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Heated tobacco products will benefit public health

August 23, 2020

THE US Food and Drug Administration (FDA) authorization for IQOS to be marketed as a modified risk tobacco product is aligned with the claims of a leading tobacco harm reduction expert that the introduction of heated tobacco products (HTPs) as better alternatives to conventional cigarette will see public health gains. Helen Redmond, adjunct professor at New York University-Silver School of Social Work, said the introduction of HTPs or heat-not-burn (HNB) tobacco products will benefit public health. She noted that there is a widespread, mistaken notion that nicotine causes cancer and other health problems. “That is false,” the professor said. “The use of nicotine is no threat, because nicotine is not the problem. Combustible tobacco is … What causes health problems is lighting tobacco on fire. The combustion releases thousands of toxic chemicals.”  The US FDA, in its recent issuance, concluded that the commercialization of IQOS in the US, a heated tobacco product, developed by Philip Morris International, is “appropriate to promote the public health.” “The availability of IQOS is an incredibly important development for the millions of Americans who continue to smoke and who suffer almost half a million preventable deaths each year,” Redmond said. It has been known for decades that tar, and carcinogens found in tobacco smoke, causes the death and disease associated with smoking, and not nicotine.  HTPs are smoke-free devices that heat, instead of burn specially-designed tobacco units to release a flavorful nicotine-containing tobacco vapor. The most popular HTP brand today is IQOS—an electronic device that heats tobacco-filled sticks wrapped in paper to generate a nicotine-containing aerosol.   “Several tobacco companies have developed HNB products like IQOS from Philip Morris and Glo Pro and Glo Nano from British American Tobacco. The technology is constantly evolving and becoming more user-friendly,” Redmond said. A recent study by Dutch researchers entitled, “A Method for Comparing the Impact on Carcinogenicity of Tobacco Products: A Case Study on Heated Tobacco Versus Cigarettes” assessed eight carcinogens (cancer-causing substances) to understand the likely health impact on individuals who switch to IQOS, compared to those who continue smoking. The researchers concluded that while not risk-free IQOS is associated with 10 to 25 times lower exposure to these carcinogens, and that this could translate into a substantially improved risk profile. The study was published on May 1, 2020 in the monthly peer-reviewed academic journal Risk Analysis. Smoke-free nicotine products include electronic cigarettes or vapes and Swedish snus. Public Health England consistently conclude in its annual reviews of all available evidence that E-cigarettes are around 95-percent less harmful than smoking.   Redmond also noted that e-cigarettes and HNB proved effective in making smokers switch since they offer the same pleasure, rituals and relaxation associated with smoking. The UK's National Institute for Health Research (NIHR) concluded in its February 2019 clinical trials that e-cigarette was twice as effective as nicotine replacement treatments such as patches and gum in helping smokers quit. “E-cigarettes and HNB products make nicotine consumption much safer. In that, they are similar to patches or gums. The crucial difference is they look and feel like cigarettes, replicating the rituals and the enjoyment of smoking for people who switch from combustible tobacco—and therefore reducing the risk of relapse,” said Redmond. Redmond cited the case of Japan where nearly a third of smokers have already switched to HNBs. “HNB products have been available in Japan since 2014. The result—cigarette sales in the country have plummeted, outstripping anything abstinence-only messages have achieved” she said.

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PMI releases first Integrated Report on performance and headways in its smoke-free future vision

July 6, 2020

Philip Morris International Inc. (PMI) has published its first Integrated Report, a comprehensive overview of the company’s environmental, social, and governance (ESG) performance and its progress toward delivering a smoke-free future—including the company’s ambition to switch more than 40 million adult smokers to its smoke-free products by 2025.  PMI said its Integrated Report 2019 demonstrates the role of the organization's strategy, governance, and performance in the creation of value over the short, medium, and long terms. The report further shows PMI’s approach and important progress in various ESG areas, while setting new and ambitious targets for 2025 that complement the company’s prior aspirations.  “Clarity of purpose is essential for the internal alignment of any company. Since we announced our smoke-free commitment in 2016, we have made enormous progress in terms of organizational capabilities, the integration of sustainability into every aspect of our transformation, and our business,” said André Calantzopoulos, PMI Chief Executive Officer. “PMI’s Statement of Purpose reaffirms our commitment to deliver a smoke-free future for the benefit of people who would otherwise continue to smoke and, hence, to global public health. It is clear to all of us at PMI that the biggest positive impact our company can have on society is to replace cigarettes with less harmful alternatives; this is at the very core of our corporate strategy and sits atop our sustainability priorities while we are progressing well on all others,” Calantzopoulos added.  The report cited PMI’s Philippine affiliate, PMFTC Inc., for its strong commitment to the development and growth of local communities. In particular, the company’s corporate social responsibility program Embrace, which involves charitable giving, social contributions and community investments that focused on access to education, women empowerment, economic opportunity, and most especially disaster preparedness and relief efforts. “As a leader in the tobacco industry and a top taxpayer in the Philippines, PMFTC has a responsible role to play in spurring economic development, empowering communities and sustaining our environment,” PMFTC President Denis Gorkun said. “We are proud of our company’s caring and giving culture. We are equally proud of our employees who champion the values of social responsibility as can be most recently seen in our societal response to the COVID-19 pandemic,” Gorkun added. In the report, PMFTC was cited as being in the forefront in providing relief assistance during disasters like earthquakes, volcanic eruptions, typhoons and floods. More than 25,000 individuals received help in the past earthquake incidences in Batanes and Mindanao; and another 7,384 families benefited from relief items during the Taal volcano eruption in January this year. In these community efforts, “PMFTC employees were at the core of relief operations.” mentioning the company employees “spirit of volunteerism and compassion for the community.”   On top of helping communities, PMFTC has placed the safety and protection of its own employees a priority. Some 150 displaced employees were provided immediate assistance in the recent Taal volcano eruption. The Integrated Report 2019 also demonstrates how PMI is focusing its resources on developing, scientifically substantiating, and responsibly commercializing smoke-free products that are a better choice than continued smoking, with the aim of completely replacing cigarettes as soon as possible. The company believes that, with the right regulatory encouragement and support from civil society, cigarette sales can end within 10 to 15 years in many countries.  It also highlights the company’s most material sustainability topics, including the health impacts of the company’s products, an aspect often not captured by external ESG assessments.  The report focuses on this key area, and describes how the company is working to reduce the harm caused by tobacco use by replacing combustible products with scientifically substantiated reduced-risk alternatives.  From the previous sustainability reporting, PMI’s evolution to integrated reporting helps investors make the connection between the product-focused sustainability initiatives, which form the core of the ESG strategy, and the financial performance over time. The report also enables the company’s stakeholders to better evaluate the company’s progress in achieving its purpose. PMI’s Statement of Purpose, adopted by the company’s Board of Directors earlier this year and published in its 2020 proxy statement, is also available in the Integrated Report.

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Aboitiz bats for more infrastructure spend

May 18, 2020

ABOITIZ InfraCapital has urged for increase in infrastructure spending, whether funded by government or private sector, saying infrastructure will rebuild the battered domestic economy.     Cosette V. Canilao, Aboitiz InfraCapital President and Chief Executive Officer (CEO), said that Public-Private Partnerships (PPPs), in particular, can help fill in gaps brought about by funding reallocations amid the ongoing COVID-19 crisis.     “We understand that the government earmarked funding from other programs, including infrastructure projects, to address the COVID-19 impact. The private sector through PPP, could take up the void that the reallocation from infrastructure projects has created,” Canilao explained.     For Aboitiz InfraCapital’s common tower project, discussions with partners Globe Telecom, Smart Telecom, and Dito Telecommunity on the first batch of towers are still ongoing.     “The current crisis has clearly proven the urgent need for digital infrastructure to support better telecommunication services, and the Aboitiz Group is ready to provide this through our common tower project,” she noted.     On-the-ground activities such as site surveys and site acquisitions are expected to resume once the Luzon and local ECQs are lifted.     Aboitiz InfraCapital also said it is ready to resume discussions with the government for its airport bids (Bohol-Panglao International Airport, Laguindingan Airport, and Ninoy Aquino International Airport [NAIA] as part of the NAIA Consortium), post-ECQ.     “We remain keen on the airport projects as we believe that these are vital in reviving the economy. As with all of the Aboitiz Group’s projects and businesses, we are as¬sessing COVID-19’s impact on our proposals,” Canilao noted.     The government and the private sector need to work more closely together in putting in place programs that would revive the travel and tourism industry, as it is one of the hardest-hit sectors in light of the current COVID-19 crisis.     Aboitiz InfraCapital is also open to discussing with the government its unsolicited proposal along with the Ayala Group and Unisys, for a National Identification Card (ID) system previously submitted to the PSA in 2018. The urgent need for a National ID system became even more ap¬parent under the present conditions to help hasten COVID-19 aid distribution.

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PAL cancels flights till end May

May 18, 2020

IN the wake of the government’s extended lockdown, Philippine Airlines (PAL) the other night announced that all domestic flights to and from its hubs in Manila, Cebu and Clark will remain cancelled up to May 31, 2020.     However, the flag carrier is evaluating the possibility of flying international routes, as well as domestic routes, to and from its Davao hub, in coordination with concerned government authorities.     “We will announce any planned flights once these are finalized,” according to PAL’s statement. The continued pause in the airline’s Manila, Cebu and Clark hub operations is in compliance with the Philippine government’s declaration of the Modified Enhanced Community Quarantine and related local restrictions from May 16 to 31.     “We are in the process of notifying affected passengers by e-mail,” according to PAL.     The current ticket of passengers booked on a cancelled flight remains valid, the flag carrier clarified.     Starting June 1, 2020 onwards, PAL plans to operate reduced number of weekly flights on most domestic routes and on selected international routes.     However, this will still depend on COVID-19 conditions, such as community quarantine restrictions, travel bans imposed by various governments and their impact on passenger demand and the public health and safety situation in each of the countries that PAL serves.     The airline will announce the list of operating flights and routes for June 2020, once the details are finalized.     PAL will continue to operate occasional special flights to repatriate stranded passengers and to transport urgent cargo such as medical equipment and supplies to help sustain critical supply chains across the Philippines and on selected international routes.

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Ayala Corp. income down 17% as lockdown hits businesses

May 18, 2020

EARNINGS of Ayala Corp. (AC) dropped 17% to P6.7 billion in the first quarter as the coronavirus pandemic dragged its property, banking and industrial segments.     In a stock exchange disclosure on Wednesday, the listed conglomerate said its consolidated revenues fell 11% to P61.72 billion in the first three months of the year, reflecting the impact of government lockdowns across its business units.     If it were to isolate the estimated impact of the coronavirus crisis, AC said its net income would have been flat due to the P1 billion divestment gains from merging AC Education and iPeople last year.     The company’s costs and expenses during the period fell 10% to P45.64 billion. Capital expenditures for parent-only businesses stood at P6.9 billion.     By business segment, real estate arm Ayala Land, Inc. posted the largest profit drop of 41% to P4.3 billion. This is attributable to the 38% lower property development revenues at P17.2 billion due to the eruption of Taal volcano in January. Leasing revenues from shopping centers and hotels also fell 9% and 17% to P4.6 billion and P1.6 billion, respectively, because of the enhanced community quarantine (ECQ) in mid-March.     Banking unit Bank of the Philippine Islands booked 5% lower net earnings at P6.4 billion, traceable to its aggressive provisioning during the period. The company posted P4.2 billion in loan-loss provisions as it expected an increase in non-performing loans because of the pandemic.     Profits of telecommunications arm Globe Telecom, Inc. slipped 2% to P6.6 billion due to higher depreciation from network investments and an increase in non-operating charges. Its capital expenditures rose 22% to P10.7 billion to support higher demand for data-related services.     Power segment AC Energy Philippines, Inc. swung to a profit  of P1.96 billion from a net loss of P2 million last year. This was driven by the P1.3-billion pre-operating revenues from its Mindanao-based subsidiary GN Power Kauswagan Ltd. Co., on top of the recovery of costs it incurred from adjustments in the construction and operations of its power plants.     Water unit Manila Water Co., Inc. posted a 4% net income growth to P1.3 billion due to non-recurring events of paying a regulatory penalty and waiving water bills last year. Its revenues rose 9% partly due to higher billed volumes.     Industrial segment led by AC Industrials saw a net loss of P564 million on the back of a global slowdown. Integrated Micro-Electronics, Inc. booked a net loss of P235 million, largely due to the lockdown of its facilities in China in February. AC Motors posted a net loss of P204 million, mostly due to the closure of its Honda Car Philippines facility in Laguna.     “While the outlook for the business environment has fundamentally changed as a result of this crisis, we take comfort in the fact that we have always maintained a strong balance sheet that provides us with flexibility as we navigate the uncertainties,” Ayala President and Chief Operating Officer Fernando Zobel de Ayala said in a statement.     “[W]e have put in place a health protocol to ensure the re-entry of our workforce in a safe and productive way… We believe this is a critical step as our businesses readjust to this new environment,” Ayala Chairman and Chief Executive Officer Jaime Augusto Zobel de Ayala added.

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Teleconsultation comes to the aid of non-Covid patients

May 16, 2020

[14 May 2020] CAGAYAN DE ORO CITY—While most businesses are shuttered, and office employees are working from home, the medical community must work hard to stay open to patients yet be tightly guarded by Covid-19 restrictions. The challenge for doctors is how to continue treating their patients even though their clinics are closed.  How can they “meet up” with patients without exposing themselves and their families to the risk of infection? Technology provides a solution: teleconsultation.  It minimizes the need to travel and face to face contact, thus protecting both the patients and health professionals from exposure to health risks.  For the first time in her 30-year practice, Dr. Corazon Mata attends to patients remotely. She is in charge of the obstetrics and gynecology hotline for the Telekonsulta Service of the Northern Mindanao Medical Center (NMMC).  Every day, she fields queries from ob-gyn patients all over Region 10, which covers the provinces of Misamis Oriental, Misamis Occidental, Bukidnon, Camiguin and Lanao del Norte. With the rapid spread of Covid, other health cases have been overshadowed, with many hospitals like NMMC recording a significant drop in patient consultations at the emergency room and out-patient clinics. The NMMC is a tertiary public hospital and one of the Covid referral centers in the region of 5 million. “This is the main reason we decided to start the NMMC Telekonsulta Service,” says Dr. Aris Austria, Telekonsulta project leader. “We were concerned particularly for our patients with chronic conditions requiring long-term medical care. Every healthcare facility should not focus only on handling the Covid-19 crisis but also consider minimizing ‘collateral damage’ on non-Covid patients.”  The NMMC Telekonsulta Service targets noncritical cases and aims to provide a venue for patients to directly consult medical professionals through their mobile phones.  Smart Communications partnered with the hospital by providing them with LTE phones capable of unlimited texts and calls to all networks and data connection. Each phone was assigned to doctors handling a specific field of specialization, such as pediatrics, obstetrics and gynecology, surgery or internal medicine. Since the start of the project in late March, the NMMC doctors have collectively handled more than 400 consultations, sent out almost 200 electronic prescriptions and facilitated around 50 referrals. They have also set appointments for actual clinic consultations for cases where a clinic visit is absolutely necessary. “A good part of diagnosing a patient is doing a complete physical,” says Dr. Ramon Yap, an internist-gastroenterologist. “But I believe the majority of patients can be safely managed through teleconsultation, albeit some patients may really have to be seen by a doctor in a clinic or referred to an appropriate institution like NMMC.” The experience is new to his 17-year practice, but he says doctors have to adapt. “The threat to the doctors is very real. We also have to think about protecting ourselves and our families, aside from trying to give comfort and healing to our patients. The limited resources that we have in our locality has made the practice of medicine very daunting and probably even unsettling.” As of the first week of April, the Department of Health (DOH) Region 10 had identified more than 4,000 persons under monitoring and around 300 under investigation. With more cases of Covid-19 positive patients and new admissions of suspected cases, the region’s health officials are not letting their guard down. The doctors admit that there are limitations to what they can perform without a face-to-face interaction, but they are finding ways to cope with this. Dr. Austria, a pediatrician, reports that teleconsultation has necessitated more parental engagement. He tells parents, “listen to the child’s breathing, feel their skin or pulse, touch the tummy, and describe what you find.” It is not the ideal way of examination, he concedes, so doctors should be cautious in utilizing information drawn from a teleconsultation to diagnose a patient’s condition. Pediatrics has the highest number of consultations. Dr. Jannie Lyne Palisbo, whose clinic is closed, is grateful that she can continue to treat her patients from home. “It is reassuring to both the patient and us physicians,” she says. Dr. Austria opines, “Teleconsultation should remain an option for patients under any circumstances that call for it, to hasten medical interventions, and to keep NMMC accessible to all the people in Region 10.”  With doctors and patients engaged in a back-and-forth exchange of information during teleconsultation, he appreciates that Smart ensures unhampered communications. The unlimited texts and calls are “a huge advantage,” enabling doctors to attend to as many patients as possible, he adds. Dr. Peter Quiaoit, NMMC medical training officer, also thanked Smart for making the out-patient department services “a phone call away” in the time of crisis.  “Smart is committed to providing innovative communications solutions that help fight the Covid pandemic.  The NMMC has taken a new path, using technology to enable their doctors to treat patients despite the current restrictions.  That’s why we are quite happy to support their initiative,” said Mon Isberto, Smart public affairs head. This being the institution’s first time to implement teleconsultation, the Telekonsulta team faced a lot of challenges, including a lack of proper guidelines or standard operating procedures, especially in consideration of patients’ informed consent and data privacy. Dr. Austria adds, “We also lacked essential materials, gadgets and enough volunteers to keep teleconsultation running. However, with support from our hospital administration and private companies like Smart, we were able to set it up eventually.” With the proper equipment and appropriate systems in place, teleconsultation will surely be part of the future of medical practice. As access to the internet and data-capable phones increases, there will be huge improvements in teleconsultation results, lowering the risk of misdiagnosis. With the Covid-19 pandemic far from over, and the risks remaining for even longer, interventions such as this will become part of the new normal, and technology will play a huge part.

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