GO Negosyo founder Jose Maria 'Joey' Concepcion 3rd called on the government not to repeat the 'same mistakes' in the country's Covid-19 vaccination efforts as he reiterated the importance of bringing in bivalent vaccines to the Philippines.

Concepcion made the statement as he raised concerns on the lack of urgency and unclear delineation of the roles of different agencies on the acquisition of bivalent vaccines.

This, after he consulted with several medical and policy experts comprising the Advisory Council of Experts, a group he organized to provide guidance to the private sector on matters of public health and the economy.

The group is composed of the country's foremost authorities on medicine, public health, economics, and research and data analytics.

'We can't afford to make the same mistakes twice with our bivalent vaccines,' Concepcion said in a statement, noting how delays in decision-making contributed to billions of pesos worth of Covid vaccines being wasted due to expiration.

Bivalent vaccines provide a broad protection against the original Covid-19 virus and a component of the Omicron variant.

In the early days of the pandemic, Concepcion led private sector efforts to procure Covid-19 vaccines through a tripartite agreement that overcame regulatory roadblocks.

The Department of Health (DoH) has announced that it has reached out to vaccine manufacturers to secure bivalent vaccines against Covid, but they are now waiting for the emergency use authorization from the Food and Drug Administration (FDA).

'This time around, we should know what went wrong, what went right, how to move forward so we can execute well,' public health advocate Dr. Tony Leachon said.

Concepcion is not alone in his concerns since medical experts admitted that the foremost cause of the delays during the Covid response was due to the lack of clarity on the roles of the Vaccine Expert Panel (VEP) and the Health Technology Assessment Council (HTAC).

The experts said there is a duplication of roles and overreach of mandates among the committees that comprise the government's vaccine bodies.

The VEP, National Immunization Technical Advisory Groups or Nitags, HTAC, FDA and Formulary Executive Committee (FEC) are just some of these government bodies that handle the procurement, approval, and administration of vaccines.

But while the VEP is under the Department of Science and Technology (DoST), the rest are under the supervision of the DoH.

The primary role of the HTAC is to examine the cost-benefit and effectiveness studies before the government proceeds with procurement while the VEP gives its recommendations regarding age indication and priority populations.

Former Health secretary and now Iloilo Second District Rep. Dr. Janette Garin said that this process should be followed.

'Unfortunately, it's not happening that way. HTAC rules. Even if the expert panel or specialty society say otherwise, fear prevails if HTAC does not give the go signal,' she said.

Dr. Maricar Limpin, immediate past president of the Philippine College of Physicians, said that 'clearly, the functions overlap across the committees. Time to delineate each and maybe collapse one or two.'

She raised the possibility and practicality of eventually removing the FEC from the equation because its functions overlap with the FDA.

Limpin said it might be better for tasks such as the assessment of factors for government procurement like cost effectiveness, distribution, and storage, to be relegated to the HTAC, which can then be included in the drug formulary.

'The FEC, tasked to look at drugs to be included in the drug formulary for government procurement and justifies PhilHealth reimbursement, appears to overlap with that of HTAC. Maybe it will be better to collapse the FEC? Or if not, there should be clear delineation of roles to avoid redundancy and speed up the process,' she asked.

The medical experts are also concerned about the 'lack of urgency' in decision-making since, as Garin noted, HTAC members do not work full-time at the HTAC while FEC usually conducts its meetings outside the National Capital Region, which results in more delays.

They also observed that government agencies adhered to their usual roles even when the situation calls for a different response.

'When the private sector was allowed to buy [the vaccines], the least that the government can do is support the inoculation as long as it's not harmful,' Garin said.

'Separate guidelines for privately procured should have been released, but they didn't want [that],' she added.

And while the medical experts appreciate the efforts of HTAC, Dr. Benjamin Co, chief medical officer of Metro Pacific Hospital Holdings and OCTA Research fellow, called it 'another red tape layer.'

'Technology is the same except for the added serotype variant. No brainer on that part,' he said. 'As for the FDA. That's another bottleneck.'