ARTICLE II

DECLARATION OF PRINCIPLES AND STATE POLICIES

PRINCIPLES

Section 1. The Philippines is a democratic and republican State. Sovereignty resides in the people
and all government authority emanates from them.

Section 2. The Philippines renounces war as an instrument of national policy, adopts the generally
accepted principles of international law as part of the law of the land and adheres to the policy of
peace, equality, justice, freedom, cooperation, and amity with all nations.

Section 3. Civilian authority is, at all times, supreme over the military. The Armed Forces of the
Philippines is the protector of the people and the State. Its goal is to secure the sovereignty of the
State and the integrity of the national territory.

Section 4. The prime duty of the Government is to serve and protect the people. The Government
may call upon the people to defend the State and, in the fulfillment thereof, all citizens may be
required, under conditions provided by law, to render personal, military or civil service.

Section 5. The maintenance of peace and order, the protection of life, liberty, and property, and
promotion of the general welfare are essential for the enjoyment by all the people of the blessings
of democracy.

Section 6. The separation of Church and State shall be inviolable.

STATE POLICIES

Section 7. The State shall pursue an independent foreign policy. In its relations with other states,
the paramount consideration shall be national sovereignty, territorial integrity, national interest,
and the right to self-determination.

Section 8. The Philippines, consistent with the national interest, adopts and pursues a policy of
freedom from nuclear weapons in its territory.

Section 9. The State shall promote a just and dynamic social order that will ensure the prosperity
and independence of the nation and free the people from poverty through policies that provide
adequate social services, promote full employment, a rising standard of living, and an improved
quality of life for all.

Section 10. The State shall promote social justice in all phases of national development.

Section 11. The State values the dignity of every human person and guarantees full respect for
human rights.

Section 12. The State recognizes the sanctity of family life and shall protect and strengthen the
family as a basic autonomous social institution. It shall equally protect the life of the mother and
the life of the unborn from conception. The natural and primary right and duty of parents in the
rearing of the youth for civic efficiency and the development of moral character shall receive the
support of the Government.

Section 13. The State recognizes the vital role of the youth in nation-building and shall promote
and protect their physical, moral, spiritual, intellectual, and social well-being. It shall inculcate in
the youth patriotism and nationalism, and encourage their involvement in public and civic affairs.

Section 14. The State recognizes the role of women in nation-building, and shall ensure the
fundamental equality before the law of women and men.

Section 15. The State shall protect and promote the right to health of the people and instill health
consciousness among them.
Section 16. The State shall protect and advance the right of the people to a balanced and healthful
ecology in accord with the rhythm and harmony of nature.

Section 17. The State shall give priority to education, science and technology, arts, culture, and
sports to foster patriotism and nationalism, accelerate social progress, and promote total human
liberation and development.

Section 18. The State affirms labor as a primary social economic force. It shall protect the rights
of workers and promote their welfare.

Section 19. The State shall develop a self-reliant and independent national economy effectively
controlled by Filipinos.

Section 20. The State recognizes the indispensable role of the private sector, encourages private
enterprise, and provides incentives to needed investments.

Section 21. The State shall promote comprehensive rural development and agrarian reform.

Section 22. The State recognizes and promotes the rights of indigenous cultural communities
within the framework of national unity and development.

Section 23. The State shall encourage non-governmental, community-based, or sectoral

organizations that promote the welfare of the nation.

Section 24. The State recognizes the vital role of communication and information in nation-
building.

Section 25. The State shall ensure the autonomy of local governments.

Section 26. The State shall guarantee equal access to opportunities for public service, and prohibit
political dynasties as may be defined by law.

Section 27. The State shall maintain honesty and integrity in the public service and take positive
and effective measures against graft and corruption.

Section 28. Subject to reasonable conditions prescribed by law, the State adopts and implements a
policy of full public disclosure of all its transactions involving public interest.
New dengue vaccine could instead cause more cases, experts warn
By Meera Senthilingam, for CNN
Updated 11:27 AM PHT Fri, September 2, 2016

The long road to a vaccine

Dengvaxia was produced by Sanofi Pasteur, which, after spending 20 years developing the vaccine, published
promising findings on its effectiveness in 2015. Trials showed the vaccine to be 59.2% effective against
dengue when results were pooled across populations and age groups, though this varied when looking at the
type of dengue, the age of those receiving the vaccine and whether people had been previously infected.

"It's effectiveness depends on the local epidemiology of dengue and how intense the transmission is," said
Neil Ferguson, director of the MRC Center for Outbreak Analysis and Modeling at Imperial College London.
"If you vaccinate people at high risk and in the right age group, you can get significant benefits."

The vaccine is now licensed for use in six countries; in April, the Philippines became the first to roll it out.
Brazil recently announced plans to implement the vaccine, and Paraguay, Singapore, El Salvador and Mexico
are due to follow suit, as they all have high burdens of the disease.

But in the new study, published Thursday, Ferguson used data from the clinical trials to assess the impact of
using the vaccine in different settings and found that its use in areas with low levels of disease, where people
are unlikely to have been previously exposed to dengue, could lead to an increase in people severely affected
by the infection due to the complexities of the virus and the way it interacts with our immune system.

The severity of coming second

"Unlike most diseases, the second time you get dengue, it's much more likely to be severe than the first time
you get it," Ferguson said. When people who have never experienced the infection get immunized, the vaccine
may act like a silent infection, gearing them up for a more severe infection should they face the real form of
the virus.

"The immunity we develop both protects us and places us at risk," said Derek Cummings, professor of biology
at the University of Florida, who co-led the study.

"It can have the potential to make things worse if it's misused," Ferguson said.

The reasons behind this unique biology come down to the virus' effect on the human immune system. When
someone first becomes infected with dengue, they experience mild flu-like symptoms while developing
antibodies. But when the person becomes infected again, though antibodies will recognize the virus particles,
they are unable to neutralize the virus and instead help it enter the person's cells to cause a more severe form
of the disease, known as antibody-dependent enhancement.

"You'd have increases in hospitalized dengue cases," Cummings said. "It would be exactly the opposite of
what you intend to do."

The models in the study found that the long-term impact of the vaccine, even when used in high-burden
settings, is likely to reduce cases of dengue by just 10% to 30% due to this tradeoff between reducing cases in
some places and increasing cases in others.

Testing before vaccinating

Both Ferguson and Cummings believe the risk of the vaccine leading to severe cases of the disease in some
could be removed with the development of serological tests for previous exposure to dengue before people
receive the three-dose vaccine. The idea would be to vaccinate only those who have been previously exposed,
and potentially with just one dose.

"This vaccine is fantastic [for people] who have seen dengue in the past," Cummings said. If it's used only on
these people, "then this could be an extremely effective public health campaign."

This form of screening would, however, mean people who have never been infected would miss out on the
vaccine, but also the risk that comes with it — at least until they become exposed.
The study found that vaccinating people who have been exposed in the past would reduce their risk of being
hospitalized with dengue by more than 90%.

"[This analysis] places even greater emphasis on targeting this new vaccine to the right people at the right
time and echoes the increasing scientific consensus that countries should be considering wide-scale testing
before deploying the vaccine," said Oliver Brady, research fellow in mathematical modelling at the London
School of Hygiene & Tropical Medicine, who was not involved in the research. "Serological testing for past
infection at the population, or even individual, level needs to be reconsidered by every country deploying this
vaccine."

But he added that making this distinction in countries where Zika is now spreading could make things more
complicated. Similarities between the two viruses mean such tests may result in false positives. "As a result,
there is greater chance of vaccinating people who may have long-term negative impact from the vaccine."

But this is not a concern for now, as no test exists to screen people in this way.

In the meantime, the team is advising policy-makers and program implementers to follow guidance when
rolling out the vaccine, for example, by identifying which communities have the highest transmission rates
and focusing on them, or vaccinating children at an older age to increase their likelihood of having been
previously exposed.

Brady added that the team may also be too presumptuous that the effectiveness of the vaccine is driven solely
by whether people have been infected. "One alternative interpretation of the trial data would be that vaccine
efficacy and/or disease severity could vary by age," he said. "It may simply be that this vaccine is not suitable
for use in children under the age of 9."

Prioritizing those at most risk

The need to focus on communities with a high burden of the disease is echoed in the WHO Strategic Advisory
Group of Experts on Immunization's recommendations for implementing the vaccine.

The WHO said it has been working with modelers, including the study authors, since April 2015 to predict the
public health and economic impact of a vaccination program.

The organization endorses the need to develop tests to identify people most likely to benefit from the vaccine
and says individual testing could be possible, especially in lower-burden countries with the proper resources
and infrastructure.

"This vaccine is not a silver bullet for dengue," Ferguson said. "The most important thing is for policy-makers
in these countries to be well aware of the benefits and risks and to set correct expectations among the public ...
as people may conclude the vaccine doesn't work."

Learning insight:

I learned that when people who have never experienced the infection get immunized, the vaccine may
act like a silent infection, gearing them up for a more severe infection should they face the real form of the
virus. When someone first becomes infected with dengue, they experience mild flu-like symptoms while
developing antibodies. But when the person becomes infected again, though antibodies will recognize the
virus particles, they are unable to neutralize the virus and instead help it enter the person's cells to cause a
more severe form of the disease, known as antibody-dependent enhancement.

Recommendation:

I realized that this article would be a great help for us student nurses to be fully aware what dengvaxia is,
so that we can use this in daily life especially when inter-acting with patient with concern of dengvaxia vaccine.