SEATTLE, Washington — The Philippines have the third-highest rate of Tuberculosis (TB) cases globally. There are approximately one million individuals currently living with tuberculosis in the Philippines. Despite the fact that there is a medication for TB and it can be cured, it has the highest death rate of all infectious diseases in the country, killing more than 70 people daily. The World Health Organization is working in the Philippines to help reduce the prevalence of TB in the country.
Tuberculosis and Health
Tuberculosis is an airborne bacterial infection and is transmitted through coughing or sneezing particles into the air as well as through consuming unpasteurized milk. The TB bacteria often attacks the lungs, but can also affect other organs and systems such as “the lymphatic system, central nervous system, urogenital area, joints and bones.” Since TB infections are acquired through air droplets, overcrowded areas are at higher risk and facilitate transmission.
A latent form of TB is extremely common in 90 to 95 percent of individuals infected with TB. These people do not experience symptoms. Individuals with the active form of TB experience coughing, chest pain, general weakness, lack of appetite, weight loss and fever-like symptoms. Treatments for TB requires a minimum of six months on antibiotics. Drug-resistant TB occurs when the original antibiotics are no longer effective, often as a result of misuse of the antibiotics or failing to keep up medication. Multidrug-resistant TB (MDR-TB) occurs when the first round of antibiotics fail. This can turn into extensively drug-resistant tuberculosis (XDR TB) if another round of medication fails to cure the illness
Social and Economic Factors
Poverty is a significant risk factor for TB. Poverty goes hand in hand with malnutrition, overcrowding, bad air circulation and poor sanitation, all of which increase the risk of TB infection. While poor living conditions increase the likelihood of contracting the disease, underserved communities also have limited access to healthcare. Many TB cases go undiagnosed, perpetuating the cycle of disease and exacerbating inequality. If treatments are administered, they are often done so poorly or inaccurately as a result of lacking resources. This can ultimately result in drug-resistant strains and contribute to an even higher TB burden in poor communities.
For these reasons, Tuberculosis in the Philippines is more concentrated in poor communities like slums. In fact, at least 39 percent of children aged five to nine and living in the slums have TB. Although the poverty rate in the Philippines is high, it has been decreasing. In 2015, the rate was 26 percent. It had dropped to 20.8 percent by the end of 2019. While the current burden of tuberculosis in the Philippines is significant, interventions that target poverty and socio-economic factors will help reduce TB by focusing on the root of the issue.
The World Health Organization
The World Health Organization (WHO) along with the Philippines Department of Health (DOH) are leading efforts to battle TB. The nation is aiming to significantly reduce tuberculosis by 2030. While the situation is a medical and public health emergency, strategies must involve many governmental branches, agencies and the private sector, according to WHO Philippines Representative Dr. Gundo Weiler.
This plan includes three main strategies. The first targets social factors of TB with involvement from the Department of Social Welfare and Development, such as loss of income during sickness, which can severely impact families and health outcomes. Second, with the help of the Department of Budget and Management, improved access to quick screening, testing, and treatment will be available to individuals suffering from TB. The Philippine Strategic Elimination Plan will provide funding, resources and health workers. Finally, the third strategy is to better implement the Comprehensive Tuberculosis Elimination Plan Act of 2016 (RA 10767), which states that care providers must report every TB diagnosis to the Department of Health.
The National TB Control Program
The National TB Control Program, working alongside WHO, has set specific goals to reach by 2020. These goals include improving TB care and prevention services, reducing the cost of TB to households, improving the data available in order to accurately measure progress and improving political commitment to put into effect these specific strategies. In addition, it has the long-term goal of decreasing the TB mortality rate by 95 percent and incidence rate by 90 percent by the year 2035.
In April 2020, WHO shared guidelines and instructions to continue the fight against tuberculosis in the Philippines amidst the COVID-19 pandemics. These guidelines address how to tackle TB and the COVID-19 simultaneously by prioritizing the safety of TB laboratory staff and community health workers while keeping the necessary TB services available and accessible.
– Maia Cullen