Doctors Without Borders/Médecins Sans Frontières (MSF) has begun providing tuberculosis (TB) medications for 141 patients in Manila’s Tondo district, supporting Manila Health Department as it struggles with drug shortages over the past year.
Patients whose treatment has been pending for several months will be able to start taking their medications, and those who had started treatment but were unable to complete it due to medicine shortages will now be able to continue.
TB is one of the world’s deadliest infectious diseases, and the Philippines is among the top 10 countries in the world with the highest TB burden. Tondo is one of the country’s most densely populated areas, with approximately 76,000 people per square kilometer. To date, MSF has screened 29,291 people and diagnosed 1,280 patients with TB. These findings translate to an average positivity rate of 4.3%, which is higher than the 3% national TB positivity rate in the Philippines.
Case-finding activities provide health care access in Tondo
Since January 2024, over 300 patients have been diagnosed with TB through MSF’s active case-finding activities in Tondo. While some patients were able to start treatment, many others were unable to do so due to the unavailability of TB drugs.
In districts 1 and 2 of Tondo, MSF has been running active case-finding activities for TB since 2022, in collaboration with the Manila Health Department. This MSF project makes TB screening accessible and available near the areas where Tondo residents live and work. There, MSF teams provide free TB screening, trace household contact cases, and refer TB-positive patients to local health centers. They also follow up with patients to ensure they adhere to the treatment regimen and break the chain of transmission.
Amalia was screened for tuberculosis in the MSF x-ray truck in Tondo in May 2022, and her diagnosis was confirmed a few days later. "I immediately thought of my mother, that was the cause of her death. I thought, maybe this will kill me too."
A temporary solution to a larger problem
“Today, we are relieved we can support the Manila Health Department and health facilities in Tondo with a donation of 54,720 tablets of TB drugs,” says Ghazali Babiker, MSF head of mission in the Philippines. “Over 100 patients who have known about their TB positive status and have been anxiously waiting for several months will be able to receive much-needed treatment. ”Proper diagnosis and treatment, especially in line with updated recommendations from the World Health Organization are key to eliminating TB, but these cannot be achieved without the sufficient and timely supply of drugs. MSF strongly urges all stakeholders involved in TB care in the Philippines to find durable solutions to tackle the drug shortage in the country.
The shortage is not limited to drugs for treating TB. There is also a delay in the provision of preventive treatment due to a shortage of tuberculin skin tests, which are needed to test some children prior to initiating preventative treatment, and because of the lack of child-friendly fixed dose dispersible tablets used for preventive treatment for children who are exposed to TB patients.
While MSF has been able to step in and fill the gap in TB care, more action is needed in the longer term. “This is a temporary solution, which cannot become the norm,” adds Babiker. “Disruptions in TB drug procurement are preventable. With ongoing international efforts to eliminate TB globally, we need strong political commitment from heads of states and civil society to participate in this effort, including in the Philippines.”
