HEALTH PRIORITIES IN THE PHILIPPINES

TACKLING MAJOR HEALTH ISSUES AMONG

THE FILIPINOS
CLARITO U. CAIRO, JR., RPh, RN, MD, FPSVI, DPCOM
Program Manager
Disease Prevention and Control Bureau
dokclar@yahoo.com
 HEALTH PRIORITIES
I. Aquino Health Agenda or Universal Health Care
II. Major Health Issues
A. Health Human Resources
B. Non-Communicable Diseases (Cardiovascular
Diseases, Cancer, Diabetes, Chronic Lower
Respiratory Diseases)
C. HIV/AIDS
D. Antimicrobial Resistance (AMR)
 ALL Filipinos Clear,rationally
determined, exclusions
Establishment of a
pooled UHC Fund & guaranteed with a are minimal and
entitlement upon explicitly and logically
birth and registration COMPREHENSIVE justified
into fund
Package of Quality
Heath Services that can
Zero co-payment for
be availed non-private
accommodation,
Contracting by
network, SEAMLESSLY from all otherwise fixed co-
integrated payment, proper
IP+OP+lab+ facility levels, either with costing of case rates,
PHARMACY
SERVICES, public NO or PREDICTABLE HMO
and private
IT-enabled cost, and treated with
utmost RESPECT
 DOH Budget, Premium Subsidies and HFEP
140
Year 2012 2013 2014 2015
120 Budget utilization 89% 86% 82% 87%

Sin Tax Law

100
Priority for:
NHTS-PR poor
Modified CCT
Billion Pesos

80
ASAPP
municipalities
60 43 Priority
Provinces
Whole of Nation
40
Initiative
NAPC-identified
20 municipalities for
Bottom-Up
Budgeting
0
2010 2011 2012 2013 2014 2015 2016
HFEP 3.25 7.14 5.08 10.77 9.05 5.59 26.87
Premium subsidy for indigents 3.53 12.05 12.64 35.3 37.06 43.83
DOH budget 24.65 31.83 42.08 53.23 83.7 86.97 122.6
 Philippines is committed to achieving
SDG Goal 3 and its 13 targets
3.4 Reduce mortality due to
3.1 Reduce maternal 3.8 Achieve universal
NCD and improve mental
mortality health coverage
health

3.5 Strengthen prevention and

3.2 Reduce child and
treatment of substance abuse
neonatal mortality
To ensure healthy (narcotics, alcohol)

lives and
3.3 End epidemics of HIV, TB, promote well- 3.6 Reduce mortality due to road
malaria and NTD, and combat
being for all at all traffic injuries
hepatitis, water-borne diseases and
other communicable diseases ages
3.a Strengthen
3.7 Promote universal access to implementation of FCTC
sexual and reproductive (tobacco)
health-care services 3.b Improve access to
affordable essential
medicines and technologies 3.9 Reduce deaths and illnesses
3.d Enhance capacity for early warning, due
risk reduction and management of to pollution and contamination
national and global health risks 3.c Increase health
financing and health
workforce in developing
countries
Source: Kiney, MP. May 2015.Technical Briefing. World Health Organization
Health Deployment Programs

Doctors* RNHeals NDPs Midwives

Dentists Med Techs PHAs

 Number and Ratio of Doctors, Nurses and Midwives in
Public Health, 2014
Doctors Nurses Midwives Pharmacist
Number 2,983 5,596 16,948 (?)
Current ratio per (?)
Population
1 : 34,047 1 : 18,149 1 : 5,993
(?)
Standard ratio 1 : 20,000 1 : 10,000 1 : 5,000
(?)
Current need 5,078 10,156 20,312

Gap* 2,095 4,560 3,328

*based on 2015 Philippine Population of 101,562,300
 Philippine Pharmacy Act
Section 31 - Pharmacist Requirement
Procurement, storage, distribution and/or
dispensing of any pharmaceutical product
in the national government and local
government units shall be made only under
the supervision of a duly registered and
licensed pharmacist.
 TOP TEN CAUSES OF MORTALITY
Number and Rate / 100,000 Population
CAUSE OF DEATH (Both Sexes) NUMBER RATE PERCENT
DISEASES OF THE HEART 112,581 117 21.9
DISEASES OF THE VASCULAR SYSTEM 68,826 71.6 13.4
MALIGNANT NEOPLASMS 50,507 52.5 9.8
Pneumonia 50,144 52.1 9.7
Accidents 36,375 37.8 7.1
CHRONIC LOWER RESPIRATORY DISEASES 24,275 25.2 4.7
DIABETES MELLITUS 22,910 23.8 4.5
Tuberculosis, all forms 22,693 23.6 4.4
Nephritic, nephrotic syndrome, and nephrosis 13,555 14.1 2.6

Certain conditions originating in the perinatal period 11,374 11.8 2.2

Source: Philippine Health Statistics 2012

 Prevalence of Hypertension, Hyperglycemia,
Overweight/Obese and Smoking (current smokers)
FNRI National Nutrition Survey

RISK FACTORS 1998 2003 2008 2013

Hypertension 21.0 22.5 25.3 22.3

Hyperglycemia 3.9 3.4 4.8 5.4

Overweight/ Obesity 20.2 24.0 26.6 31.1

Smoking 32.7 34.8 31.0 25.4

Coca-Cola Pepsi
Harmful Use
Diabetes
of alcohol
 The EPIC study published in the Archives of
Internal Medicine May 2016 studied how 23,000
people adhered to four simple behaviors: Not
smoking, exercising 3.5 hours a week, eating a
healthy diet and maintaining a healthy weight.
Adhering to those four behaviors alone
prevented 93 percent of diabetes, 81 percent of
heart attacks, 50 percent of strokes, and 36
percent of all cancers.
Integrating pharmacists in patient care could
increase access to health care and improve
outcomes for underserved populations.
Patients with chronic illnesses do well when
pharmacists manage their care.

Annals of Internal Medicine, April 2016

 HIV

One of the few countries in the world with an expanding HIV epidemic.
 DOH-DESIGNATED TREATMENT HUBS
BAGUIO GENERAL HOSPITAL AND MEDICAL CENTER (CAR) CAGAYAN VALLEY MEDICAL CENTER (R2)

ILOCOS TRAINING AND REGIONAL MEDICAL CENTER (R1) JOSE B. LINGAD MEMORIAL REGIONAL HOSPITAL (R3)

JAMES L. GORDON MEMORIAL HOSPITAL (R3) MANILA SOCIAL HYGIENE CLINIC (NCR)
QUEZON CITY KLINIKA BERNARDO (NCR)
PHILIPPINE GENERAL HOSPITAL (NCR)
SAN LAZARO HOSPITAL (NCR) MARIKINA SOCIAL HYGIENE CLINIC (NCR)

RESEARCH INSTITUTE FOR TROPICAL MEDICINE (NCR) BICOL REGIONAL TRAINING AND TEACHING HOSPITAL (R5)
MAKATI MEDICAL CENTER (NCR)
EASTERN VISAYAS REGIONAL MEDICAL CENTER (R8)
THE MEDICAL CITY (NCR)
VICENTE SOTTO MEMORIAL MEDICAL CENTER (R7)
DR. RAFAEL S. TUMBOKON MEMORIAL HOSPITAL (R6)
CEBU CITY SOCIAL HYGIENE CLINIC (R7)
OSPITAL NG PALAWAN (R4B)
GOV. CELESTINO GALLARES MEMORIAL MEDICAL CENTER (R7)
WESTERN VISAYAS MEDICAL CENTER (R6)
CARAGA REGIONAL HOSPITAL (R13)

CORAZON LOCSIN MONTELIBANO MEMORIAL REGIONAL HOSPITAL (R6) BUTUAN MEDICAL CENTER (R13)

NORTHERN MINDANAO MEDICAL CENTER (R10)

ZAMBOANGA CITY MEDICAL CENTER (R9)
SOUTHERN PHILIPPINES MEDICAL CENTER (R11)

GENERAL SANTOS CITY DISTRICT HOSPITAL (R12)

 Commodities, Drugs, Supplies Procured by DOH
for STIs & HIV/AIDS

Commodities procured Amount

(in PhP)
Antiretroviral Drugs 184,914,814
Drugs for STIs and Opportunistic 14,953,400
Infections (OIs)
HIV test kits and laboratory supplies 23,306,280
Syphilis Test Kits 3,500,000
CD4 testing 3,991,103
Condoms and water-based lubricants 11,984,520
 HIV/AIDS CORE TEAM (HACT)
primary group tasked to provide treatment, care, and support services to
PLHIV, as well as to implement policies and guidelines on matters relating
to HIV and AIDS in a hospital setting

Depending on the organizational structure/specialty of the hospital, the

Infection Control Committee (ICC) may also function as the HACT

multidisciplinary group composed of, but is not limited to, physicians,

nurses, medical technologists, psychiatrists/psychologists,
PHARMACISTS, nutritionists, dentists, and medical social workers
Drug-resistant infections
- or "superbugs" could
claim 10 million lives a
year and could cost a
cumulative $100 trillion
of economic output by
2050 if the world does
not act to slow down the
rise of drug resistance
24
World Health Organization (2014). Antimicrobial resistance. Global report on surveillance infographic
25
 NATIONAL AMS IN
ANTIBIOTIC
GUIDELINES
HOSPITALS

aimed at ensuring
rational prescribing, GOOD PUBLIC
dispensing and use of PHARMACY /CONSUMER
PRACTICE ADVOCACY
antimicrobials in the
country
27
AO 63. series of 1989 entitled
Rules and Regulations to
Implement Dispensing
Requirements under the
Generics Act of 1988 Section
2.1 states that Prescription or
Ethical Drugs can only be
dispensed upon a written
order of a validly-registered
physician, dentist or
veterinarian.
The pharmacist should serve as a medication
counsellor to the patient, most especially in
instances where the physicians were unable to
explain to the patient the repercussions of poor
compliance and self-medication.
Health for Juan and JuanaMoving Forward with the
Philippine Health Agenda May 4, 2016