By Perfecto T. Raymundo, Jr.
MANILA — The Doctors Without Borders conducted on Friday (Nov. 29) stressed the global plan of ending TB by 2030 during the Media Orientation on Tuberculosis (TB) in the Philippines at the Bayview Park Hotel Manila.
The workshop with the theme: “Puksain Natin ang TB”, was coordinated by the Probe Media Foundation, Inc (PMFI).
It was highlighted that TB is one of the deadliest infectious diseases worldwide, and the Philippines ranks among the top ten countries with the highest TB burden.
Governments around the world, including that of the Philippines, are strongly urged to dedicate resources and efforts to eliminate TB.
Every day, numerous people lose their lives to this disease in the Philippines unnecessarily
As of Dec. 31, 2023, there have been 612,534 new cases reported.
Many of these patients develop drug-resistant TB, which is more costly and challenging to treat.
The Philippines is one of the few countries where the number of people with TB continues to rise each year, particularly among marginalized populations in low-resource settings.
Everybody and all the stakeholders must have the awareness of TB and what’s going on from the regional and Philippine perspective.
The event served as an informative and insightful discussion about the current situation of TB in the country, strategies and programs, challenges, gaps, and key initiatives that work towards eliminating TB.
Resource persons were representatives from Doctors Without Borders/Médecins Sans Frontières (MSF), World Health Organization (WHO), Department of Health (DOH), and others.
Polly Cunanan is the regional information officer of the Doctors Without Borders based in Singapore.
Cunanan said that the MSF is in 70 countries in the world and has 400 projects all over the world.
Dr. Ghazali Babiker, Doctors Without Borders/MSF Head of TB Working Group, said “We cover 70 countries all over the world. Most of our work is based on medical missions.”
“MSF is mainly focused on medical emergencies such that climate change also has impact on health,’ he added.
” The MSF is also focused on International
Humanitarian Emergencies. We usually work with local community leaders to have ownership of all undertakings and without any political agenda,” Dr. Babiker said.
“We try to address the issues,” he said.
He cited the Gaza situation in Israel which suffered in the conflict between the Hesbolah militant group and Israel.
Dr. Cathy Hewison, MD, Doctors Without Borders Head of TB Working Group, in a video, presented the MSF and TB globally where MSF is present in 70 countries.
Dr. Hewison cited the MSF medical mission in Malawi in Africa, and the MSF Clinic in Mumbai, India.
She said that they are also performing researches on TB where six months is the recommended period of treatment for TB.
There are treatment options for TB. The MSF is also heavily engaged in the diagnosis of TB.
The Test Avoid Cure TB in Children (Tactic) Team is also conducting the study on the four-month treatment of TB as well as the cost of treatment from US$500 to US$400.
The TACTIC project focuses on 3 main pillars such as field implementation, operational research, and advocacy.
Out of the six treatment regimens, five regimens have come out.
Dr. Thomas Dale Hiatt, TB Officer of WHO,
an epidemiologist, said that TB is a bacteria that affects the lungs which replicate and may last to a full blown disease.
Dr. Hiatt highlighted that 25% of the world is infected with TB. Two-thirds of cases are in 8 countries.
There are 1.2 million deaths due to curable TB disease each year or 100,000 each month of the year.
There is an End T-Strategy from 2016-2035 to reduce the catastrophic cost to TB patients globally.
The UN High Level Meeting (UNHLM) targets 90% for 2027 with TB preventive treatment with a US$5-billion funding per year.
The last TB drug treatment was introduced in 1991.
A person in TB treatment is not infectious.
PhilHealth includes X-ray in its health package coverage for its members and their dependents.
The DOH cited the success of the “Doctors to the Barrio” program during the time of the late Sen. and erstwhile Dr. Juan Flavier.
It also presented the 2023 TB Burden where 10.8 million people fell ill with TB.
The Philippines is one of the countries with increase in incidents of TB.
Only 33% of the target population nationwide was screened by CXR in 2023.
No region in the Philippines was able to meet the target.
Among all regions, only NCR achieved the target of DRTB treatment with 101%
However, there are more clinically diagnosed TB cases.
The treatment success rate (TSR) of Drug-Resistant TB (DRTB) in the public sector is 90% and 34% in the private sector.
The success of the treatment of TB is one of the priority outcomes of the DOH under the eight-point socio-economic agenda of the administration of President Ferdinand R. Marcos, Jr.
There is the Development of TB National Strategic Plan covering 2025-2030, including the DILG and the DOLE, in order to achieve the international commitments such as in the UN Sustainable Development Goals (SDG).
Dr. Babiker presented the MSF TB Project in Tondo, Manila, particularly in District 1 and District 2 in line with the global plan of ending TB by 2030.
The model of care consists of screening, patient support, health promotion, operation research, and advocacy.
The MSF does not directly treat the patients but with the patient support, they are linked to the Manila Health Center, household contacts, adherence, and TB preventative treatment.
Mobile X-ray goes to the sites to strengthen the diagnosis and treatment of people with TB in Districts 1 and 2 of Tondo, Manila where District 1 is highly populated and District 2 is more of an industrial area.
There were 111 participants in 2023 and 122 participants per day in 2024 in the screening, diagnosis, and treatment of TB in Tondo, Manila
The challenges are low attendance due to stigma, prioritization, transportation, and no support in households for the patients to initiate or continue the treatment.
The DOH has adopted the four-month regimen treatment for children with TB.
“We are closely coordinating with the local government of Manila in trying to find solutions to these problems,” Babiker said.
“The major sponsors have a big role to play on this,” he added.
Babiker noted though that the low supply of medicines for TB treatment is not only a problem in the Philippines but globally as well.
Dr. Samantha Tinsay, Municipal Health Officer of Bantayan, Cebu, said that one of the challenges is the geographical location being an island town in Cebu province.
Dr. Tinsay said that there are more than 5,000 presumptive TB cases as of October 2024, noting that diabetes is one of the underlying factors of TB.
Bantayan, with 25 Barangay health centers, is the first in the country to have an electronic health records such that it has the highest consultant claims of P15 million from PhilHealth making it the highest in the Western Visayas Region.
Bantayan, through the MSF, is providing health services to isolated populations as well as persons deprived of liberty (DPLs).
An ordinance has been enacted in Bantayan for the elimination of TB in the island municipality.
Dr. Tinsay said that Bantayan, which is a first class island municipality, now has 281 Barangay Health Workers (BHWs) as the municipal government has enacted an ordinance securing the jobs of the BHWs even with the change in the Barangay leaders.
She said that with the Mandanas ruling of the Supreme Court, there was an increase in the National Internal Revenue Allotment for the devolution of the services of national government agencies to the local government units nationwide.
Arch. Eloisa “Louie” Zepeda-Teng, a TB survivor, lost her “vision, career, friends and self esteem in 2007”, which for her was a triple discrimination.
Teng’s life experience was featured in the TV performed by Roxanne Guinoo.
She participated in the Union Barcelona in 2014. She is also active in the Global Coalition of TB Advocates (GTA).
Teng is the world’s first survivor of TB who also lost her vision.
She became a Global Fund speaker that raised US$14 million.
She founded the TB People Philippines, which is multisectoral and with 24 chapters all over the world advocating for LIFT-TB Philippines.
She urged for an end to discrimination to people with TB.
“We go from national to regional to the grassroots level,” Teng said.
The Fast Track The Cure is advocating, through the social media and mainstream media, to eliminate fear of TB and to end the mortality rate of TB as spearheaded by the DOH.
