By DR. GUNDO WEILER
This year’s World Tuberculosis (TB) Day theme is: “It’s time.” It is an urgent call for action to urge world leaders to keep the promises they made at the first-ever UN high-level meeting on TB in New York last September. At that meeting, Secretary of Health Dr Francisco Duque III committed to the bold target of finding and treating 2.5 million people with TB in 2017-2022.
Tuberculosis is an airborne disease. About 1 million Filipinos have active TB disease. This is the third highest prevalence rate in the world, after South Africa and Lesotho. It is a highly curable disease. Yet, it is the number one killer among all infectious diseases. Every day more than 70 people lose their lives to TB in the Philippines needlessly. Many of these patients develop drug-resistant tuberculosis, which are more expensive and difficult to treat.
We need to end TB from this planet by 2030. Yet, the Philippines is among the few countries where the number of people with TB continues to increase every year.
The Philippines must rise to this challenge and deliver on the commitments that Secretary Duque made in New York. For that, the country needs to run an aggressive and sustained campaign against TB. That is the only way to bend the epidemic curve of TB towards its elimination.
It’s time to ask ourselves some hard questions
Fighting TB requires us to go beyond the health sector. Are we engaging other departments enough to act and be accountable for their roles in ending TB? For instance, about 100,000 to 150,000 people with TB suffer from catastrophic costs while seeking treatment in the public sector every year. The main reasons for that are loss of income, transport costs, and nutritional supplements. Can the Department of Social Welfare and Development support patients, using Conditional Cash Transfers, for screening, testing, and treatment against TB?
Fighting TB requires the private and public sectors to work together. Are both sectors collaborating with each other enough? About 150,000 people with TB seek care in the private sector every year although most of them are poor. They may do that because of time, distance, and confidentiality issues in public health facilities. They have the right to choose their providers. But unless we support those patients too, we can never achieve the national targets to end TB. Besides, these patients are more likely to suffer from catastrophic costs due to TB care than those who seek care in the public sector. Can the Department of Health provide advanced diagnostics and drugs for free to these patients within the private sector networks without compelling them to change their providers?
Fighting TB requires systematic screening for TB among all high-risk groups, especially in vulnerable communities. Are we doing that enough already? According to the bold and ambitious national strategic plan of the Department of Health, about 6-9% of the general population needs to undergo chest X-ray screening annually. Similarly, 2-3% of the general population needs to undergo testing with rapid molecular diagnostics annually. Has the Department of Health been able to mobilize adequate quantities of the required diagnostics and drugs to ensure their uninterrupted supply?
Fighting TB using an aggressive and sustained campaign requires adequate boots on the ground. Do we have enough of them already? Ideally, the cities and municipalities that have the highest number of missing patients should have dedicated frontline supervisors to coordinate and run the TB campaign. Additionally, all big hospitals should have dedicated officers to coordinate and implement a screen-all policy against TB within those hospitals. This will help to find people with TB early and treat them promptly, thereby cutting the chain of transmission rapidly. Can the local governments deploy such frontline supervisors and workers quickly?
As a nation, it’s time to answer these questions and act
Ending TB requires concerted action by all sectors and all care providers. Everyone has a role to play in ending TB – individuals, communities, businesses, governments, societies. Everyone must join the race to end TB by 2030. Can all readers of this article post their ideas on social media using the hashtag of #RaceToEndTB?Can all readers also reach out to their local governments to advocate for adequate financial and human resources to screen all high risk groups with chest X-ray annually and for TB symptoms regularly?
In New York, Secretary Duque declared that he will focus on three game-changers: high level commitment, massive screening, testing, and treatment, and mandatory notifications by the private sector. He has appealed to all of us to lend our full support to the Department of Health. Are we ready to join him in this now-or-never fight to end TB once and for all?
The World Health Organization is committed to working side-by-side with the communities, the governments and other partner agencies to wipe out this top killer. The clock is ticking. We cannot lose another day. It’s time to ensure that no one dies of TB anymore. It’s time to find and treat the 2.5 million Filipinos with TB by 2022. It’s time to #EndTB!
Dr Gundo Weiler is the WHO representative in the Philippines.