Don’t delay Cancer Assistance Fund guidelines

In the past six months, my 67-year-old father-in-law has been experiencing drastic weight loss, weakness, continuous coughing and breathing difficulty. After a series of medical tests, we learned that the manifestations were caused by a tumor in his right lung. He has lung cancer.

The family is hoping that National Integrated Cancer Control Act (NICCA), which was signed into law in 2019, would help my father-in-law ease his out-of-pocket expenses as he seeks proper care to address and improve his medical condition.

Despite the shift in health priorities in the past couple of years due to the COVID-19 pandemic, there have been milestones attained in relation to the law. The government, through its lead agency, the Department of Health (DoH), has worked together with several stakeholders to implement the provisions of the law and bridge the gaps to bring quality healthcare to cancer patients.

For instance, the NICCA Council was officially created early last year. It is envisioned as a policymaking, planning, and coordinating body that would ensure the judicious use of available resources as mandated in the law. Cancer patients, persons living with cancer, and cancer survivors are now considered as persons with disabilities (PWDs) by virtue of Administrative Order (AO) No. 2013-0005-B issued in October 2021.

Moreover, cancer access sites are steadily expanding, with 31 sites nationwide as of February 2022, compared to the initial 14 sites prior to the 2019 passage of the law.

The access sites aim to establish a continuum of care at least for the eight priority cancer types, namely, 1.) breast cancer, 2.) childhood cancers, 3.) gynecologic cancers, 4.) liver cancers, including colorectal and other digestive tract cancers, 5.) adult blood cancers, 6.) head and neck cancers, including thyroid, 7.) lung cancer, and 8.) prostate, renal and urinary bladder cancer.

And then, last June 8, 2022, the DoH released AO No. 2022-0013. This order pertains to the Guidelines for the Implementation of the Cancer and Supportive-Palliative Medicines Access Program (CSPMAP), which will also be known as “Ayuda sa Kanser” (translated as “Aid for Cancer”) or simply as “Ayus Ka.” The CSPMAP is a sub-program component of the NICC Program and refers to the mechanism in providing access to free medicines that are not yet covered by PhilHealth to minimize or eliminate out-of-pocket expenditures.

According to the same AO, the funding for the CSPMAP will be sourced from the annual Cancer Control Program (CCP) and Cancer Assistance Fund (CAF) budget line items. For the past two years, the CCP and CAF have been given allocations in the approved national budget or General Appropriations Act (GAA), FY 2022. Both allocations, P786.956 million for CCP and P529.200 million for CAF, were specified in the special provisions of the DoH budget.

As specifically stated in the GAA’s special provisions, the CCP “shall be used to cover the cost of cancer treatment and care… and will be exclusively for the procurement of cancer, supportive care and palliative care medicines covering the eight treatable cancer types.” The CAF “shall be used to fund the cost of cancer treatment and its cancer-related components, including the needed diagnostics and laboratories for the eight cancer types subject to the implementing guideline has been issued by the DoH and Department of Budget and Management (DBM).”

According to the recent information from the DoH, the said implementing guideline for the CAF will be issued as a Joint Memorandum Circular with the DoF. Upon learning this, the non-ex officio members of the NICCA Council immediately sent their formal letters to the offices of the President and of the Health Secretary, appealing for the urgent issuance of the Memorandum Circular to be able to facilitate the utilization of the allocated CAF budget which has been idle since the GAA was signed early this year.

The P529.2 million CAF allocation will protect and deliver the promise of the NICCA by providing help for more patients of the needed diagnosis or active treatments. If not issued before the end of this administration on June 30, the circular will be passed on to the new administration and may result in further delays. New officials taking over these agencies will likely take time to get familiar with operations and review these implementing guidelines before making any decisions.

Apparently, as of this writing, the said Joint Memorandum Circular has not yet been issued.

Meanwhile, my father-in-law, together with perhaps thousands of cancer patients, is scheduled to undergo therapy beginning next month in one of the cancer access sites. They were assured that the cost of their treatments would be covered.

We are praying that with the immediate issuance of the implementing guidelines of the Cancer Assistance Fund, this promise of the National Integrated Cancer will happen.

Alvin Manalansan is the Health and Nutrition fellow of Stratbase ADR Institute and is a co-convenor of UHC Watch.