If it worked to bring down the number of leprosy cases in the country, it should have similar results if the strategy is used in the fight against tuberculosis.

Frustrated over the poor compliance among patients diagnosed with TB, the Department of Health has drafted an executive order that will ensure no drugs used in the therapy for the pulmonary disease will be available through the private sector. 

It’s a bold move, Health Secretary Paulyn Ubial admitted. But if it’s the only way to ensure that TB patients get full treatment, then it must be done.

She told the media at a news conference that making the expensive medications available over-the-counter has more often than not resulted in poor compliance.

“They buy it. But as soon as finances are very low and they feel better, they stop taking the drugs,” Secretary Ubial lamented.

Not only is treatment disrupted, it eventually leads to drug resistance, which is more expensive to treat and takes longer than PTB. Incomplete therapy further means increasing the risk of infection within a community.

“But if the DOH will provide until we are the only source of drugs, I think with our success in leprosy, it should work with TB, as well,” the Health chief explained.

Secretary Ubial recalled that more than a decade ago, when leprosy prevalence was high, only the DOH had drugs. Once a patient was diagnosed, they would be given the medication for free until they completed the treatment regimen.

With the proposed EO, only the Health department will have the drugs for tuberculosis therapy so it can capture the population and ensure they get full treatment.

“That’s a bold step on how we handle TB in this country - we eliminate commercial anti-TB drugs. It’s business unusual.”

The Health chief said President Rodrigo Duterte was committed and had the political will and is expected to sign the EO, whose main aim is to help patients suffering from the pulmonary disease.

Once signed, the EO will ensure ful access, full provision for TB drugs to be provided by the public sector only, she said.

For multidrug resistant medications for TB (MDR-TB), a strict logistic management system must be instituted to make sure there are no stocks out.

She acknowledged that it is when patients who purchase their anti-TB drugs from the private sector then discontinue taking them due to lack of finances or because they think they are healed, that drug resistance occurs.

“We didn’t have that (resistance) with leprosy so we want the same strategy in place for the TB programme,” Secretary Ubial said.

Results of the National Tuberculosis Prevalence Survey conducted in 2016 showed no evidence of decline in TB prevalence since 2007. The number of new cases last year was 554 per 100,000 population, which is much higher than the World Health Organization estimate of 322/100,000 in 2015.

Based on the results, at least 1 million Filipinos are expected to have PTB in 2017, a number that will not help in achieving the target of TB elimination by 2020. MIMS

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