Confusion, blame game fuel Philippines’ Dengvaxia vaccine scandal

Relatives display pictures of children, who supposedly died after getting injected with the anti-dengue fever vaccine Dengvaxia, during a Senate investigation about the vaccine in Manila. (AFP)
Updated 17 April 2018
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Confusion, blame game fuel Philippines’ Dengvaxia vaccine scandal

  • Several measles outbreaks have struck the nation, claiming at least 13 lives, since the controversy began
  • Certainty about the children’s cause of death may remain clouded because post-mortem diagnosis of dengue can be a tricky process

IMUS, Philippines: Melinda Colite shakes with rage as she clutches a photo of her grandson, who she says died after getting the anti-dengue fever vaccine at the heart of a bitter scandal in the Philippines.
While Dengvaxia’s maker Sanofi has said unequivocally that its world-first vaccination is safe, Philippine authorities disagree publicly over whether it could have contributed to children’s deaths.
The resulting confusion has prompted a dangerous plunge in vaccination rates in the Philippines for other diseases.
It has also added to a swirling political battle, fanned by bloggers who back President Rodrigo Duterte and have an audience of millions of Facebook followers.
“The blame game has taken over the main issue,” Ronald Mendoza, dean of the Ateneo de Manila University’s School of Government, said. “It may be doing damage to public health rather than protecting it.”
Health authorities have said child vaccination rates against illnesses like measles have dropped by as much as 25 percentage points over the previous year as public anger and mistrust has grown in the Dengvaxia case.
Several measles outbreaks have struck the nation, claiming at least 13 lives, since the controversy began.
The trouble started last year, shortly after the Philippines gave Dengvaxia to some 837,000 students as part of a public immunization campaign.
Sanofi hailed the vaccine as a breakthrough in combating dengue, which kills hundreds in the Philippines every year, mostly children.
But the company set off a panic when in November it said a new analysis showed the vaccine could lead to more severe symptoms for people who had not previously been infected with dengue.
It prompted Manila to halt the campaign and left hundreds of thousands of terrified parents wondering if their children were at risk.
Sanofi has repeatedly said the vaccine is safe, noting in a March statement: “No causal-related deaths were reported in 15 countries after clinical trials conducted for more than a decade with 40,000 subjects involved.”
“There continues to be no evidence that any deaths have been causally linked to our vaccine,” it added.
But that has not stopped allegations emerging of vaccinated children dying of super-charged cases of dengue after getting Dengvaxia.
“It could not have been anything else. He started complaining of frequent body aches after his third injection,” Melinda Colite, 55, said of her 12-year-old grandson Zandro.
As of last week, 65 deaths have been reported to authorities and are under investigation, the health department says.
Different branches of the Philippine government have disagreed openly about potential risks of the vaccine, leading to confusion for the public.
“We cannot conclude at this point that Dengvaxia directly caused the deaths,” Health Secretary Francisco Duque told lawmakers in February, referring to the cases of 14 children who received the vaccine.
However, after additional potential cases emerged, the government assigned its legal service that represents the poor, the Public Attorney’s Office, to take up the matter.
Its chief lawyer, Persida Acosta, told lawmakers in February: “They (death certificates) said they were (killed by) acute respiratory arrest, encephalitis, appendicitis, septic shock. All of those are mimics of severe dengue.”
Certainty about the children’s cause of death may remain clouded because post-mortem diagnosis of dengue can be a tricky process.
The most accurate and widely used way of testing, called RT-PCR, relies on genetic material that degrades quickly after a person dies, especially in warm climates like the Philippines, virus expert Benjamin Neuman said.
“The challenge of determining a cause of death by RT-PCR can swiftly move from difficult to impossible,” he added.
It is also unclear if this type of testing has been used in the cases under investigation.
Supporters of the president have been eager to assign blame for the Dengvaxia scandal to his predecessor, Benigno Aquino, who has criticized Duterte’s deadly anti-drug crackdown.
Though the vaccination campaign was approved and launched under Aquino’s administration, it continued for a time under Duterte.
Well-known blogs have posted entries calling for Aquino to be jailed and questioned whether the vaccine is a “time bomb.”
Ruth Jaime, whose 12-year-old grandson Alexzander died due to a blood infection months after his last dose of Dengvaxia, says the situation is clear for her.
“Of course, no one will admit what caused his death,” said the fishmonger in her home west of Manila.
“If you had a healthy child and he dies after getting an injection would you not attribute his death to that?”


Locked away, forgotten: Muslim Uighur wives of Pakistani men

Updated 37 min 28 sec ago
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Locked away, forgotten: Muslim Uighur wives of Pakistani men

  • Beijing has been accused of interning members of its Muslim population to “re-educate” them away from their faith
  • Pakistanis often rally loudly in defense of Islam and Muslims whenever they are perceived offended around the world

ISLAMABAD: The last time Chaudhry Javed Atta saw his wife was over a year ago — the Pakistani trader in dried and fresh produce was leaving their home in northwestern China’s heavily Muslim Xinjiang region to go back to his country to renew his visa.
He remembers the last thing she told him: “As soon as you leave, they will take me to the camp and I will not come back.”
That was August, 2017. By then, Atta and Amina Manaji, from the Muslim ethnic Uighur group native to Xinjiang, had been married for 14 years.
Atta is one of scores of Pakistani businessmen __ and he says there are more than 200 __ whose spouses have disappeared, taken to what Chinese authorities tell them are education centers.
Beijing has been accused of interning members of its Muslim population — by some reports as many as 1 million — to “re-educate” them away from their faith. It is seen as a response to riots and violent attacks that the government blamed on separatists.
“They call them schools, but they are prisons,” Atta said. “They can’t leave.”
Pakistanis often rally loudly in defense of Islam and Muslims whenever they are perceived offended around the world — most recently over cartoons depicting the Prophet Muhammad. In 1989, protests spread from Pakistan elsewhere, leading to the fatwa by Iran’s Ayatollah Ruholla Khomeini against author Salman Rushdie for his depiction of Islam in his book Satanic Verses.
But political and economic factors, including concerns about losing out on vast Chinese investments, have kept Pakistan and other Muslim countries silent about the plight in China of fellow Muslims, the Uighurs.
“Cold, hard interests will always carry the day” in international relations, said Michael Kugelman, deputy director of the Asia Program at the Washington-based Wilson Center. “The Muslim world’s deafening silence about China’s treatment of Muslims can be attributed to its strong interest in maintaining close relations with the world’s next superpower.”
China is financing major development projects in cash-strapped Pakistan. Islamabad says Beijing’s up to $75 billion development project known the China-Pakistan Economic Corridor — part of an effort to reconstruct the historic Silk Road linking China to all corners of Asia — will bring new prosperity to Pakistan, where the average citizen lives on just $125 a month.
For Atta, it’s not just the separation from his wife.
He has also had to leave their two sons, who are 5 and 7 years old and whose passports were confiscated by the Chinese government, in the care of his wife’s family. Otherwise, he said, the authorities would have put them in an orphanage.
He went back to China twice for a few months but both times his visas expired and he had to return to Pakistan. Getting in touch with family in Xinjiang is a circuitous route that involves reaching out to Pakistani friends still there, who then track down family members willing to talk.
“Now especially I am worried. It is now eight, almost nine months, that I have not seen my children,” he said. “I haven’t even been able to talk to them.”
Last week, Atta finally talked to his brother-in-law after a friend discovered he had a heart attack and was recovering in a hospital in Urumqi, the capital of Xinjiang.
“He said my sons were good, but he had no news of my wife,” said Atta.
China routinely responds to queries on Uighurs by saying its policies are aimed at creating “stability and lasting peace” in Xinjiang but President Xi Jinping’s campaign to subdue a sometimes restive region, including the internment of more than 1 million Uighurs and other Muslim minorities, has alarmed a United Nations panel and the US government.
Mushahid Hussain, chairman of Pakistan’s Senate Foreign Affairs Committee, said the cardinal principle of Pakistan-China relations is to refrain from commenting on anything to do with the other country’s domestic issues.
“Given the relationship of Pakistan with China, and in the Muslim world in particular, the Chinese narrative is apparently being accepted across the board as the one that is correct,” Hussain said.
A steady stream of Pakistani men has visited Beijing in recent months , lobbying for the release of their wives to little avail. Some say they met Pakistan’s ambassador to China, Masood Khalid, on multiple occasions, and were told their issues were raised privately with the Chinese.
Another Pakistani man in a similar predicament, Mir Aman, went to China more than 25 years ago as a poor laborer in search of work.
There, he met his wife, Maheerban Gul, they worked hard and eventually bought a hotel. The couple has two daughters, Shahnaz, 16, and Shakeela, 12, both now with their father in Pakistan.
Last year, Aman first tried to go back to China alone, but the authorities denied him entry at a border crossing without his wife. Then they returned together to Xinjiang. There, she was ordered to report every morning to the police, who gave her books on the Communist Party to read.
“When they would see anything written in Urdu, a prayer mat or something related to religion, they would seize it,” he said. “They want to eliminate Islam.”
After a few weeks, Aman was ordered to leave even though he had a six-month visa. He was told he could return after one month. When he did, his wife was gone.
For four months he pestered police every day, threatened to take his life in public. He was finally allowed to see his wife, who was brought to a local police station, for just an hour.
They cried. When the meeting ended he was told to go home to Pakistan “and stop making trouble for the administration,” Aman said.
He has no idea where she is being held.