The TB mobile clinic turned over to the DOH-CAR in Baguio on February 15, 2024 (Source: PIA website)
Tuberculosis (TB) is an infectious disease that most often affects the lungs and is caused by a type of bacteria. It spreads through the air when infected people cough, sneeze, or spit, but is also preventable and curable. To meet this anticipated health problem on a national scale, President Ferdinand E. Marcos Sr. set up the Lung Center of the Philippines through Presidential Decree 1823. The Lung Center was inaugurated on January 23, 1982.
The most recent law regarding TB is Republic Act 10767, or the Comprehensive Tuberculosis Elimination Plan Act of 2016. The Department of Health (DOH) has implemented this law through activities that reduced TB cases. One of these is the TB preventive treatment (TPT), which can prevent progression to active TB disease. The national government has expanded its TPT eligibility not only to childhood contacts who are under five years of age and people living with HIV, but also to all household contacts regardless of age.
Screening of contacts is performed to rule out active TB disease. After symptom screening for under-five and chest X-ray for other household members, tuberculin skin testing is done for those without TB risk factors, and bacteriologic diagnostics for those presumptive of TB. The team then coordinates referral to a facility physician for those requiring further clinical evaluation. They also offer TPT to eligible clients with specific treatment regimen based on patient preference—daily isoniazid for six months, daily isoniazid-rifampicin for three months, or weekly isoniazid-rifapentine for three months.
In 2022, which marked the beginning of the presidency of Ferdinand Bongbong Marcos Jr., 44,417 people underwent TPT. This figure represented a 130-percent increase from 19,096 people who had the said treatment in 2021. Furthermore, in 2022 the number of TB-related deaths decreased by 1.6 percent, signaling the effectiveness of efforts to combat TB.
In line with the Global TB Plan 2023-2030 that targets to end TB globally by 2030, President Ferdinand Marcos Jr., during the 2023 State of the Nation (SONA) cited TB as one of his priorities. He underscored the important role of each stakeholder and partner in the fight against TB. He instructed DOH Secretary Ted Herbosa to address the TB situation using a whole-of-society approach with the participation of national and local governments, academe, societies, and development partners, and the private sector and practitioners.
In response, Sec. Herbosa said that to end TB in the Philippines by 2030, the focus should be on having 100 percent of those who have tuberculosis to be diagnosed, and those diagnosed to get ample medication. “During my term up to 2028, I’m going to make sure that every person with pulmonary TB gets the medicine,” Herbosa added.
On the part of a TB survivor and president of TB People Philippines, Ma. Loisa Teng, “always put the laboratories near the residents. Before, we had it in the rural areas like in other regions, but we had to travel for six hours just to get a laboratory..”
To prevent and cure TB by activating the partnership as instructed by President Ferdinand “Bongbong” Marcos Jr. during the SONA, one of the DOH’s concrete actions in the Cordillera Autonomous Region (CAR) in February 2024 is using mobile TB clinics donated by the Philippine Business for Social Progress (PBSP). This mobile clinic is powered by the latest technology using artificial intelligence (AI) that fast-tracks patients’ screening. In addition, TB patients even in remote areas can be given free treatment and medication through the mobile clinic.
“We plan to end TB and going down to the communities using the mobile TB clinic is an effective strategy,” according to DOH-CAR Director Amelita Pangilinan.
President Marcos Jr. also shared a similar view on the state-of- the-art mobile TB clinic that can reach far-flung areas, which is helpful in the early detection of TB.
Other mobile TB clinics were later turned over to DOH-Ilocos Region, DOH-Central Visayas and DOH-Bicol. “This is the first mobile TB clinic in our region. This is worth around P8 million and is fully equipped,” said Dr. Jannish Alcala-Arellano, DOH-Bicol Local Health Support Division Chief.
Vence John Quine, a 26-year-old TB survivor from Camarines Norte, thanked President Marcos Jr. for his campaign against TB. He recalled that when he began experiencing TB symptoms, he immediately sought medical attention. As a result of the collective effort, the DOH-Bicol reached a 92-percent treatment success rate in the first quarter of 2024.
Antonio Rollo Mecarsos of Lanao del Norte thanked the existence of the TB mobile in their province: “Dako akayo nakong kalipay nga dunay libreng sa mga tawo nga walay ikabayad sa pagpa-check up. Nagpasalamat ko sa gobyerno ni PBBM nga gitagaan mi og higayon nga kami mga kabos makabenepisyo mi sa libreng consultation sa TB mobile clinic.” (I am very happy that there are free check-ups for people who cannot afford to pay. I am grateful to PBBM for giving us the opportunity as poor individuals to benefit from the free consultation through TB mobile clinic)
Another technology donation was received by the DOH from the Korean Innovation Company. The donation included the Xpert MTB/RIF assay (Gene Xpert), a state-of-the-art molecular test capable of early diagnosis of mycobacterium tuberculosis MTB and simultaneous assessment of Rifampicin resistance.
Occidental Mindoro achieved 92.86 percent treatment success rate in the third quarter of 2024, which is higher than the 89.55 percent they got in 2023. One factor attributed to this success rate is the TB case detection through “the use of Gene Xpert.One of the best practices of the province is having the Gene Xpert that enables easier detection of TB,” explained Sheila Abeleda, Provincial Health Officer of Occidental Mindoro.
Furthermore, one of the eight portable X-ray machines donated by the United States Agency for International Development (USAID) was initially used in Valenzuela City in March 2024. Seven other units of the machine have been strategically distributed to geographically isolated regions and areas with high TB prevalence.
This machine is compact enough to fit in a regular-sized backpack and is battery-operated. Each battery can capture at least 100 images. Within five minutes, the photo from the machine is ready and can determine the presence or absence of TB in the person, even without a radiologist since it is also powered by AI.
“In Metro Manila, our streets can be narrow and a regular car cannot enter. But this portable X-ray can be brought in a suitcase, so we can reach those who are difficult to reach,” said Dr. Lalaine Mortera, of the USAID Tuberculosis Innovations and Health Systems Strengthening program.
Another local government unit (LGU) and private partnership was signed between Majayjay, Laguna, and Fujifilm Philippines. Fujifilm conducted their first medical mission in the said town and did TB screening using X-ray systems (FDR nano and FDR Go PLUS). Fujifilm plans to continue their activity annually to support the program of President Marcos Jr. for Filipinos who are fighting against TB.
Rep. Ray Reyes, AnaKalusugan Representative and Vice Chairman of the House Committee on Health, also supports the health advocacies of President Marcos Jr. and the deployment of portable X-ray technology in remote areas. But he also recognized that more should be done. “A lot of health-care policies need to be updated and future-proofed.” Thus, he filed House Bill 9799 seeking to amend the Comprehensive Tuberculosis Elimination Plan Act.
DOH-11 National TB Program Head, Evelyn Uy-Gelito, on the other hand, reminded the public that “Don’t be afraid if you have symptoms of TB. The DOH, under President Ferdinand Marcos Jr. and other support groups will be there to help you.”
With these worthwhile projects on the ground, it will just be a matter of time before tuberculosis becomes a blot of memory in the people’s minds. #
