Interview with Dr Thelma E. Tupasi, Executive Director, Tropical Disease Foundation in Manila, Philippines
Dr Thelma Tupasi, an infectious disease specialist, founded the Manila-based non-profit group and remains its executive director. The group provides services free-of-charge to patients with multidrug-resistant tuberculosis (MDR-TB) at the International Center for Tuberculosis. She discussed her experiences in an interview at the foundation.
John Donnelly Q: How did you get started in fighting TB?
Dr Thelma Tupasi A: I was a TB patient myself when I was in medical school. With that experience, I decided that I had to do something relevant in TB.
Q: What do you remember from your days as a patient?
A: It happened in 1963 … I had to take the drugs every day for 18 months, including six months of injections with streptomycin. It was very difficult. However, my classmates always made sure that I took my medicines, as in present-day DOTS [the basic package that underpins the Stop TB Strategy].
Q: When did you start getting involved with MDR-TB?
A: The first cases were found in 1999. I told my younger colleagues that if we want to be relevant, we need to treat these cases. Many were against it because of the high cost of treatment. But we believe that as doctors we have an obligation to find the appropriate treatment for these patients.
Q: Aside from money, what has been the most important factor in running a MDR-TB treatment programme?
A: The commitment from the people here. All these young people are fully committed to fighting TB. The other important factor was the vibrant and dynamic public–private partnership.
Q: What concerns you about fighting MDR-TB in the future?
A: For us to make this a national programme, we need to have a lot more people participating. We should not exclude anybody. Advocacy needs to be enhanced. We also need health system strengthening. But there shouldn’t be any reason not to move forward.
Q: What’s your advice to Ministers of Health who are in the process of expanding MDR-TB programmes?
A: Battle number one is engaging the private sector. Private practising physicians contribute to the generation of new cases of MDR-TB because some TB patients are not being treated appropriately. Engage them. Make them partners. Look at me – I’m a private practitioner and I’m doing everything I can for the public health system.