Republic of the Philippines
HOUSE OF REPRESENTATIVES
QUEZON CITY

Seventeenth Regular Congress
First regular Session

HOUSE BILL no, 483 2

Introduced by Representative 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 eamers. 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.



Republic of the Philippines
HOUSE OF REPRESENTATIVES
QUEZON CITY

Seventeenth Regular Congress
First regular Session

HOUSE BILL no4 882

Introduced by Representative 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 the 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 5 to 14 years.

(b) 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.

(2) 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-rables 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 to 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 modern 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 govemment 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. 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 fo carry out the provisions of this
Act shall be charged against the current year’s appropriation of the concemed goverment
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,