Manila, Philippines – Health officials in the Philippines are racing to contain a deadly measles outbreak the government has blamed on a marked decline in immunisations amid a scandal surrounding a vaccine against dengue fever.

More than 70 people – mostly children – have died nationwide since January, with a high concentration of cases in the capital, Manila, and its surrounding provinces.

Across the country, over 4,300 people have contracted the highly contagious disease since January, a 122-percent jump compared to the previous year, according to the Department of Health.

Many of those affected are from poor families that depend on public health services for treatment and medicines, both of which the government is now hard-pressed to supply.

In downtown Manila, the government-run San Lazaro Hospital is crammed with measles patients, while doctors say they are stepping up preparations for more admissions.

In communities and villages, health workers have been urging hesitant parents to immunise their children against measles and other diseases such as polio, diphtheria, hepatitis and the flu.

Over the past year, fewer parents have used the government’s free basic immunisations fearing that vaccines could harm their children.

Health officials say vaccination rates among children have gone down from 85 percent to 60 percent, and even as low as 30 percent in certain communities.

As a result, experts say, many children have been left vulnerable to measles, with unvaccinated adults also facing the risk of contagion.

Vaccine ‘drama’

Francisco Duque III, the health secretary, has blamed the vaccine scare on the Public Attorney’s Office, particularly its chief lawyer, Persida Acosta, who has been leading an investigation of a public vaccination campaign against dengue fever in 2016 and 2017.

Measles, a contagious disease, killed an estimated 110,000 people in 2017, according to the World Health Organization (WHO). The vast majority were children under five.

The disease starts out like a common cold, then it progresses into high fever along with worsening symptoms. It’s contagious through direct contact and through the air. Once it infects the respiratory tract, it then rapidly spreads throughout the whole body. Within days, rashes appear on the face and neck until fully covering the infected.

WHO says that deaths occur because of complications with the disease, such as encephalitis (an infection that causes brain swelling), diarrhoea, dehydration, ear infections or severe respiratory infections. Research from WHO found that Southeast Asia suffers from more cases of measles than anywhere else in the world.

In 2017, there were 107,292 suspected cases in Southeast Asia. The figure dropped to some 83,000 suspected cases the following year.

Acosta has insisted the vaccine called Dengvaxia caused the deaths of dozens of children even though parallel investigations have not led to that conclusion.

The chief lawyer figured prominently in televised Dengvaxia investigations by the Senate and the House of Representatives, presenting relatives of alleged victims and claiming that autopsies conducted by her office found that the deaths were “possibly” linked to the vaccine.

Acosta’s public appearances were characterised by emotional outbursts, drawing criticism from other officials who described her behaviour as “hysterical”.

The controversy began in November 2017, when Dengvaxia manufacturer Sanofi Pasteur announced that the vaccine may not be effective in some cases and could lead to severe dengue infections among people who have not previously had the disease.

At the time, more than 700,000 people, mostly schoolchildren, had already received at least one dose of Dengvaxia through a $67m government project to eliminate dengue fever, one of the most common and lethal diseases among Filipino children.

The Department of Justice has since filed negligence and corruption cases against former President Benigno Aquino, two of his cabinet secretaries and several other officials who implemented the Dengvaxia immunisation programme.

Acosta’s office filed separate charges, including against Duque, who took over as health secretary a month before Sanofi Pasteur’s announcement, and who halted the Dengvaxia project in December 2017.

Duque called the accusations “malicious and baseless”.

“The Dengvaxia scare, all this drama that they were doing, have really caused damage to the integrity and the effectiveness of the Department of Health,” Duque told reporters, referring to the Public Attorney’s Office.

‘Politically-motivated witch-hunts’

Acosta denied responsibility for the vaccine scare, saying it was “unfair” to pin the blame on her and her office.

“Maybe they should ask themselves whether they failed to campaign for safe vaccines like the one for measles,” said Acosta, referring to Duque and other health officials.

Salvador Panelo, spokesman for President Rodrigo Duterte, defended Acosta, saying she was “just doing her job” in rallying alleged Dengvaxia victims to press charges.

Panelo however also affirmed Duque’s view that the Dengvaxia affair caused the vaccine scare that led to the measles outbreak.

In response, Duterte has called on his health officials to increase efforts to immunise children, urging parents to avail of basic vaccines they could get free at public health centres.

Opposition figures allied with Aquino criticised Acosta and accused her of using the Dengvaxia cases to discredit the political opponents of Duterte, whose 2016 election campaign capitalised on the public’s disillusionment with Aquino’s administration.

“Our country’s immunisation programme is now in a quandary and our children’s health is under threat because of the vaccine scare triggered by Acosta’s grandstanding to be in Duterte’s good graces,” said Senator Leila De Lima, who has been jailed on drug charges following her probe into killings in Duterte’s war on drugs.

Senator Risa Hontiveros, who used to lead the health committee, has called on Acosta to resign.

“She stood at the gravesides of poor dead children to wage a vicious campaign of disinformation, pseudo-science and politically-motivated witch-hunts,” Hontiveros said.

“Her lies and hysterics contributed directly to the erosion of public trust in our vaccination programmes.”

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