Wanted: leaders for TB-free PH

Every day, more than 60 people die in the Philippines due to tuberculosis. This daily tragedy endures even though TB is entirely curable. Moreover, the number of Filipinos who develop active tuberculosis every year has not changed in more than a decade.

Today is World Health Day, a day to commemorate the people who are affected by TB and those who have lost their lives due to this disease. It is also a time to reflect on what we can do to end the TB epidemic.

At any given point in time, over one million Filipinos have active TB. In addition, 573,000 people develop TB every year, with males being affected three times more than females. Yet, only about half of all active TB patients are diagnosed, treated and notified. The remaining half may not even know that they have TB because they may have only mild or slightly unusual symptoms. These patients may continue to suffer and spread TB without even knowing.

The solution for a TB-free Philippines is already known: It is a combination of early detection and uninterrupted treatment. The best way to detect TB is through X-ray screening followed by bacteriological confirmation, preferably using a rapid molecular test. The government is taking strong steps to provide greater access to TB screening and testing. The best way to treat TB is to give quality-assured drugs to TB patients without interruption for six to nine months. Because interrupted treatment often makes the disease incurable, the government is designing new approaches and technologies, including digital apps, to ensure zero interruptions.

Achieving a TB-free Philippines requires strong leadership—not just from the government, but from all of society. Everyone can be a leader in our fight against TB. Therefore, we call on all Filipinos to lead the fight. Talk to your constituency representatives. Support campaigns that use X-ray screening linked to rapid molecular testing. Call for policies that deliver community and home-based TB care for patients using quality-assured diagnostics, drugs and innovative technologies. Share your experiences and expectations on social media, using the hashtags #WTBD2018 and #EndTBPH.

We also call on all governors, mayors and community leaders to learn more about TB and take action to address the TB situation in your areas. Ask your health workers about the estimated number of people who suffer from TB every year. Ask them how many TB patients they are finding and treating every year. Support them to find the missing TB patients through a massive screening campaign linked to rapid molecular testing. One of the best ways to do this would be to do annual X-ray screening for everyone who visits health facilities as part of a routine checkup. Those who have TB-like X-ray lesions should then be required to undergo bacteriological confirmation, preferably using a rapid molecular test.

We also call on the private sector to join hands with the public sector in this fight. The private sector treats over 125,000 TB patients every year. But treatment success rates are likely to be lower for patients who seek TB care in the private sector in spite of the best efforts of private physicians. This is because private physicians may not have the capacity to track and ensure completion of full treatment. Hence, private physicians need to refer all TB patients to the government and seek the support of public health nurses to ensure high treatment success rates.

The formal corporate sector employs about 25 percent of the population. Most employees undergo X-ray screenings during annual checkups. All companies need to ensure that employees who have TB-like X-ray lesions should benefit from bacteriological confirmation. Companies should also guarantee support to people with TB as they undergo complete treatment, without facing discrimination.

The Department of Health has a strong plan to end TB. Health Secretary Francisco Duque III has reassured us that he will be a strong leader in the fight against TB. The DOH is now designing operational plans to launch a massive effort against TB. But the national plan can be successful only if everyone contributes.

Let us all join hands to deliver rapid, massive, overwhelming and decisive force to end the TB epidemic. Let us all be the leaders that the country needs so that we can save precious lives.

Dr. Gundo Weiler is the World Health Organization’s representative to the Philippines.