Conference Summary

The primary discussion revolved around answering the question “Paano Susugpuin ang Sakit na Tuberculosis (TB)?” which is a continuing discussion on the eHealth PH website last year. It was stated that in 2012, the country already achieved the 2015 MDG goal of halving the both the TB prevalence and mortality with an applausable 461 and 24 per 100,000 population respectively compared to the 1990 data, which is 3 years ahead of the scheduled date. First and second line anti-TB drugs are available. Other NTP supplies are available. Faster diagnostic tools are available. Researchers are everywhere. Financial assistance is at reach. It was however discussed that there is a need to consider process documentation of he achievement (MDG Target 6C). In particular to consider examining ISTC (International Standards for Tuberculosis Control), particularly ISTC 1, 9, 16 in the context of Philippine experience. A mixed method is appropriate (quantitative-qualitative) which in effect provides a Philippine roadmap of experience in TB control within the ISTC framework. If we do this we rationalise our efforts in more systematic approach, allowing best practice to multiply. It was averred that the challenge towards effective control, management and ultimately the elimination of TB in the country has always been in terms of case-finding and case-holding. With the Enhanced PhiPACT 2010-2016 and the new NTP MOP, the road map has been set and policy guidelines clarified in terms of establishing mandates of both national and local health service providers, including the engagement of other stakeholders. The real challenge is in sustaining the gains beyond TBLINC and IMPACT project life, thus, there is really a need to continuously monitor and advocate for the sustained commitment of LGUs to NTP elimination targets as part of Good Governance, by way of institutionalizing the NTP program in their Local Health Development and Investment Plan. Both print and TV/Radio communication products are also being used to lure or attract patients exhibiting symptoms of possible tuberculosis infection to their nearest TBDOTS facility.

In terms of Drug Resistant TB, we are still a long ways to go in terms of detecting and successfully treating our DRTb patients. The latest Drug Resistance Survey conducted by the NTRL shows that there was a decrease in the proportion of MDRTB among the new notified cases but the same rate is still observed for retreatment cases. It means that there is a significant drop in the estimates for MDRTB burden in the country. The problem though is that this estimate is based only on the notified new and retreatment cases, and not the general TB population in general. We may still be missing a significant number of MDRTB patients coming from non DOTS treatment. Based on country data, we have improved in casefinding as we have enrolled 2390 DRTB cases last year, nearly all of them to be at least Rifampicin resistant based on GeneXpert. Abundant research is ongoing in the field of having a shorter 9 month regimen for MDRTB patients and evaluating the reasons for lost to ff-up among MDRTB patients. One of the proposed methods of addressing MDRTB is by looking at the aforementioned ISTC 9, or a mobile help centre. It was shown that using a mobile bus in order to detect DRTB in Palawan has increased casefinding in the area, showing on site diagnosis and prompt results, thus providing for a viable solution, and allows for appropriate referrals.