As time goes by, there seems to be a gradual influence of modern sensibility on the way humans perceive the concept of health. In fact, nowadays, there seems to be a blurring of the line between health and wellness. Because of this, it is inevitable that in a modern society, people are now being more conscious with their body and their health is now being a worrisome for them. Thus, science, especially the field of medicine and health sciences, has permeated popular culture in a sense that people have already treated health as a “religion”.
A perfect example of this phenomenon is the rising popularity of stem cell technology because it has already become a transnational activity and issue. Because of this technology’s transnational influence, governments around the world have been very supportive of it. And now, this transnational activity has entered the Philippine healthcare and medical discourse, and issues in its funding are arising. Although stem cell technology is a relatively new and promising technology which will help address health concerns in the country, the federal funding of this technology will only be a burden for the government for it is not a necessity, has questionable benefits, and is impractical and not practicable.
This paper, then, seeks to determine the origin of how the concept of stem cell entered the Philippine health and medical discourse as well as issues regarding the federal funding of stem cell research and technology in the country. Furthermore, the writer wants to state that although this paper is arguing that the government should not fund stem cell research in the country, this paper is not trying to argue on the necessity, beneficiality, practicality, and practicability of stem cell research and technology in general, or should it be implemented in the country without federal funding. Also, although some issues of bioethics are going to be tackled in this paper, the writer does not intend to side on certain beliefs of some culture or religion. The discussion on the ethical issues affiliated with the federal funding of stem cell research and technology are entirely made on a social, political, and economic basis.
But before the paper begins on enlisting the arguments against the federal
funding of stem cell research and technology in the country, it will first provide a background of how it came to the Philippine context.
Starting now from what was stated in the introduction, that modern sensibility has gradually influenced people’s perception of the concept of health, it is important to note that with modern technology it has provided an avenue for medical research to continuously uncover new facts and principles that build upon existing knowledge to modify the way we think about biological processes (Trounson xix). In relation to this, throughout the age of medical research, it can be inferred that the reason why there is a continuous activity regarding medical research is because there is a growing interest among scientists in the discovery of new and revolutionary methods of treating certain illnesses that are difficult to be treated in the present like cancer, diabetes, and other degenerative illnesses.
It is true that after the nineteenth century, it was thought that “germs” are the main causes of death among Americans in terms of health-related deaths. But with the birth of the twentieth century and the booming twenties, there has been a paradigm shift in trying to find out the causes of health-related casualties. It was believed then that as generations come, people will be more conscious to degenerative illnesses than that of infectious diseases.
Since then, there have been many studies that try to give cure to these degenerative illnesses like cancer, diabetes, etc. And yes, there have been successful discoveries, and there are some failures or “still ongoing” studies like the attempt to find the cure for diabetes. These then, can be the rationale behind the endless string of studies in the field of medicine and health sciences. However, it is also without doubt that the reason why scientists are so interested with medical research is that, in a social context, the field of medicine and health sciences tries to give pertinent solutions to the people’s needs, wants, and interests in having a healthy lifestyle, being safe from diseases, and in having a beautiful and healthy body.
It is intriguing, though, to know that medical research is also being influenced by the interest of the people, of the mass to be more specific. From this, we can then assume that health has been popularized already. In fact, after the first half of the twentieth century, in the final phase of the popularization of health, masses of Americans took a special interest in health as shown in their willingness on spending dramatically increased amounts of money for their health, not only on medical care but gymnasium and similar group memberships and paraphernalia as well to be able to have a healthy lifestyle, thereby blurring the line between health and wellness (Burnham 67).
It is then without doubt, according to Trounson that “in the history of science, certain discoveries have indeed transformed our thinking and created opportunities for major advancement, and so it is with the discovery of stem cell technology…” (xix).
Indeed, if there is to be an example of how the field of health and medicinal sciences became popularized, it is the rise of the stem cell.
It was November of the year 1998 that stem cell came to the scene of health in popular culture. There were separate announcements in this time by two groups of medical researchers, lead by James A. Thomson of the University of Wisconsin and John Gearhart of the John Hopkins University School of Medicine, about the isolation of the human stem cell.
That’s why recently there has been an increased interest among professionals and the public for the stem cell technology other than any fields in biology.
But why is there such an interest in stem cell?
The ability of the stem cell to provide an in-depth understanding of the biology of the cell and its promising abilities in the field of medicine are the reasons why stem cell is what getting the imagination of the scientists. They are interested in the stem cell because of its property of self-renewal (the ability to produce cells identical to the mother cell) and the ability to make differentiated cells (daughter cells that have limited and focused potential) (Melton and Cowen xxiii).
It is a relatively new and promising technology that can lead to the cure for diabetes and more advanced treatment of cancer and other degenerative
illnesses. Furthermore, there is a possibility that through regenerative medicine that makes use of stem cell, cancer and heart disease can now be cured. But what makes stem cell technology a buzz among the public is because it has been a hit in the field of cosmetology for stem cell technology can prevent body aging. Also, through the popularization of the stem cell, there have been certain hypotheses that stem cell technology can prolong someone’s life span compares to the average human life span.
Because of the popularization of stem cell, it is without doubt that it will become a global issue. Its impact has made transnational influence already.
It is because presently, science is a transnational activity – the work and research of scientists have no national boundary (Savulescu and Saunders c3). However, the regulation of science is still being placed under national jurisdiction. It is often that there are different laws and ethical standards in each country, and of course, transnational studies in science are being affected.
This implies that there are “some fundamental cultural, social, [political], and economic forces that drives controversy and conflict, not only in the United States, but in Europe and elsewhere” (Green 265).
Due to this, there have been suggestions from different groups from the scientific community specializing in stem cell research and technology that there should be a regulation of stem cell research in different countries because of the potential of this technology especially if the administrations will give importance for the politics of public health (Savulescu and Saunders c3).
Later on, because of this transnational influence, there has been a steadfast support from governments all over the world for stem cell technology and in the effort of making stem cell research and technology a transnational activity, also due to the transnational collaboration of scientists from different countries to impart among themselves knowledge about stem cell technology.
One of these countries is the United States which pioneered research in this field, where modern medical techniques were developed using this technology. In fact, stem cell research has a long history already in the US. There have been debates regarding the ethical issues associated with stem cell technology, specifically the use of human embryonic stem cells, and issues regarding the federal funding of stem cell research and technology. Only last 2009, US President Barack Obama approved the bill amending the federal funding of stem cell research and technology in the US.
It is also important to note that other countries in Asia and other third world countries have been influenced by this transnational activity. In 2004, three private stem cell banks were established in South Africa. Even though, these banks were private, the government has shown interest and support for these private research entities and stem cell research as well because of the Human Tissue Act that allows the use of human embryos that are not more than 14 days old in their research projects. Last March 2012, a group of scientists from the Council for Scientific and Industrial Research in South Africa was able to produce pluripotent stem cells – a feat and a first from a third world country.
Meanwhile in Asia, legislation was passed in China that allows the stem cell research and India, another third world county in Asia, has now launched programs using stem cell technology. Singapore is now known as Asia’s Stem Cell Center, where more than forty groups of researchers are to be found, some of it are funded by the government.
The Philippines is no exception. A third world country from South East Asia, the country has proved that we are not to be left behind in terms of medical development.
Stem cell technology was introduced to the Philippines as a technology used in the medical field of cosmetology. A few examples of the usage of this technology in this field are the alteration or surgery of certain body parts like the nose or breasts and the age-defying medications that fight off skin or body aging. However, discoveries that are exchanged through transnational studies brought to the Philippines some breakthroughs in the use of stem cell technology. That’s why some groups of specialists from the country has already joined the transnational activity that is collaborative stem cell research and used the discoveries in stem cell research in other medical fields other than cosmetology.
The group of specialists from the National Kidney and Transplant Institute pioneered the use of stem cell in transplantation in 1990. From then on, the institution has strived to raise the standards of stem cell technology through providing modern facilities and continuous research in the field especially in its usage in Dendritic Cell Vaccine Therapy in collaboration with the Lung Center of the Philippines.
Another spearheading group in the field of stem cell technology in the country is the group from The Medical City where they used their discoveries to be the pioneers in the medical technique of personalized molecular medicine in the country through their Regenerative Medicine Program that is lead by Dr. Joyce Bernal.
Other groups that have explored stem cell technology in the country are the groups from St. Luke’s Medical Center, Eye Institution, and the Makati Medical Center.
Notice that all of the institutions mentioned are private institutions. It is with no doubt that the government might have an interest in a public stem cell center. The interest was then materialized on September 13, 2011 when House Bill No. 5287 or the Stem Cell Center of the Philippines Act of 2010 was passed to the congress. The house bill, introduced by Rep. Carmelo Lazatin, states that a government-run stem cell center has to be established in the country that will be the premier center for research and technology applications of stem cell which will be, in essence, funded by the government.
However, we need not to follow the United States in federally funding stem cell research and technology in the country. That although stem cell technology will help address health concerns in the country, the federal funding of the technology will only be a burden fir the government for it is
not a necessity, has questionable benefits, and is impractical and not practicable.
Firstly, the federal funding of stem cell research is not a necessity. The government has more pressing concerns that should be prioritized first in the health care system.
Instead of building new facilities for a single stem cell center, why not improve the infrastructures of public health institutions? We need more public hospitals, especially in the provinces and rural areas where access to medical assistance is scarce, that are also well-equipped with modern advances in medicine and have competitive health workers.
This way, we’re already hitting two birds with one stone. Not only that the government is providing more health facilities for the people, but it is also providing jobs for practitioners in medicine like doctors, nurses, midwives, and etc. as well. Through this, the government is making a small step towards lessening underemployment in the country and the number of health professionals that have to work abroad. Also, the government has to address issues regarding the PhilHealth system. According to the Philippine Health System Review, although estimates of PhilHealth coverage of the population vary, there are legitimate concerns that the amount of financial protection provided by the county’s largest insurance program is actually small, at least relative to its infrastructure and available resources (Romualdez et al. 36-39).
In addition to this, the government has to financially support instead research in the advanced treatment of epidemic diseases that are more rampant in the country especially among the poor.
Secondly, the federal funding of stem cell technology has questionable benefits. The fact the government will fund stem cell research will do ensure that stem cell treatment may be open to the public at a lower price. However, stem cell treatment is not the same for anyone, thus, there will be different processes such that because stem cell treatment must be a personalized treatment, but this will require a lot of costs because specialists will then have to prepare different treatments for different patients.
Even so, that the treatment may be open to the public at a lower price might affect the quality of the treatment because (1) price tag may limit potential scope of stem cell treatment, particularly if treatments are individually customized, which may be necessary and (2) such limitations might lead to further problems and will have to require financial support again. Furthermore, Evert and Zavarzadeh argue that: “…[B]ut public funding is itself the immediate form of surplus labor in conducting stem cell research…Those who use the excuse of the usefulness of stem cell research for curing illnesses argue that public funding (the social surplus) but privatize its cost of new research (funding it through people’s taxes) but privatize its profits. The new procedures/medicines that will be developed will then be patented by these companies and sold at a high profit back to the people who have provided the funding (through their taxes) for these discoveries.” (116)
Indeed, since the government will have to fund a costly research, there will be no choice left than to spend a considerable part of the taxes collected from the public for stem cell research which then raises the question: Who are the actual beneficiaries of federal funding of stem cell research then?
Thirdly, the federal funding of stem cell technology is impractical and not practicable because the facilities and technology required in making sure that an advance science like stem cell technology meets high standards are definitely going to be of high maintenance and expensive value. According to a press release of the Department of Health last September 4, 2012 in its website, DOH Secretary Enrique T. Ona announces the proposed 2013 budget of the department.
He announces that there is an increase for this year’s healthcare budget. Furthermore, he emphasizes that the budget is allotted in line with the administration’s effort to alleviate poverty, thus the imperative implementation of the Kalusugan Pangkalahatan by the department. He further broke down the components of the budget. He emphasized that 69% of the budget will be used for priority projects, and that the budget will ensure the enrolment of indigenous families under the healthcare system. Moreover, part of the budget is to address concerns regarding the improvement of current medical facilities and work force from the barangay up to the regional level especially in rural areas. Concerns regarding immunization and infectious diseases will be addressed by the budget as well.
Ona ends the press release by stating that the budget will help the nation achieve its Millennium Development Goals, and further suggests that to further bolster the sustainability of the budget, the Senate has to pass into legislation the tobacco and alcohol excise tax reform bill and the reproductive health (RH) bill. Ona emphasized in the press release that 69%, a big part of the budget, will be used to address priority projects, activities, and programs in support of KP of the DOH.
The following programs are as follows: Subsidy for Health Insurance Premium payment of indigent families to the National Health Insurance Program, Health Facilities Enhancement Program, Implementation of the Doctors to the Barrios and Rural Health Practice Program, Family Health including Responsible Parenting, Expanded Program on Immunization, National Pharmaceutical Policy Development including provision of drugs and medicines, medical and dental supplies to make affordable quality drugs available, Tuberculosis Control, the elimination of diseases as public health threats such as malaria, schistosomiasis, leprosy and filariasis, other infectious diseases and emerging diseases including HIV/AIDS, dengue, food and water-borne disease, and Rabies Control Program.
Notice that the programs that are to be prioritized by the majority of the budget are the timely concerns in the health sector in the country. The researcher argues that the remaining percentage of the budget will be unable to financially support the implementation of the Stem Cell Act, and that to include the proposal to the priority programs will be impractical for the research itself is quite inconclusive and will be not practicable for it is an expensive technology. Furthermore Ona said at the press release that, “It is imperative for us to support the proposed DOH 2013 budget in order to build on the health gains of 2010-2012 and continue the direct, immediate, and substantial health benefits for our people, especially the poor.”
Thus, the current proposed budget for the Department of Health is already spot-on on addressing the priorities of the government for the health sector. Without a doubt, stem cell technology is a high maintenance and expensive technology, thus efforts on trying to keep up with certain standards will significantly diminish the budget. However, as Ona said that “it is an imperative…to support the proposed DOH 2013 budget,” with the remaining percentage of the budget in support of other projects, federal funding of stem cell technology seems not practicable.
Moreover, stem cell technology has yet inconclusive results that doesn’t address the more pressing concerns in the context of the Philippine health setting – that is, it cannot cure epidemic diseases like malaria, dengue, and typhoid fever which are more rampant in the country. Further on, there are a few select professionals that specializes in stem cell technology, thus the government still need to provide training for certain health professionals so that they can specialize in stem cell technology and treatment for the proposed public stem cell center which, in essence, is an additional expenditure.
In the end, the conditions and standards set by stem cell research and technology do not fit in the context of the Philippine health setting. Besides, with the rising protest against stem cell technology because of it not being in tune with the established norms and ethical standards in the country, it will be better off that the government should not fund it because the country is still amidst debates between the implementation of certain bills that go against the foundations of moral standards in the country.
Burnham, John C. How Superstition Won and Science Lost: Popularizing Science and Health in the United States. New Brunswick: Rutgers, the State Univeristy, 1987. Print. Department of Health, Republic of the Philippines. DOH 2013 Budget Promises Better Health for All Filipinos. Department of Health. Department of Health, Republic of the Philippines, 4 Sept. 2012. Web. 28 July 2013. . Ebert, Teresa L. and Mas’ud Zavarzadeh. Class in Culture. Boulder: Paradigm Publishers, 2008. Print. Green, Ronald M. “Embryo as Epiphenomenon: Some Cultural, Social, and Economic Forces Driving the Stem Cell Debate.” Global Bioethics: Issues of Conscience for the Twenty-First Century.
Ed. Ronald M. Green, Aine Donovan, and Steven A. Jauss. New York: Oxford University Press Inc., 2008. 265. Print Melton, Douglas and Chad Cowen. “Stemness: Definitions, Criteria, and Standards”. Essentials of Stem Cell Biology. By Robert Lanza, et al. 2nd ed. Toronto: Elsevier Inc., 2009. xxiii. Print. Republic of the Philippines. Cong. House. Rep. Carmelo Lazatin. An Act Establishing Stem Cell Center of the Philippines and Strengthening Research on Stem Cell Technology. 15th Cong., 2nd Sess. HR 5287. Quezon City: Philippine Congress, 2011. Print. Romualdez, Alberto G., Jr., et al. “The Philippines Health System Review.” Health Systems in Transition 1.2 (2011). 36-39. Print. Savulescu, Julian and Rhodri Saunders. “The Hinxton Group Considers Transnational Stem Cell Research.” Hastings Center Report 36.1 (2006). c3. Print. Trounson, Alan. “Why Stem Cell Research.” Essentials of Stem Cell Biology. By Robert Lanza, et al. 2nd ed. Toronto: Elsevier Inc., 2009. xix. Print.
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