Keynote Speech of Secretary Enrique T. Ona for the 17th Annual Philippine Coalition Against Tuberculosis (PHILCAT) Convention

August 19, 2010





    A very pleasant afternoon to each and everyone! It is an honor for me to be here with our partners as we hold the 17th Annual Convention of the Philippine Coalition Against Tuberculosis. 

    The theme for this year’s convention is PhilCAT 2010: Partnership Towards Strategic Interventions in TB Control. This highlights the need for all of us involved in the fight against TB to continue seeking innovative ways and solutions in addressing this disease if we are to reach the goal of sustainably reducing the incidence of TB and hopefully eliminating it by 2050.

    We recognize that much has been done and achieved particularly since the beginning of the millennium that has drastically reduced the burden of TB and together  we coninute to make progress.

    Although the Philippines is still in the WHO Watch List as one of the 22 countries with the highest burden of TB,  we, however, have consistently achieved our targets for TB Case Detection rate of at least 70% and Treatment Success Rate of at least 85% among new smear positive TB cases in the last six years. Moreover, the burden of TB disease in the country has declined over the decade through adopting the DOTS strategy in 1996 as well as the Public-Private Mix DOTS (PPMD) approach in TB management.  With the progress to date, and the continuing collaboration of among the public and private sectors, elimination of Tuberculosis is a distinct possibility and achievable goal!

    This year marks another beginning, a starting point for our national plan to stop TB in the Philippines. The 2010-2016 Philippine Plan of Action to Control TB or PhilPACT has already been accomplished.  This will will serve as the medium-term plan to achieve the Millennium Development Goals of cutting the cases and deaths due to TB in the next six years. The 2010-2016 PhilPACT is intended to serve as a road map to reduce TB to a level where it is no longer a public health threat in the country. All of us - policy makers, managers, implementers, local and international partners, and everyone who is committed to working towards a TB-free Philippines are its expected users and beneficiaries. I am also very glad to announce that the League of the Provinces of the Philippines and the League of Municipalities have already pledged their support to this national plan as a guide on their localization of the TB Control Program. To our LGU partners, again we say thank you for this new partnership!

    The Department of Health sees the present engagement with our various stakeholders as an important cornerstone of our fight against Tuberculosis. I wish to emphasize three important initiatives that I believe are important to us, with the hope that we can share and act on them collectively as we intensify our efforts and control strategies in the next six years.

    The first one is to strengthen public and private partnerships in TB. In President Noy’s State of the Nation Address, the word PPP or public-private partnership, he mentioned several times throughout the speech. This is a strategy that we have in fact, long begun in our  National TB program and where the Philippines has been recognized as a model and a global leader in our efforts against TB. 

    Public- private partnerships are no doubt, key to successful health initiatives and they are very much needed in combating the menace of TB  in the developing world. In our country, many of our patients turn first to private physicians when they are ill. That is why our efforts to eradicate TB must always involve the private sector. We should ensure that their goals are aligned with those of government and that their efforts reinforce the initiatives we are doing so that we all can move forward. But apart from the private providers, we should also intensify partnerships with the academe, the NGOs and the civil society at large.  Their contributions can be in the form of resource-sharing, research, technical assistance, transfer of knowledge & technology,  training, and many others. All our efforts must be aligned perfectly to one common vision and cause ---- –that is to halt and reverse the TB epidemic and realize a TB-Free Philippines and a TB-free world by 2050!

    The second initiative is to increase the engagement of LGU health facilities and hospitals in the implementation of National Tuberculosis Control Program. It has been reported that most hospitals do not necessarily implement the DOH and internationally-recommended DOTS strategy. Evidence shows that without proper linkage to the National TB Control Program, these health facilities are in fact providing poor quality diagnoses and treatment. While public private mixed DOTS (PPMDs) have been launched and have contributed to current gains in case detection and cure rates, a lot more still have to be done. Moreover, while PhilHealth already has TB-DOTS package for TB patients in Rural Health Units, a great number of RHUs especially those in 4th – 6th class municipalities are still not accredited for this program and hence, cannot avail of reimbursements.

    These hospitals are not able to provide DOTS services and the Rural Health Units are not accredited for TB DOTS because they are poorly stocked, not well equipped both in terms of manpower capacity and equipment. Last week, I visited the provincial hospital in Davao Del Sur and the Barangay Health Station in Davao and I saw the very poor state of our hospitals and our local health facilities. But these are just symptoms of an underlying deficiency that has plagued our healthcare system ever since and this is the lack of resources for health.  But as with any complex disease, cure and treatment are never simple. We should find innovative and creative ways to overcome the problem of our hospitals and health facilities. The Department of Health is committed to help the LGU health units and provincial and district hospitals improve their capacities and capabilities through manpower and equipment.

   But of course, these will never be enough. The DOH will also help the health facilities and hospitals find suitable and sustainable mechanisms for them to generate resources to further improve the health facilities. In particular, our Rural Health Units need technical assistance in order for them to be accredited to the TB DOTS program of PhilHealth. Perhaps, our partners can help us with this.

    Speaking of PhilHealth, they will play the biggest part in our efforts to solve the problem of meagre resources for our health facilities and hospitals. Based on my personal and informal survey of the different public hospitals I have visited, the proportion of hospital patients with PhilHealth enrolment is below 30%. Improving PhilHealth coverage will indeed be beneficial for our health facilities. These will bring additional income for which they can in turn use to procure equipment and to buy medicines for their patients. Improving PhilHealth coverage not only of the “true indigents” but also of the informal sector which is the most difficult to catch, is among the top priorities of this Administration. In fact, on October 2, the DOH and Philhealth will hold a PhilHealth enrolment day which will target the enrolment of around 500,000 poor families based on the identification made by the DSWD.  We shall also target  families belonging to the informal sector. 
   The third thing I want to address is the vulnerable populations such as our poor constituents, senior citizens,  children, and those with co-morbidities – they are all at greater risk of TB and are likely to have worse treatment outcomes than the general population. Their complex needs are often overlooked and they experience barriers to access routine health care particularly at the hospital and LGU levels. Health-care providers should recognize the increased risk of TB in these populations and give special attention to surveillance and preventive services.

  Partnerships are at the heart of our success but this must come from the strength of our conviction and the political will to take action. I call on all the partners – the leaders and representatives of government and non-government organizations, as well as the civil societies, to act immediately and to act now. You are our partners in this effort and we cannot do it alone.

    Lastly, I thank the organizers of this convention, the Philippine Coalition Against Tuberculosis or PhilCAT and the Philippine Tuberculosis Society, Inc., for their joint efforts to make this occasion a success and an opportunity to review our progress and strategies in TB prevention and control.  The 17 years of PhilCAT and the 100 years of PTSI are formidable achievements that we should all be thankful for. No doubt, you matter in our history of success. You serve as our strong arm in the National TB Program and we rely on your efforts as we continue to reach and care for all TB patients in need.

Maraming salamat at Mabuhay tayong lahat!