I have lauded in previous columns the Aquino health agenda. What used to be a utopian dream of health for all now appears to be within reach.

I feel happy when indigent patients tell me that their PhilHealth coverage took care of all, if not a big part, of their hospital bills. I thought that this was a good indicator of inclusive growth, with the countrys economic gains trickling down to the poorest of the poor.

Ive always said in my talks that, for me, President Aquino is the most health-oriented president we ever had. But his recent statements suggesting his health priorities made me wonder about his concept of Public Health and what preventive medicine entails.

There are speculations on why Health Secretary Ike Ona has gone on leave for four weeks to prepare answers to President Aquinos questions on the mass vaccination campaigns of the Department of Health. If I had read between the lines correctly, I think P-Noy is wondering why we have to spend so much money on upgrading government hospitals instead of concentrating on preventive strategies like immunization.

Govt focus

I think there can be no disagreement that the government must focus on preventive strategies. Im sure Aquino gets that kind of advice from everyone. The so-called New Public Health, or NPH, is defined as one which puts emphasis on preventive medicine. But probably it was not explained to the President that prevention does not only entail immunization or other primary preventive interventions.

When we speak of preventive medicine, were actually referring to three levels of preventionprimary, secondary and tertiary.

Primary prevention means implementing programs and services to prevent diseases such as mass immunization, and promoting the reduced usage of tobacco products and other harmful substances. Basically equipped and adequately manned primary health units should be able to handle these.

Secondary and tertiary prevention may require more well-equipped healthcare facilities.

Secondary prevention aims for early diagnosis of a disease when one has no symptoms yet. There are diseases, like high blood pressure, that may well be diagnosed in primary healthcare facilities; but others, like diabetes, cholesterol problems, early cancers, lung and liver diseases, may have to be referred to secondary or tertiary hospitals for a more thorough evaluation, early diagnosis and treatment to stop the worsening of these and prevent complications.

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Aquinos dilemma on preventive and curative medicines