Waging a revolution against TB in Negros island

Don Salvador Benedicto (DSB) is a poor municipality in Negros Occidental Province, with a population of about 24,000 spread across seven barangays (villages). The town’s economy is mainly based on agriculture. In 2006-2007, health records showed that TB was listed as the third leading cause of deaths in the municipality. DSB also had no microscopists to do laboratory examinations, no doctors to manage TB patients, and no nurses to counsel and follow up on patients. Available midwives were largely untrained and tended to dispense anti-TB drugs without proper diagnosis of patients.

To address the situation, the local government beefed up the municipality’s TB control services, implementing the DOTS (Directly Observed Treatment, Short-course) strategy. With USAID assistance, much-needed microscopy services were set up, and the necessary commodities such as sputum cups and chemical reagents were purchased. The local government covered transportation and handling costs of anti-TB drugs from the Provincial Health Office, thus ensuring a regular supply of drugs for TB patients. Through the health unit, volunteer health educators called Health Enforcers were mobilized to find, refer, follow-up on persons with TB symptoms and to conduct community health education. The group consists of local youth council chairpersons, the barangay councilor for health, local health workers, and representatives from the police and social welfare offices. In fact, the Health Enforcers are led by the chief of police, who has taken courses in nursing. As a result of these interventions, the number of TB cases detected and treated has increased. From two cases in 2007, reported cases increased to seven in 2008 and spiked to 34 as of September 2009. Trained as microscopists, midwives contributed to the detection of positive TB cases. The Health Enforcers also played a big role in increasing the number of persons exhibiting TB symptoms who consult providers at the health center. As of September 2009, about 200 people sought care for suspected TB. Of these, 42 were diagnosed positive for TB and began treatment. Of these, 25 completed treatment and were certified cured, while 16 are still undergoing treatment. Community health education on TB, coupled with the availability of health services, encouraged more persons with TB symptoms to seek care. In Don Salvador Benedicto, the grassroots spirit of volunteerism shown by the Health Enforcers synergized well with USAID technical and training support to strengthen laboratory services, recording and reporting, thus ensuring that the social revolution against tuberculosis has a fighting chance for success. According to Mayor Lawrence de la Cruz, “With good governance, we protect the vulnerable from TB." This article was contributed by the Philippine Business for Social Progress (PBSP), the largest corporate-led social development foundation in the Philippines, which manages the Linking Initiatives and Networking to Control Tuberculosis (TB LINC) project. Led by the Department of Health, TB LINC is a five-year, USAID-funded technical assistance project that aims to reduce TB prevalence, morbidity, and mortality. The project supports the Business Roadmap to the Millennium Development Goals by contributing to the global target of at least 70 percent case detection rate and 85 percent cure rate.