Philippines
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The Philippines ranks ninth on the list of 22 high-burden tuberculosis (TB) countries in
the world, according to the World Health Organization’s (WHO’s) Global TB Report
2008. It has the second highest number of cases in the WHO Western Pacific Region,
and TB is the sixth greatest cause of morbidity and mortality in the country. In 2006,
approximately 107 Filipinos died each day from the disease, but significant strides have
been made in increasing case detection and treatment. In 2004, the country achieved a
TB case detection rate of 72 percent, exceeding the WHO target of 70 percent, and
reached 77 percent in 2006. According to national data, the case detection rate was
75 percent in 2007. National data for 2007also showed that the proportion of cases
notified that were sputum-smear positive (SS+) had risen to about 64 percent,
indicating the quality of treatment continues to improve. The DOTS (directly observed
treatment, short course) treatment success rate for new SS+ cases has been above
target the WHO target of 85 percent for the past seven years, reaching 89 percent in
2006 (national data).
While the national performance levels are already high, many provinces are still below
target levels due to various systemic and social factors, including the difficulty of
breaking down the stigma of TB, which keeps many of those infected from seeking
care. The management of multidrug-resistant (MDR) TB is expanding, with support
from the Green Light Committee; however, the presence of extensively drug-resistant
(XDR) TB has been reported by WHO. The availability of over-the-counter TB drugs
and self-medication by patients continue to contribute to the emergence of TB drug
resistance.
USAID Approach and Key Activities
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USAID has been supporting TB prevention and control activities in the Philippines for
the past seven years, aiding Philippines’ National TB Control Program (NTCP) and the
Department of Health (DOH) in strengthening the public and private sectors’
capacities to implement DOTS. Collaboration with private practitioners is critical to
reducing TB prevalence in the Philippines, as people with TB symptoms are more likely
to seek treatment from private providers than from public providers. In fiscal year
(FY) 2008, USAID funds for TB programming in the Philippines reached more than $5.4
million. In October 2006, USAID launched the Linking Initiatives and Networking to
Control Tuberculosis project, the U.S. Government flagship TB project that supports
the Philippine Government to continue the coordination and collaboration of TB
control within and between the public and private sectors. Specifically, the project
aims to improve the policy, financing, and regulatory environments for DOTS;
strengthen service delivery; and increase demand for DOTS services through social
mobilization and behavior change communication. USAID’s assistance includes the
following activities and interventions:
- Enhancing national- and local-level planning, financing, monitoring, and
supervisory capacities
- Ensuring that health managers and providers are knowledgeable in all aspects
of DOTS, policy reform, and advocacy
- Strengthening TB surveillance, laboratory capacity, and quality control
- Improving TB drug management
- Implementing information, education, and behavior change communication
activities
- Assisting the DOH in strengthening the accreditation and reimbursement
process of the national health insurance program
- Enhancing the DOH and local governments’ TB policy and financing arrangements to ensure long-term sustainability of
TB services
- Strengthening the private sector’s role in quality DOTS service delivery and its coordination with the public sector
USAID Program Achievements
USAID's program has contributed to substantial improvements in human and infrastructure capacity and includes the following achievements:
- Assisted with ongoing efforts of the national health insurance program to improve the process for accrediting DOTS
centers and reimbursing centers for TB services
- Strengthened DOTS program planning and management at the national and local levels by strengthening monitoring and
supervision and developing 13 provincial investment and operational plans, ensuring consistency with national priorities
- Supported strategies for a more efficient and cost-effective supply chain for TB commodities
- Established national policies for management of TB in children and programmatic management of MDR-TB
Case Detection and Treatment Success Rates Under DOTS
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Note: DOTS treatment success rate for 2006 will be reported in the 2009 Global Report.
Source: Global Tuberculosis Control: Surveillance, planning, financing:WHO Report 2008. |
Partnerships
USAID partners in TB control in the Philippines include the DOH’s NTCP and other government departments, including the
Department of Education and the Department of Labor and Employment. Nongovernmental partners include the Philippine
Coalition Against Tuberculosis, the Philippine College of Occupational Medicine, World Vision International, the Philippine
Tuberculosis Society, Inc., and others. In addition, USAID collaborates with multilateral organizations, including WHO and the
Global Fund to Fight AIDS, Tuberculosis and Malaria. In 2003, 2006, and 2008, the Philippines was approved for Global Fund TB
grants worth $11.4 million, $16.7 million, and $138.7 million, respectively. The Global Fund grants aim to strengthen quality
DOTS implementation, engage the private sector in DOTS, increase demand for TB services, and improve management of MDRTB.
The Tropical Disease Foundation is the principal recipient of the grants.
February 2009
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