Seeking more partners
The Philippines has tried to control multidrug-resistant TB (MDR -TB ) for nearly as long as any country in the world.
And yet it has only just begun.
After eight years of building up the programme, the MDR-TB treatment programme has expanded mainly to… Metro Manila. That amounts to about 13% of the population in a country of 91 million people and 7107 islands.
Inhabitants outside the metropolitan area who have had the misfortune of contracting MDR-TB have had two choices: travel to the Manila region to get treated, or don’t get proper treatment.
One figure puts the need in stark perspective: the MDR-TB programme has treated about 1300 patients in its first eight years, but the World Health Organization (WHO) estimates that about 12 000 people are infected annually with MDR-TB in the Philippines.
In response to that unmet need, the Government, in early 2009, started an ambitious three-year programme to expand MDR-TB treatment to all major regions of the country. In its first year, the programme hopes to open 10 MDR-TB treatment centres in six regions.
The scale up means identifying local partners; selecting structures for clinics and laboratories; equipping laboratories; and training a wide range of health personnel.
“It’s going to take an amazing amount of work to make this happen,” said Dr Rosalind G. Vianzon, Director of the National TB Control Programme, which is part of the Department of Health. “We’re not ahead of this problem. We need to get running to catch up.”
Michael N. Voniatis, a WHO TB expert who works in Vianzon’s office, said that the public sector in Metro Manila and private partners have proven that the country can treat MDR-TB effectively. “But the next three years will be critical in the attempts to interrupt transmission countrywide,” he said.
Vianzon said her office has learnt many lessons from the experiences in Metro Manila – most notably that it needs help from all sources.
“We have learnt from our experiences in the past several years that a big problem like TB, or an even more serious problem like MDR-TB, cannot be addressed just by ourselves in Government,” she said. “We need all the stakeholders involved – private and public. We need everyone.”