Strengthening research in the Philippines

MANILA, Philippines — Did you ever wonder why we spend money on health research? Should we not just wait for the data generated from researches by high-income countries (like US and Europe) and use their results in the Philippines?

To illustrate, let me share a family’s sad story about genetic testing. DNA sequencing gives information on a person’s risk for disease, response to drugs and even one’s ancestry. It has been offered as a direct-to-consumer genetic testing for healthy individuals and families to provide information on an individual as well as his family’s risk for common diseases such as cancer, heart disease and diabetes.

A family recently paid more than P100,000 for genetic tests that yielded “normal results.” The parents were surprised because their child is NOT normal, hence, the consult in my clinic. The public must remember that most (if not all) commercial genetic tests do not have the genetic variants that are unique to Filipinos. The Philippine Genome Center is now working on these unique sequences.

While the Filipino can catch up with evolution of technology? Yes we can. But the increasing complexities of technology, the administrative infrastructure, and the increasingly sophisticated knowledge level of the researchers involved all carry a price tag.

Government support

I have been doing research for three decades on the fields of genetics, birth defects and newborn screening. Funding has always been limited. But in the past eight years, I have witnessed the substantial increase in budgets of the Department of Science and Technology (DOST) and the Commission on Higher Education (CHED) for health research as scientists try to use technology to better understand the health of the Filipino.

Researches provide an opportunity for the country to build the country’s research portfolio on health, medicine and biotechnology programs, a potential goldmine to support the macroeconomic growth of the country through science and technology.

Dr. Raul Destura developed a Dengue diagnostic kit that has higher sensitivity (means a positive result is really positive) and higher specificity (means a negative result is really negative) and has expanded this experience to other infectious diseases relevant to the country.

Dr. Rody Sy’s research identified specific genetic markers that if present in a Filipino patient, may indicate that he will not respond to common drugs used in the treatment of high blood pressure, statins (used for lowering cholesterol) and anti-platelet agents (blood thinners like aspirin and clopidogrel). After validating in a larger patient group, these findings can assist doctors in selecting the correct drug for each patient’s condition.

Dr. Edsel Salvana’s research on HIV genes showed that the subtype in the Philippines shifted from the western subtype B to the Southeast Asian subtype, which seems to be more aggressive and develops drug resistance faster. He continues to work on HIV to ensure that Filipinos living with HIV receive the best possible care, and that vaccine efforts include the Philippine strain. 

These government-funded researchers and many more are opportunities for better health for our Filipino population. 

Researches, publications, citations

At the 2019 Times Higher Education Rankings, the University of the Philippines (UP), specifically, the Citation Score on Clinical, Pre-Clinical and Health, garnered a score of 98.8, higher than other internationally-renowned universities such as University of Oxford (92.7), Stanford University (92.1), University of Cambridge (88.5) and Harvard University (87.4).

Citations denote research influence. The research influence indicator looks at universities’ role in spreading new knowledge and ideas. The citations help to show how much each university is contributing to the sum of human knowledge. They tell whose research has stood out, has been picked up and built on by other scholars and, most importantly, has been shared around the global scholarly community to expand the boundaries of our understanding, irrespective of discipline.

The impressive Citations Score UP is a reaffirmation that the works of the Filipino scientists in the field of clinical, pre-clinical and health are respected by the international community.

The future

What can we expect in the future?

With an increased budget from the Philippine Council for Health Research and Development (PCHRD), more Filipino-centric affordable diagnostic kits will be available for common diseases in the Philippines such as schistosomiasis (still endemic in 28 provinces in 12 regions); chikungunya (transmitted by a day-biting affected mosquito) and salmonella (presenting with diarrhea, fever, abdominal cramps and vomiting).

Filipino genetic markers for cancer, diabetes, and other conditions will guide physicians in the choice of medicines (personalized medicine). Genetic markers will allow early diagnosis before complications set in.

The drug discovery program of DOST-PCHRD will bring cheaper alternatives to the expensive drugs from abroad.

The biomedical devices program of DOST-PCHRD will bring cheaper alternatives to imported medical and hospital equipment.

And many more.

I am convinced that the Philippines is ready to adopt technology. But for this to happen, the government must increase investments so that scientists can work on technology best fit for the Filipinos. DOST-PCHRD must encourage universities and colleges to put premium on research. Core facilities are now available at the National Institutes of Health in UP Manila and the Philippine Genome Center in UP Diliman. These core facilities are meant to support researchers from all state universities, higher education units and research institutions. — Carmencita Padilla

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Carmencita Padilla, MD, MAHPS is a professor of pediatrics and chancellor of the University of the Philippines Manila. She is responsible for the Newborn Screening Act of 2004 (RA9288) and the Rare Diseases Act of 2016 (RA10747).