Philippine Standard Time
Saturday, January 18, 2020
The National TB Control Program, organized in 1978 and operating within a devolved health care delivery system, is one of the public health programs being managed and coordinated by the Infectious Diseases for Prevention and Control Division (IDPCD) of the Disease Prevention and Control Bureau (DPCB) of the Department of Health (DOH). Headed by a program manager and supported by 20 technical and administrative staff, it has the following mandate: (1) develop policies, standards and national strategic plan, (2) manage program logistics, (3) provide leadership and technical assistance to the lower health offices/units, (4) manage data, and (5) conduct monitoring and evaluation. The program's TB diagnostic and treatment protocols and strategies, issued through the Manual of Procedures, are in accordance with the policies of World Health Organization (WHO) and the International Standards for TB Care (ISTC). Its last strategic plan was the 2010-16 Philippine Plan of Action to Control TB or PhilPACT.
The NTP closely works with various offices of the DOH, such as the National Center for Health Promotion (NCHP) for advocacy, communication, and social mobilization; the Epidemiology Bureau (EB), and the Knowledge and Management Information and Technology Services (KMITS) for data management; Health Policy Development and Planning Bureau (HPDPB) for policy and strategic plan formulation; Material Management Division (MMD), Central Office Bids and Awards Committee (COBAC) and Food and Drug Administration (FDA) for drug and supplies management; the National TB Reference Laboratory of the Research Institute for Tropical Medicine (NTRL-RITM) for laboratory network management; Lung Center of the Philippines (LCP) for PMDT-related researches and training activities and the 17 regional offices (ROs) for technical support to the provincial health offices (PHO) and implementing units; and the Philippine Health Insurance Corporation(PhilHealth) for the TB-DOTS accreditation and utilization of the TB-DOTS outpatient benefit package.
The 17 ROs through its regional NTP teams manages TB at the regional level while the PHOs and city health offices (CHOs), through its provincial/city teams are responsible for the TB control efforts in the provinces and cities. TB diagnostic and treatment services are part of the basic integrated health services which are provided by DOTS (Directly Observed Treatment, Short Course, current means of delivery of treatment Services) facilities which could either be the public health facilities, such as the RHUs, health centers, hospitals; other public health facilities, such as school clinics, military hospitals, prison/jail clinics; NTP-engaged private facilities, such as the private clinics, private hospitals, private laboratories, drugstores and others. Community groups, such as the community health teams and barangay health workers participate in community-level activities.
NTP closely works with the 17 government offices and 5 private organizations in compliance with the Comprehensive and Unified Policy (CUP) issued by the Office of the President in 2003. Under the framework of public-private mix (PPM) collaboration in TB-DOTS, NTP collaborates with non-governmental organizations, such as the Philippine Coalition Against TB (PhilCAT), a consortium of 60 groups, and the 100-year old Philippine TB Society, Inc. (PTSI) and many others. Various developmental partners and their projects provide technical and financial support to NTP, such as the World Health Organization (WHO), United States Agency for International Development (USAID), Global Fund Against AIDS, TB and Malaria (Global Fund), Research Institute of TB/Japan Anti-TB Association (RIT/JATA), Korean Foundation for International Health (KOFIH) and Korean International Cooperation Agency (KOICA) and KNCV Tuberculosis Foundation.
Table 1.5. Status of the impact targets
|Incidence Rate||Less than the baseline||322/100,000||Achieved|
For the outcome targets, the case detection rate and treatment success rate for drug susceptible TB were achieved by the end of 2016. However, the targets for case detection rate and treatment success rate for drug resistant TB cases were not achieved. Table 2 shows the accomplishment for the outcome targets.
Table 2.5. Status of the outcome targets
|Case Detection Rate, Drug Susceptible (All forms)||90%||92%||Achieved|
|Treatment Success Rate, Drug Susceptible (All Forms)||90%||92%||Achieved|
|Case Detection Rate,Drug Resistant TB||62%||32%||Not Achieved|
|Treatment Success Rate, Drug Resistant TB||75%||49%(2012 cohort)||Not Achieved|
Of the five (5) output targets, only two (40%) were achieved. These are the number of TB patients provided with treatment and number of TB patients counseled and tested on HIV. See Table 3 for the status of the said indicators.
Table 3.5. Outcome Indicators
|No. of TB symptomatics provided with DSSM||5.5 million||4,717,535||Not achieved;Patients who underwent examination using Xpert MTB/Rif as a primary diagnostic tool is not accounted for.|
|No. of TB patients provided with treatment||1.5 million||1,701,059||Achieved|
|No. of children provided with treatment or preventive therapy||730,000||181,728||Not achieved; There were inadequate stocks of drugs for children due to quality issues of the procured drugs and low uptake of IPT.|
|No. of MDR-TB detected and provided with second line anti-TB drugs||19,500||18,886||Not achieved due to lack of access to diagnostic and treatment facilities for drug resistant TB cases.|
|No. of TB patients provided with PICT on HIV/AIDS||45,000||57,590||Achieved|