The World Health Organization (WHO) said the “Philippines has a long way to go” in eradicating tuberculosis (TB), even as the Health department confidently announced that the country will be able to attain the millennium development goal of reducing TB deaths by 50% within five years or 2015.
The number of deaths due to TB stands at an average of 75 Filipinos every day. Diagnosed as curable, it ranks 6th among the top leading causes of mortality and morbidity in the Philippines.
DOH assistant secretary Nemesio Gako said the “Philippines has made great strides in combating TB.”
Citing recent statistics, Gako said that DOH reported a decrease in the number of mortality due to TB from 38.2 deaths per 100,000 population to a rate of 31 per 100,000.
“While the Philippines is still included in the WHO watch-list of 22 high-burdened countries, it has lowered its ranking in TB prevalence from 7th to 9th,” Gako said in a press conference at the Lung Center of the Philippines in Quezon City.
In 2006, the Philippines signed the Global Plan on TB, which seeks to reduce the prevalence and mortality of tuberculosis by 50% between 2006 and 2015. The Global Plan outlines a benchmark figure of 70% case detection rate (CDR), 85% treatment success rate (TSR) and 85% cure rate.
National TB program manager Rosalind Vianzon said that midway to the 2015 goal, the Philippines already breached the benchmark figures set by the WHO in terms of CDR and TSR.
She said that about 75% of TB-carrying Filipinos were already detected while 90% were successfully treated since the health department implemented its early detection program for TB in the 1990s.
Vianzon noted the DOH saw an increase in TB case detection in the past five years from 134,000 to 150,000 per year. She explained that the best way to stop TB disease from further spreading in the community is to have TB-carrying patients detected, treated and finally cured.
Despite the optimism of health officials, a 2010 technical briefer on the National TB Program prepared by the DOH showed a declining trend in three benchmarks.
Only 72% of TB cases were detected and 89% were treated as of 2008. DOH records showed that the cure rate is pegged at 79%, or six percent short of the 85% cure rate targeted by 2015.
As early as 2006, the Philippines already attained the 75% target for case detection and maintained that rate until 2007. But figures dropped to 72% in 2008. Treatment success rate also slightly dropped from 90% in 2006 to 89% in 2008.
Cure rate registered the biggest decline among the three benchmarks. The technical briefer on TB showed the cure rate reaching 83% in 2006, slightly dipped to 82% the following year, and dropped to 79% in 2008.
Health officials said the declining trend on TB statistics coincided with the government’s heavy fund allocations to eradicate the disease. Vianzon said state funding for TB prevention increased five folds, to P1.1 billion in 2010 from P100 million in the past three years.
Dr. Woojin Lew, medical officer at WHO-Philippines, said the Philippine government has “a long way to go” in terms of detecting, treating and curing highly infectious TB patients.
“Although prevalence rate is decreasing, I think there is not enough to achieve the target by 2015,” Lew said during the press conference.
Lew said that mortality among highly infectious TB patients remains high in the Philippines, a fact admitted by Health officials.
Vianzon said that detection of high-risk TB patients is “difficult.”
Based on the 3rd National Prevalence Survey on TB conducted by the DOH in 2007, Multi-Drug Resistant Tuberculosis or MDRTB among new cases increased from 1.5% in 1997 to 2.1% ten years later.
The survey also showed that MDRTB among re-treatment cases slightly decreased from 14.5% in 1997 to 13% in2007, while prevalence of smear-positive TB and culture-positive TB almost dropped by 100% between 1997 and 2007.
Health activists claim the Philippine government failed to bring down the morality rate due to TB despite advances in technology and heavy state funding.
“After more than five decades, TB still ranks among the top causes of disease and death in this country,” said Dr. Geneve Rivera, secretary-general of Health Alliance for Democracy. “This, despite advances in medicine and in health-related technologies, and amidst government programs.”
Rivera said in a statement that TB is the “real measure of the quality of lives of Filipinos today…. It reflects the extent of our underdevelopment – our inability to provide the quality of life necessary for our people to be healthy enough to resist being infected. As such, social determinants of health should be addressed with equal, if not more, importance.”
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