Truth in forests and trees

There is a proverb which warns people from “not seeing the forest for the trees,” meaning someone is seeing the details but not the overall or big picture. I think we are in a moment like this in the dengue vaccination issue, in the debate over the tax reform bill that Congress has just passed, Sereno impeachment process, and Isabelle Duterte’s pictures. Actually, in all cases, the trees, i.e. the details, are also important but one must not forget the forest, what these controversies tell us about where we are as a society and where we are headed.

The dengue vaccination issue seemed straight forward. On one hand, there is the narrative of a conscientious president addressing a public health problem decisively after receiving all the information necessary. For sure, President Aquino was impressive, credible in his testimony before the Senate committee chaired by Senator Dick Gordon. He was dignified, cooperative and gave straightforward answers. That the information turned out to be flat out wrong is not his fault, according to his supporters. Sometimes, decisions have to be made weighing all the information available at that time. For those supporters, it was a “damn if you do, damn if you don’t” situation. They argue that President Aquino would have been accused of inaction if he waited for the next administration to make the vaccination decision given the prevalence of dengue in the country.

The tree in this issue for me is the accountability of the Aquino and Duterte officials who made the decision to launch (for the former) and continue (the latter) the dengue vaccination campaign even as the debate about its efficacy and risks continued. Another tree is the legal liability of the Sanofi officials who mounted a sophisticated marketing strategy on the Aquino officials, blinding the latter to make a bad decision. Finally, one more tree is the role of congressional representatives who lobbied former health Secretary Pauline Ubial who, against her better judgment, continued the vaccination program in the first year of the Duterte administration.

The forest to these trees is the way we make policy decisions in our country. The dengue vaccination controversy reveals how appalling our decision-making process is. On what needed to be science-based and precautionary, given the magnitude of dengue as a problem, the scientific uncertainty involved, the risks that have been raise, and the amount involved, politics prevailed over good sense.

The scientists of the Department of Health, through the Formulary Executive Council, were ignored and even pressured to give a limited approval; subsequently, even the conditions which they imposed were set aside.

I have learned in my stint in the Department of Environment and Natural Resources, in my engagement on climate change for the last three decades, and my current work as head of Manila Observatory, that you ignore your scientists at your own peril, and in this case at the peril of thousands of children and billions of precious public health money.

President Aquino himself, as pointed out by Dr. Susie Mercado, formerly with the World Health Organisation and an ex-DOH official, clearly had wrong information about the extent of the dengue problem. For sure also, there was a big debate on the efficacy and risks of proceeding the Dengvaxia purchase. As I believe President Aquino’s assertion that he was not told about objections to this decision, one can only conclude that there was a bubble, a cordon sanitaire around President Aquino that blinded him to the concerns that were being raised.

There is another forest here that has been raised, and that is the specter of corruption. But there is so far no proof about that. I am inclined to believe that this is more an issue of a successful marketing strategy by a big pharmaceutical company that pulled all the levers to make a big sale that was crucial for its bottom line. 

One hopes that lessons can be learned in this Dengvaxia controversy. This lack of evidence and science based policy decision making is not exclusive to the Aquino government. Previous administrations have been guilty of this. Currently, the Dutere administration is doing this in its war against drugs.

Another controversy where the forest and trees lens can be used is the uproar over the tax reform program of the Duterte program, popularly known as TRAIN, which Congress has just approved. I congratulate Senator Sonny Angara and Congressman Dax Cua, and their principals Senate President Koko Pimentel and Speaker Pantaleon Alvarez, for making this happen. The leadership of Finance Secretary Sonny Dominguez and his lead undersecretary on this, Karl Chua, was crucial. Seeing the latter in action during the bicameral conference was awesome, to say the least.

One big tree here is the reduction of tax rates for all tax payers, which definitely is a welcome relief for many. But that comes with a significant revenue loss that had to be offset by increase in taxes. 

A second tree is the imposition of an increase in excise taxes on coal and other minerals. This is long overdue and is important for the message it sends about dirty fuels and industries. The increase on consumer electricity bills would be negligible. The last-minute deletion of the VAT for domestic coal was terrible, as condemned by Senator Joel Villanueva, and that should be revisited at another time. In any case, Senator Loren Legarda has once again proven her mettle as a legislator that can get things done. A 50/100/150-peso increase is less than the 100/200/300 increase the Senate approved but it is still eventually a 1500 per cent increase from the pathetic 10 pesos we charge now. More than anything, it sends the message that coal is on the way out of our energy mix. That makes this tree a big picture matter.

The forest in TRAIN is its impact on the poor. I am not qualified to comment on that but it is something that we must all pay attention to. To the extent that TRAIN enables BUILD BUILD, BUILD, the ambitious Duterte infrastructure program, it could benefit the poor if the latter leads to authentic economic development. But the direct impact to the poor of the new or increase in taxes must still be weighed and mitigated.

In the impeachment process against Chief Justice Sereno, the trees are the testimonies against her, including by some of her fellow Justices, all of which would show that at worst she had made mistakes as a manager but certainly has not committed impeachable acts. The forest is the independence of the judiciary which could be burnt down as a result of this process.

Finally, the pictures of Isabelle Duterte. The trees include the costs of those dresses, the extravagance of the family that purports to be poor, and the age of Isabelle that makes the pre-debut narrative a stretch.  But the forest for me is still the fact that this is a 15 year old (according to Raissa Robles) whose actions should not occupy so much public space as it has now occupy. What does that tell us of our country?

Trees are important. But let’s keep in mind the forest. Let’s specially make sure we don’t burn it down and we grow the forest, our country, to be better, more prosperous and peaceful, and yes happier.

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Topics: dengue vaccination , Senate committee , Dick Gordon
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