Health & Life Sciences Update: ASEAN Leaders Release Declaration on Antimicrobial Resistance

Health & Life Sciences Update | November 30, 2017
Authors: Shay Wester, Hai Pham, Ying Hui Tng,  Natalie McDaniel, Hui Ying Lee
 
LOOKING AHEAD
 
 

Week of January 29: Health & Life Sciences Industry Mission to Vietnam and the Philippines 

Please save the date for the Health & Life Sciences Industry Mission to Vietnam and the Philippines during the week on January 29. Official invitation and registration details to follow. Please contact Ying Hui Tng at yhtng@usasean.org or Hai Pham at hpham@usasean.org with any questions or to express interest. 

 
THE COUNCIL'S TAKE
 
 

ASEAN Leaders Release Declaration on Antimicrobial Resistance

On November 13, the ASEAN Leaders released a Declaration on Antimicrobial Resistance (AMR): Combatting AMR through One Health Approach, at the 31st ASEAN Summit in Manila, Philippines. This declaration builds on previous multinational AMR action plans such as the Global Action Plan adopted by World Health Organization (WHO) Member States in 2015 and the “Communiqué of Tokyo Meeting of Health Ministers on AMR in Asia” in 2016. The ASEAN strategic plan to combat AMR includes various key priority areas such as: Creating a national action plan and adopting the One Health approach on combatting AMR. It also aims to promote awareness through campaigns such as World Antibiotic Week and advocacy efforts with stakeholder participation. Furthermore, it aims to strengthen training and education programs for professionals and students to promote appropriate antimicrobial prescribing.

Regulatory mechanisms will also be implemented or improved, including no prescription-no antibiotics in human and veterinary medicine and antimicrobial stewardship programs and infection prevention, control and treatment measures to effect behavioral changes on appropriate prescribing to reduce the burden of infection towards the overall improvement of patient outcomes. It also aims to strengthen national and regional capacities for research and development of new antimicrobials. Furthermore, tasks the ASEAN Health Ministers Meeting (AHMM) with support from the Senior Officials Meeting on Health Development (SOMHD) to develop and monitor the implementation of the plan.

This declaration will help member states align their respective AMR initiatives and foster an environment that will enable the sharing of best practices in the region. The full joint declaration can be found here.

Philippines House of Representatives Approves Bill on Mental Health

On November 20, the Philippines House of Representatives approved the third and final reading of the proposed Comprehensive Mental Health Care Bill. It was the final hurdle for the landmark Bill to overcome after the Senate had passed its own version earlier in May. A conference committee will now reconcile any differences between the two versions before submitting it to the President, who is expected to sign the Bill into law before the end of the year. This development provides relief to advocates of the Bill, who cite data from the Department of Health (DOH) and the World Health Organization that suggests 20% of Filipino adults suffer from mental health concerns.

The Bill lists the rights of persons with mental illnesses and mandates local government units to provide or upgrade mental health services. The DOH will also be responsible for formulating a national mental health program and develop a system that could deliver psychiatric services at the regional and provincial levels. While some criticize the bill for focusing on human rights instead of practical service delivery, Senator Risa Hontiveros, the sponsor of the Bill in the Senate, argues that such an approach will remove the stigma associated with mental health and facilitate the integration of mental health into the broader healthcare system.

Vietnam’s Ministry of Health Seeks to Relieve Pressure on Central Hospitals

Central hospitals in Vietnam have been facing shortages of both medical staff and equipment. In Hanoi, the Department of Finance (DOF) has sought to alleviate the issue by centralizing the bidding process for procurement for public hospitals. It organized two bids for medical equipment and supplies, which were won by two joint ventures. However, 30% of hospitals in the capital city have yet to conclude negotiations with these suppliers owing to disputes over quality, prices and origin. Several hospitals have submitted proposals to the city’s Department of Health (DOH) in favor of autonomous procurement, which would allow them to maintain higher standards of quality. The move away from individual tenders had been a necessary response to the problem of bidding mismanagement, which resulted in prices of drugs differing widely between hospitals and provinces. However, a high degree of centralization in procurement has proven to be ineffective because of the differing needs of hospitals, which resulted in the dissolution of the central procurement agency in Hanoi in October.

There is a greater need for transparency in the tender system, which would ensure higher quality and more reasonable prices. This is important for foreign companies, who cannot participate directly in tenders and must operate through local distributors. These companies would benefit from increased transparency to help ensure that their local intermediaries meet hospital standards and thereby prevent any premature termination of distribution agreements. At the same time, hospitals can check that medical supplies are of high quality.

The Ministry of Health (MOH) is also rolling out a new basic healthcare package to ease pressure on central hospitals. It is working with Vietnam Social Security (VSS) to cover 76 basic services and 241 types of medicines at commune-level medical facilities. It is also hoped that this initiative will increase the accessibility of healthcare to citizens and encourage local facilities to enhance their capabilities. This initiative is expected to result in a surge in demand for the medicines covered under the package.

 
ADVOCACY UPDATE
 
 

Roundtable  on Pharmaceutical Pricing Policies Across ASEAN

On November 16, the Council held a roundtable on pharmaceutical pricing policies across ASEAN in our Singapore office. The Council addressed Malaysia, Philippines and Thailand as urgent priorities and stressed the need for sustained engagement with aligned advocacy messages even in one-on-one meetings with countries. The Council has noted that there is a possibility of raising pricing policy to the ASEAN level due to commonalities among the different companies and issued faced. Furthermore, the Council acknowledges that engagement must be complementary with what countries are already doing and is interesting in refraining from adopting a pricing approach in favor of framing its engagement as creating a path towards production, distribution and technology transfer. The full notes from the roundtable can be found here. 

 
IN THIS UPDATE
 
 
ASEAN
Asean leaders adopt ‘One Health’ approach vs antimicrobial resistance

Cambodia
Elderly battle hypertension while youths struggle with modern diseases
Cambodia expects rapid decline in maternal death rate by 2030

Laos
One Health concept advocated for disease control
ADB, Lao PDR Sign Agreement to Enhance Sanitary, Phytosanitary Management Systems

Malaysia
Health Ministry rejects claims of antibiotics shortage at government health clinics
More ethnic Chinese, Indian kids shortsighted, says don
'Halal' is not just about food - HDC
Be prudent in use of antibiotics, says Health DG
Staggering 3.6mil Malaysians have diabetes

Myanmar
Guiding Drug Law Reform in Myanmar
Mandalay gets new TB treatment facility
Challenges Impede Development of Myanmar’s Public Health
Diabetes health care to be expanded

Philippines
House OKs comprehensive mental health bill
ASEAN adopts pact on microbial resistance
FDA cites Duque’s role in approval of contraceptives
Duterte rejects MICC proposal to lift open-pit mining ban

Singapore
Singapore Wants To Add Biotech Hub To Its List Of Accomplishments
Singapore won't take up new US cut-off for hypertension
Sweet drinks off the menu at primary schools
MOH tweaking rules to improve healthcare

Thailand
'Distorted news' deemed health issue in junta-run Thailand
Anthrax outbreak fear after goat meat meal
Thailand Pesticides Registration Report 2017
Thai children getting fatter, survey finds

Vietnam
Iodine-enriched ‘3 Mien Bouillon’ contributes to iodine deficiency prevention in Vietnam
​Vietnam pulls off first hematopoietic stem cells transplantation for unrelated donors
MoH proposes reducing food safety red tape
Policies needed to improve healthcare for the elderly
People to benefit from basic healthcare package
End misuse of antibiotics, combat resistance, experts say
Hà Nội hospitals unhappy with centralised bidding results
 
ARTICLE CLIPS
 
 
ASEAN

Asean leaders adopt ‘One Health’ approach vs antimicrobial resistance BusinessMirror 15th Nov 2017
The leaders of the Association of Southeast Asian Nations have agreed to adopt the “One Health” approach to tackle the pressing issue on antimicrobial resistance (AMR) in order to ensure a holistic, multisectoral and multidisciplinary method in combating it at the regional and country levels.

Cambodia

Elderly battle hypertension while youths struggle with modern diseases Phnom Penh Post 15th Nov 2017
As Cambodia transitions from a “least developed country” to “developing country”, fast food chains from wealthier nations are also pouring into the Cambodian market – in response to demand from the younger generation, who are looking for trendy things, tasty foods, and also tend to have a distaste for physical labour. These are some of the driving factors behind the emergence of modern diseases such as obesity, hypertension, diabetes, heart diseases and even cancer. There are no exact numbers or data on which, or how many types of food, can cause such problems.

Cambodia expects rapid decline in maternal death rate by 2030 Phnom Penh Post 15th Nov 2017
Maternal and newborn health is a top priority of the Cambodian government, with efforts having resulted in impressive gains in expanding the reach of services for maternal and newborn health. However, the maternal and newborn mortality rates remain a challenge for the country. The maternal mortality rate in Cambodia has been decreasing since 2005, from 472 deaths in every 100,000 live-births in 2005 to 170 deaths in every 100,000 live-births in 2014 [Cambodian Demographic and Health Survey – CDHS- 2014]. New data will be available in the coming CDHS in 2020. According to Catherine Breen Kamkong, deputy representative of the United Nations Population Fund (UNFPA), her organisation has been operational in Cambodia since 1994. UNFPA provides technical and financial assistance to the Ministry of Health in areas of sexual and reproductive health including family planning, skilled birth attendance, emergency obstetric and newborn care (EmONC), which are globally recognised as key interventions for reducing the maternal mortality rate. UNFPA provides technical and financial assistance to the Ministry of Health through the government systems and structure to reach health care providers and communities.

Laos

One Health concept advocated for disease control Vientiane Times 21st Nov 2017
Health officials and medical staff across the country will work more closely with local authorities and development partners to strengthen the control of seasonal diseases under the One Health. A meeting on the subject took place yesterday, led by Deputy Health Minister, Associate Prof. Dr Phouthone Moungpak, and attended by senior officials from provincial health departments. At present, health officials are unable to properly collaborate with other sectors on preparations for and the response to all public health emergencies, he said.

ADB, Lao PDR Sign Agreement to Enhance Sanitary, Phytosanitary Management Systems The Financial 20th Nov 2017
The Asian Development Bank (ADB) and the Government of the Lao People’s Democratic Republic (Lao PDR) signed an agreement on 13 November for a $10 million grant as additional financing for a project that will enhance Lao PDR’s sanitary and phytosanitary (SPS) capacity, and improve food safety as well as plant and animal safety in the country.

Malaysia

Health Ministry rejects claims of antibiotics shortage at government health clinics NST Online 21st Nov 2017
The Health Ministry has denied claims of an antibiotics shortage at government health clinics nationwide. Its minister Datuk Seri Dr S. Subramaniam said the ministry has a policy of moving medicine from other government health clinics, in cases of supply shortage. "If there is a shortage of supply of a particular medicine in one health clinic, we can move it (the stock) from other health clinics. "This policy is to ensure that we do not face any shortage of medicine," he told reporters after launching the 2nd Cambridge-Oxford-Sunway Biomedical Symposium at Sunway University here today. Subramaniam was responding to a report on supposed antibiotics shortage at government health clinics nationwide. He however noted that shortages can occur at times.

More ethnic Chinese, Indian kids shortsighted, says don Malay Mail Online 20th Nov 2017
The prevalence of myopia or shortsightedness among Malaysians is said to have reached a “concerning” level, mainly due to lack of public awareness on the importance of going for regular eye checks.

'Halal' is not just about food - HDC NST Online 19th Nov 2017
Malaysia has 13 halal standards, which not only certify food items as well as food premises, but also cosmetics, personal care, pharmaceuticals and logistics. Apart from the food and pharmaceutical industry, among others, Jamal said Malaysian halal industry players had also been actively producing halal vaccines, nutraceutical products (dietary supplements and medicinal food ingredients) as well as devices that are used during medical operations.

Be prudent in use of antibiotics, says Health DG Malay Mail Online 16th Nov 2017
The Malaysian Ministry of Health has classified antibiotic resistance a primary health care threat of the 21st century.  Director-General of Health Datuk Dr Noor Hisham Abdullah said overuse and misuse of antibiotics is to be blamed.  “Although antibiotic resistance is a process that occurs naturally, there has been a significant acceleration over the years due to overuse,” he said. 

Staggering 3.6mil Malaysians have diabetes NST Online 14th Nov 2017
Diabetes cases are on the rise In the country with 3.6 million Malaysians out of a population of 32 million suffering from the non-communicable disease. Health Minister Datuk Seri Dr S. Subramaniam said about another 1.8 million Malaysians might be having diabetes but were unaware they have it because they never went for health screening. With regular screening, diabetes can be detected at the early stage and optimum treatment given, he said in a statement in conjunction with World Diabetes Day 2017 yesterday.

Myanmar

Guiding Drug Law Reform in Myanmar Transnational Institute 29th Nov 2017
The draft bill introduces important changes to Myanmar drug law. Most significantly, it intends to place public health at the heart of the country’s drug control strategy, and lengthy prison penalties for drug use have been eliminated to facilitate access to health services for drug users. This is a positive improvement and must be applauded as a progressive measure. Nevertheless, the draft bill also contains a number of shortfalls that could be addressed with a few basic, although fundamental, adjustments. This paper thoroughly analyses the draft bill, and looks in detail at its provisions in the light of UN drug control treaties, international human rights norms, and the latest evidence and international best practices. We hope that this document will be a useful tool for members of the Government, Members of the Parliament, and other policy makers who are taking part in the drug law and policy reform processes in Myanmar. In this way we believe it can help further improve the current legislation.

Mandalay gets new TB treatment facility The Myanmar Times 27th Nov 2017
A new tuberculosis treatment facility in Mandalay was turned over to the health ministry on Saturday to further boost Myanmar’s fight against the deadly but curable disease, the Three Millenium Development Goal Fund management office said.

Challenges Impede Development of Myanmar’s Public Health The Irrawaddy 15th Nov 2017
Myanmar’s de facto leader and State Counselor Daw Aung San Suu Kyi has repeatedly singled out the minister for health and sports as one of the few Cabinet members whose performance she has been consistently satisfied with since taking office nearly two years ago. Despite this praise, however, after decades of institutional neglect of public services by the military junta, the public health sector still regularly faces criticism for being understaffed and providing substandard care. “The health status of the Myanmar population is poor and compares unfavorably with other countries in the region,” the Health and Sports Ministry acknowledged in its recently launched 2017-2021 National Health Plan.

Diabetes health care to be expanded The Myanmar Times 17th Nov 2017
Primary health care services covering diabetes will be implemented in 70 townships this year, and further expanded in designated zones of remote and rural areas, said Dr Ko Ko, program manager for diabetes under the Ministry of Health and Sports.

Philippines

House OKs comprehensive mental health bill InterAksyon 20th Nov 2017
Voting 223-0, the House of Representatives approved on third and final reading the country’s first Comprehensive Mental Health Care bill, which will aim at giving Filipinos access to free mental health services. If House Bill No. 6452 has the same provisions as the Senate version, which was earlier approved, then the bill would no longer go through the bicameral conference committee meeting but go straight to Malacañang for President Rodrigo Duterte’s signature, Majority Leader Rodolfo Fariñas said. The bill seeks to promote mental wellness, prevent the progress of mental health problems through intervention, and properly address existing mental disorders. One key features of HB6452 is the inclusion of substance addiction in the coverage of the Comprehensive Mental Health Act, such that any person who is covered under the Dangerous Drugs Act shall undergo assessment and examination, and if diagnosed with a clinical condition, shall have the right to mental health care services as provided.

ASEAN adopts pact on microbial resistance Manila Times 21st Nov 2017
Leaders of Association of Southeast Asian Nations member-states have adopted the Declaration on Anti-Microbial Resistance (AMR) as an outcome of the 31st Asean, the Department of Health (DOH) announced last week. “With the political commitment to combat AMR gathered from the heads of the Aseam member-states, the Declaration was finally adopted on 13 November 2017 in time for the celebration of the 31st Asean Summit,” the DOH said in a statement. It said leaders of the 10 Asean member-countries have agreed to adopt the “One Health” approach to tackle the pressing issue on AMR that would ensure a holistic, multi-sectoral, and multi-disciplinary approach in combating it at the regional and country levels. “It’s a one health approach because it does not only concern human health but it will also affect animal health. With Asean, our approach is really to integrate different actions coming from both human and animal health sectors,” DOH spokesperson, medical doctor Lyndon Lee Suy, explained in a recent media briefing.

FDA cites Duque’s role in approval of contraceptives Manila Bulletin 21st Nov 2017
The Food and Drug Administration (FDA) recently lauded the “valuable role” played by newly appointed Health Secretary Francisco Duque in the “timely conclusion of the recertification of the 51 contraceptive products ordered reviewed by the Supreme Court (SC).” In a media briefing recently, FDA Director-General Nela Charade Puno said “Secretary Duque’s acceptance of the health portfolio was well-timed and was a blessing to the FDA.” “In more ways than one, Secretary Duque’s guidance to, as well as his confidence and trust in, the processes and procedures of the FDA, proved to be very valuable as the reevaluation and recertification process came to the homestretch,” Puno explained. The FDA head had earlier hinted that the agency was “under pressure” from various quarters as it reviewed and reevaluated the contraceptive products to ensure that these are safe and non-abortifacient as direct by the SC. “Secretary Duque provided that assurance that the results of the FDA review will stand the scrutiny both of its stakeholders and critics because the review is based on a scientific and technical process,” Puno said. “That assurance boosted our confidence in the integrity of both the process and its results,” Puno added.

Duterte rejects MICC proposal to lift open-pit mining ban Rappler 21st Nov 2017
President Rodrigo Duterte said on Tuesday, November 21, that he will reject the recommendation of the Mining Industry Coordinating Council (MICC) to lift the ban on open-pit mining. "Ayaw ko (I don't like it) because it is destroying the soil and walang corrective measures kaagad (there are no corrective measures right away)," he told reporters during an interview in Taguig City. Duterte said he would have followed the recommendation if he were convinced that mining companies would be able to immediately rectify the damage to the environment wrought by their operations. (READ: Duterte warns miners: Spend on rehab 'or I'll tax you to death') "'Di na bale sana kung may makita akong (It would have been okay if I saw in the) scraped area, when I go back there to visit the place, I could see a lot of trees growing and the environment corrected of its destruction," the President said. He added that, as a Filipino, he is "hurt" by the impact of mining on the environment, all for the profit of big corporations.

Singapore

Singapore Wants To Add Biotech Hub To Its List Of Accomplishments Forbes 20th Nov 2017
Singapore has made a mark in a range of industries recently. It's been named a top city for startups, a leading smart city, a spacetech hub, and it's internationally known as one of the most business-friendly countries in the world. But it can now add emerging medtech and biotech hub to that list. As of 2016, Singapore's medtech industry was worth more than $ 3 billion USD, and the government aims to grow the sector considerably. The country already hosts a number of international medtech manufacturers and facilitates public-private partnerships for companies looking to connect with academics and researchers in their areas of expertise. Singapore also serves as a gateway to the broader Asia-Pacific market, which offers high growth potential in the next several years, making it particularly attractive to startups and global multinationals alike. Both find a favorable welcome in the city-state, which in the past has pledged tens of millions of dollars to medtech startups operating there.

Singapore won't take up new US cut-off for hypertension The Straits Times 18th Nov 2017
Singapore will not be adopting the new, stricter high blood pressure definition of 130/80 that the American Heart Association (AHA) has recommended.

Sweet drinks off the menu at primary schools The Straits Times 17th Nov 2017
Even as primary schools are doubling down to fight diabetes following a Health Promotion Board (HPB) initiative launched this year to, among other things, sell less sugary drinks, one school has already been waging the war against sugar for years.

MOH tweaking rules to improve healthcare The Straits Times 16th Nov 2017
The Ministry of Health (MOH) is actively looking at and changing policies, legislation and rules that hinder instead of help in the provision of healthcare. "At the ministry, we sometimes don't know that some of the rules we have can lead to unintended outcomes," said Senior Minister of State for Health Chee Hong Tat. Instead of the rules working to make things go smoothly, they sometimes disincentivise more appropriate treatment options.

Thailand

'Distorted news' deemed health issue in junta-run Thailand ABC News 29th Nov 2017
Thailand's military government says it is fighting a new threat to public health: distorted news reports. The country's health ministry announced Tuesday it is launching a new smartphone application that will allow users to flag media content they find "inappropriate" so it can be forwarded to government authorities. "I believe that we can all help guard, observe, investigate and support the process of having safe and positive media to benefit our youth, families and society in general," Panpimol Wipulakorn, deputy director-general of the health ministry, said at a news conference.

Anthrax outbreak fear after goat meat meal Bangkok Post 28th Nov 2017
At least three out of more than 30 villagers in Tak who consumed goat meat are suspected of having contracted anthrax after they developed characteristic symptoms of the disease. Doctors are still awaiting the results of tests conducted on samples of the animals' carcasses to see if they were infected, Thawatchai Setthasupphana, director of state-run Mae Sot Hospital in Mae Sot district, said yesterday. Several dead goats were delivered to the villagers, who were unclear about their history.

Thailand Pesticides Registration Report 2017 Digital Journal 17th Nov 2017
The "Pesticides Registration in Thailand 2017" report has been added to Research and Markets' offering. Gain critical insight into pesticide product registration in Thailand. This report details what type of pesticides Thailand is importing and developing as well as what type of crops they are being used on.

Thai children getting fatter, survey finds Bangkok Post 13th Nov 2017
Weight issues and obesity are two of the biggest health problems facing Thai children – a trend that could cause Thailand to miss its target of improving nutrition and achieving food security by 2030, according to a recent survey. The survey on Thailand's status regarding the United Nations' Sustainable Development Goals (SDG), carried out by the National Statistics Office and the National Economic and Social Development board, found problems of being overweight and obese among Thai children aged under five increased two-fold to 10.9% between 2015 and 2016.

Vietnam

Iodine-enriched ‘3 Mien Bouillon’ contributes to iodine deficiency prevention in Vietnam Tuoi Tre News 27th Nov 2017
In the alarming situation of iodine insufficiency in Vietnam, UNIBEN Company has actively collaborated with experts from the Nutrition Center of Ho Chi Minh City for researching and developing a new food product – iodized bouillon, which is currently highly recognized by nutritional practitioners. In order to facilitate healthy eating habits among the population, UNIBEN has also distributed a significant amount of the iodized bouillon to millions of Vietnamese families.

​Vietnam pulls off first hematopoietic stem cells transplantation for unrelated donors Tuoi Tre News 17th Nov 2017
For the first time in Vietnam’s medical history, a patient has successfully undergone hematopoietic transplantation of stem cells derived from the peripheral blood of an unrelated donor. Stem cells from a Taiwanese donor were transported to Ho Chi Minh City for the medial operation, marking an important milestone in Vietnam’s medical advances. Hematopoietic stem cells transplantation (HSCT) is the transplantation of multipotent hematopoietic stem cells – those that give rise to all the other blood cells – most often performed on patients with certain cancers of the blood or bone marrow.

MoH proposes reducing food safety red tape Viet Nam News 17th Nov 2017
The Ministry of Health has proposed to the Government to reduce or simplify the number of administrative procedures in food safety management. Deputy Director of the health ministry’s Việt Nam Food Administration Trần Việt Nga said this week that five groups of administrative procedures had been proposed to be cut, including food production and trading conditions, announcement of food product and State inspection on foods, certification on meeting food safety standards, and food advertisement and food safety knowledge certification.

Policies needed to improve healthcare for the elderly Vietnam News 16th Nov 2017
Việt Nam is advised to quickly develop the model of family doctors, as well as improve the capability of hospitals and medical centres that specialise in taking care of the elderly, in order to meet increasing demand from senior citizens. The advice was released at a workshop held on Monday in Hà Nội. According to the World Health Organisation (WHO), Việt Nam is among the countries with the fastest aging rate in the world. The number of the elderly is over 10 million people, accounting for 11 per cent of the nation’s total population, but the national system to provide health care for the elderly remains severely lacking.

People to benefit from basic healthcare package Viet Nam News 15th Nov 2017
In order to reduce pressure placed on central hospitals, the basic medical services package at commune level medical facilities will be implemented from December, 2017. The package, including prevention, consultation and treatment services for all citizens, is fully covered by Việt Nam Social Security.

End misuse of antibiotics, combat resistance, experts say Vietnam News 13th Nov 2017
Experts called for stronger action from all sectors to stop the misuse and overuse of antibiotics to combat resistance on the occasion of the third World Antibiotic Awareness Week on November 13-19. Highlighting the importance of commitment at the local level, the National Steering Committee for Antibiotic Resistance, the Food and Agriculture Organisation (FAO) of the United Nations and the World Health Organisation (WHO) co-organised the event to kick off Antibiotic Awareness Week in Vĩnh Phúc Province on Monday.

Hà Nội hospitals unhappy with centralised bidding results Viet Nam News 13th Nov 2017
The centralised bidding process to procure medical equipment and other supplies for public hospitals in the capital city is floundering on disagreements over quality and pricing, local reports say.