3874

Introduced by Hon. Gavini “Apol” C. Pancho

Explanatory Note

Despite the enactment of Republic Act 9482, otherwise known as the Rabies
Act of 2007, and the National Rabies Prevention and Control Program (NRPCP)
under the Department of Agriculture which seeks to eradicate rabies in the country
by 2020, rabies remains a public health threat. Each year 300 to 600 Filipinos die of
rabies, according to the Department of Health. At least 50 percent of the victims are
children aged 5 to 14 years. In its latest report, the Philippines ranked fifth in the
rabies list of the World Health Organization in terms of prevalence in a specific area.
This of course does not include unrecorded incidents or those cases that did not
reach the health centers or hospitals.

According to the The Merck Manual of Medical Information rabies is an acute
and deadly viral infection of the brain that causes irritation and inflammation of the
brain and spinal cord. It is one of the most terrifying diseases known to man. It is
usually introduced into humans through the bites of infected animals but other
means of transmission are possible. Rabies is usually transmitted from a dog's saliva
and enters the human body through breaks in the skin, according to the health
department. It can also enter the body through a person's eyes and mouth. Aside
from dogs, other animals, which can transmit the rabies virus are cats, bats and
foxes. Domesticated animals like cattle, carabao, pigs, goats and horses also have
rabies.

Medical books say the incubation period of rabies—from the introduction of
the virus to the moment it reaches the spinal column or brain—is variable. The
nearer the site of the bite to the brain, the faster will be the movement of the virus.

Health experts say rabies develops with three main phases: the early period
followed by excitation phase and finally coma. People without immunization shots
may be given an injection of rabies immunoglobulin (different from the vaccine as
this provides immediate protection). This has antibodies against the virus, depending
on the state of the animal.

Rabies vaccines are given as injections to the patients arm. A total of five
injections need to be administered over 14 days. The WHO guidelines state that the
shot is given initially (day 0), followed by shots of vaccine on days 3, 7, 14, and 28,


as it stimulates the body to protect itself from the virus with much longer time.
Currently there are more than 400 centers all over the Philippines, around 20 in
Metro Manila, including the one at the Research Institute for Tropical Medicine in
Muntinlupa City and at San Lazaro Hospital in Manila.

However, the problem lies in access to the vaccine particularly with the poor
because the cost for acquiring vaccination shots is extremely high even for the
financial capacity of above minimum wage earers. And while the vaccine is
provided free in our government hospitals, the normal package of the vaccine is
good for three people. Hence an individual victim needs to wait for two more victims
before the vaccine can be administered

‘One must bear in mind that cases of rabies could be fatal, thus, appropriate
measures should be done without delay. Though a small number of people have
survived rabies, the disease is usually fatal and death is inevitable once the
symptoms appear. Once the symptoms develop in the victim, neither the vaccine
nor the immunoglobulin is effective against the virus. If not treated immediately, a
rabies-infected patient may die within three to five days.

Hence, the life of a Filipino is placed at risk every time a patient is made to
wait for “vaccine partners” just because the vaccine is currently packaged for
multiple recipients and cannot be singly administered.

Even as this bill is presented the lives of hundreds of Filipinos, particularly
children aged 5 to 15 years old who are most vulnerable to the disease, are currently
at stake,

To address this injustice this measure seeks to authorize the Department of
Health to transact directly with pharmaceutical suppliers of the rabies vaccine so that
a separate package that can be singly administered can be made available in all our
government hospitals,

With this sense of urgency, the early passage of this bill is sought.

GAVINI “APQL” C. PANCHO
Represenfetiv
2" Distriét ofBulacan


Republic of the Philippines
HOUSE OF REPRESENTATIVES
QUEZON CITY

Sixteenth Regular Congress
First regular Session

Ger 3874
HOUSE BILL NO,

Introduced by Hon. Gavini “Apol” C. Pancho

AN ACT
AUTHORIZING THE DEPARTMENT OF HEALTH TO TRANSACT WITH
PHARMACEUTICAL SUPPLIERS TO PRODUCE SPECIAL SINGLE PACKAGING
OF ANTI-RABIES VACCINE AND APPROPRIATING FUNDS THEREFOR

Be it enacted by the Senate and House of Representatives of the Philippines
in Congress assembled:

SECTION 1. Title.- This Act shall be known as the “Anti-Rabies Special
Package Act of 2014”.

SECTION 2. Declaration of Findings and Policy. - (a) Rabies remains a
public health threat— annually 300 to 600 Filipinos die of rabies and at least 50
percent of the victims are children aged § to 14 years.

(0) Patients are given a total of five injections that need to be administered
over 14 days. Normally each vaccine injection is very costly and beyond even the
expendable budget of above minimum wage eamers.

(c) The vaccines are administered free in government hospitals but the normal
package of the vaccine is good for three people. Hence an individual victim cannot
be injected immediately but will need to wait for two more patients before the vaccine
can be administered. This needlessly puts the victim's life in jeopardy because a
rabies-infected patient may die within three to five days if not treated immediately.
Once the symptoms develop in the victim, neither the vaccine nor the
immunoglobulin is effective against the virus.

(d) It is the declared policy of the State to protect and promote the right to
health of the people.

(e) The State shall pursue the implementation of the Republic Act 9482,
otherwise known as the Rabies Act of 2007, and the National Rabies Prevention and
Control Program (NRPCP) which includes among others, free and immediate access
to rabies vaccine for Post Exposure Treatment in all government hospitals.


() Towards this end, the State shall authorize the Department of Health to
transact with pharmaceutical suppliers to produce a special single packaging of the
anti-rabies vaccine for use in all government hospitals, and to take such action as
will be necessary to achieve the purposes of this Act

SECTION 3. Definition of Terms. - For the purpose of this Act, the following
terms shall mean:

(a) Bitten refers fo an act by which an animal seizes, cuts or grips with its
teeth so that the skin of a person has been wounded, pierced or scratched,

(b) Rabies refers to a highly fatal disease caused by a lyssa virus, transmitted
mainly through the bite of an infected animal and is characterized by muscle
paralysis, hydrophobia and aerophobia, and other neurological manifestations.

(c) Rabies Vaccination/immunoprophylaxis of Humans refers to the
inoculation of humans, with modem day rabies vaccines or Rabies immunoglobulin,
by a trained doctor or nurse under the supervision of a qualified medical practitioner.

(d) Post-exposure Treatment (P.E.T) refers to an anti-Rabies treatment
administered after an exposure to Rabies, which include local wound care, Rabies
vaccine, with or without anti-Rabies immunizing agent.

SECTION 4. Scope. The provisions of this Act shall apply to all
pharmaceutical suppliers of the rabies vaccine as well as all government hospitals
operating in the country.

SECTION 5. Implementing Rules and Regulations. Within sixty (60) days
after the effectivity of this Act, the DOH, together with the Department of Agriculture,
the Department of Trade and Industry, and authorized pharmaceutical suppliers of
the rabies vaccine shall promulgate the implementing rules and regulations
governing this Act

SECTION 6. Prohibitions/ Sanctions. (a) The contract (to supply
government hospitals) and accreditation of any pharmaceutical supplier of the rabies
vaccine in the country that will not cooperate with the DOH and conform to the
provisions of this Act will be suspended and indefinitely discontinued until such time
that conformity with the provisions of this Act is made.

SECTION 7. Appropriations. The amount necessary to cary out the
provisions of this Act shall be charged against the current year’s appropriation of the
concerned government agencies.

SECTION 8. Separability Clause. If for any reason, any provision of part
hereof is declared invalid, the other provisions not affected thereby shall remain in
full force and effect

SECTION 9. Repealing Clause. - Any provision of the law, presidential
decree, executive orders, rules and regulations contrary to the provision of this Act is
hereby repealed, amended or modified accordingly.


SECTION 10. Effectivity. — This Act shall take effect fifteen (15) days after its
complete publication in the Official Gazette or in at least two (2) newspapers of
general circulation, whichever comes earlier.

Approved,