Anti-TB program—one other sufferer in COVID-19 frenzy – Well being and Way of life
By Rafael Castillo MD.
What is currently the biggest “monster” in public health in the Philippines and around the world?
If your answer is New Coronavirus Disease (COVID-19) you are completely mistaken.
COVID-19 has sparked all the media hype and ripped everyone out of their heads. The fact of the matter is that COVID-19 is not really the biggest or deadliest health risk that we should all be focusing our resources on in order to control it.
In any case, we should allocate financial and other resources to treat COVID-19 cases and reduce their spread, but we should not neglect the infectious disease killers that have long stunted our compatriots’ health. Among them is pulmonary tuberculosis (TB).
TB kills 1.5 million people worldwide each year and 70 Filipinos die every day in the Philippines.
We need to keep the initiatives that seem effective in the fight against tuberculosis, and we need resources to keep the momentum going. Slashing the budget for TB control by P1 billion next year is definitely a major blow that can undo the gains made over the past five years. What a great waste that would be!
The 65-member organizations of the Philippine Coalition Against Tuberculosis (PhilCAT), along with tuberculosis advocates and survivors, have written an urgent letter to Sen. Bong Go, chairman of the Senate Committee on Health and Demography, calling for the tuberculosis budget to be restored for next year to maintain the National TB Program (NTP). The implementation of the Philippine Tuberculosis Elimination Strategic Plan, Phase 1, which began in 2018 and will be completed by 2023, will suffer greatly from the budget cut.
Long term effects
“Any setbacks in fighting the TB epidemic at this point will have devastating long-term effects of unnecessarily lost lives and the rolling back of successes to the 2015 low levels,” the petitioners wrote.
Based on reports from the World Health Organization (WHO), an estimated 591,000 Filipinos were diagnosed with TB and more than 25,000 were killed in 2018. More than a third of Philippine households are looking for assistance from the government in treating TB.
In the private sector, the average family with a member with tuberculosis spends at least 20 percent of their annual household income on treating tuberculosis, which makes poverty even worse. Given the reduced household income from the COVID-19 pandemic, this can be a real challenge for the average household.
TB is not like other acute respiratory infections, where a week of antibiotic treatment would be enough to eliminate the bacteria. TB requires at least six months of treatment with three to four drugs.
For financial reasons, many patients stop taking their medication after a month or two when they feel better. They hardly notice that this premature termination of the treatment causes the TB mycobacteria in their lungs to return vengeful and more resistant to the treatment.
The government has committed to funding and treating 2.5 million TB cases by 2022. “In order for us to find TB cases, we need logistics to support case identification and treatment,” said Dr. Camilo Roa Jr., former PhilCAT chairman and a key player in the country’s anti-TB campaign. He added that TB testing, treatment and prevention are available and made affordable for high-exposure countries like the Philippines.
“Continuing to invest now as planned is cheaper than postponing and treating later, because by then the number of infected and infectious people will increase exponentially and containment will therefore be more expensive. Then we have the problem of drug-resistant TB, ”he explained.
According to Dr. Roa there are currently around 18,000 Filipinos with drug-resistant TB, which costs 50 times more to treat. We can expect this to increase if the budget cut is not corrected next year.
Model studies by WHO and the Stop TB Partnership, another global anti-TB alliance, show that the number of TB deaths from the COVID-19 pandemic is likely to rise rapidly. PhilCAT is seriously concerned about this. If the 67 percent budget cut approved by the Department of Budget and Administration (DBM) is not restored, the NTP will suffer significantly.
The NTP requires pesetas 3.6 billion annually to effectively implement a responsive, patient-centered, integrated public health response to eradicate TB. Of this, the Ministry of Health has pledged 1.5 billion pesetas for 2021. With a cut of 1 billion pesetas from the TB budget for next year, the budget currently approved by the DBM to support the NTP is only 502 million pesetas, which PhilCAT describes as “unfortunately an all-time low for a TB country with high pollution. “
Bigger bang for our money
The Alliance is concerned that this could significantly undo and undermine the pre-COVID-19 pandemic achievements. That amount can only procure first-line TB drugs for 243,385 adult Filipinos with TB per year, which is only 41 percent of the estimated cases for 2021. Therefore, more than half of TB cases could go untreated, which can dramatically increase the number of TB cases. resistant cases.
TB drug inventories could also decline next year if not addressed early enough. “There will be unnecessary delays in the diagnosis and treatment of tuberculosis, which will further increase the unhindered spread of tuberculosis and facilitate the development of drug-resistant tuberculosis, which is more expensive to control. and worse, it will take dramatically more lives, ”warned Allianz.
That’s a shame because TB is curable and preventable. COVID-19 is eating up a large chunk of the health budget this year and next, but we can make a bigger profit on the treatment and control of tuberculosis.
Unlike COVID-19, there are currently established rapid tests, an effective cure and preventive treatment for TB that are more affordable worldwide. “It has been estimated that for every peso spent on TB control, P44 comes back,” said Dr. Roa.
He added that TB killed 27,000 Filipinos in the past year, much more than the annualized death rate for COVID-19. In a year from now, we should expect our COVID-19 cases to decline, especially as a vaccine becomes available. For TB, however, the WHO predicts that our problem will grow even greater due to the COVID-19 effect on our healthcare system.
“If we don’t keep up the drive to end tuberculosis, more tuberculosis deaths and more Filipino families will become poor just because one household member has tuberculosis,” warned Dr. Roa. PhilCAT hopes that appropriate legislation will be passed to ensure that local government units allocate sufficient resources to support the local implementation of the TB program through universal health coverage in a decentralized health system.
I join PhilCAT and other anti-TB advocates and sincerely hope that the DBM is educated on the negative impact of the budget cut on the country’s anti-TB program. It is not too late. You can always correct it. What is P1 billion compared to the thousands of lives it could save!
However, the news is pretty sad. It suggests that TB is viewed as a non-urgent health problem to be concerned about. Hence, well-founded plans for permanent extinction are not well understood and appreciated. Or maybe it’s just not well communicated.
It seems that COVID-19 has a much better public relations and media relations manager than TB.