In 2011, the Philippines achieved the Millennium Developmental Goals (MDG) for tuberculosis. The Post 2015 Global Strategy Framework for TB aims to achieve the following Goals for 2025 compared to 2015: 75% reduction of deaths from tuberculosis, a 50% reduction of the incidence of tuberculosis and there being no affected families facing catastrophic costs due to tuberculosis.
Amongst the Pillars and Components of the Framework is the engagement of communities, civil society organizations and public and private care providers. The contribution of the private sector in the case finding of tuberculosis with the public-private mix DOTS (PPMD) is a significant 11%.
To achieve the goals for a TB Free Philippines and World, it would be important that the private sector continues to be involved in the fight against tuberculosis.
On April 9, 2015 in an activity sponsored by Pfizer Philippines, I gave a talk to a group of 35 physicians, mostly Family Physicians, Consultants and some Residents in Tagum, Davao del Norte. This was on the latest International Standards of Tuberculosis Care (ISTC 3rd ed. 2014) and The Manual of Procedures (MOP 5th ed. 2014) of the National Tuberculosis Program (NTP).
When Dr. Eugene Ramos was working for Biomedis as the Chairperson of the Joy for Caring Advocacy, he asked physicians to contribute stories of healing which they wished to share with other physicians. This was published in the rough in 1985 in a book entitled “Stories That Heal”.
Here is the one of the three stories I shared…
A forty year old nurse who was diagnosed with breast cancer, and had not followed up for two years after surgery, decided to undergo chemotherapy. On re-evaluation, she had Stage 4 disease with liver, lung, pleural and bone metastasis. Chemotherapy was tried but failed and she was admitted for dyspnea due to moderate pleural effusion.
Her dyspnea improved with closed tube thoracostomy followed by pleurodesis. Thereafter, she was noted to be getting weaker and would soon need to be intubated and attached to a mechanical ventilator.
The option to withhold life support measures was discussed with the patient and her relatives. The husband agreed with the suggestion but the patient and her mother decided to proceed with whatever means possible to sustain life. While we were hoping that the patient and her mother would change their stand, the patient was fast deteriorating.