At the ribbon-cutting ceremony for the new mobile x-ray truck that will be used for the Doctors Without Borders TB project were (left to right) Medical Coordinator Dr. Morpheus Causing; Head of Mission Jean-luc Anglade; Dr. Arnold Pangan, RSW, City Health Officer, Manila Health Department; Dr. Maria Julieta Recidoro, Medical TB Coordinator, Manila Health Department; and Medical Coordinator Olivier Camelique. Manila, Philippines, 2022. © MSF / Regina Layug Rosero
Addressing TB amid the COVID-19 pandemic
In the City of Manila, Doctors Without Borders is working with the Manila Health Department (MHD) by supporting their commitments to prevent, diagnose, treat and care for people with TB. Dr. Marve Duka-Fernandez, project coordinator for Doctors Without Borders, talks about how the COVID-19 pandemic has put the progress of TB programs at risk.
Dr. Marve Duka-Fernandez, project coordinator for Doctors Without Borders, talks about how the COVID-19 pandemic has put the progress of TB programmes at risk. Manila, Philippines, 2022. © MSF / Regina Layug Rosero
Last year, in Districts 1 and 2 of Manila, 1,564 people with TB were put on treatment. This is below the 2021 estimated number of TB cases for these two districts, which was 3,835. In the same year, 140 people who were close contacts of those with TB were provided highly effective TB Preventive Treatment (TPT). But considering that the average number of contacts per person is five people, we estimate that there are actually around 7,000 individuals who should be on TPT.Marve Duka, Project Coordinator
Dr. Ara Jurao, Regional Medical TB Coordinator, Metro Manila Center for Health Development, says, “We must invest to ramp up our TB interventions leading to a TB-free Philippines. Given the alert level that we have for COVID, we can now go back to service delivery for our TB patients. Investment in quality diagnostics, anti-TB drugs, improvement of the reporting system, TPT, and treatment, all this is very critical to address the funding gap and to achieve our commitments to end TB.”
To commemorate World Tuberculosis (TB) Day, Doctors Without Borders / Médecins Sans Frontières (MSF) signed a cooperation agreement with the Manila Health Department (MHD) for the use of GeneXpert MTB/XDR machine. The GeneXpert machine will be installed by Doctors Without Borders in Tondo Foreshore Health Center and Lying-In Clinic, one of the health centers in Tondo District 1. Manila, Philippines, 2022. © MSF / Regina Layug Rosero
Partnership with Manila
Doctors Without Borders began its partnership with the Manila TB Department in 2021, with contact tracing activities piloted in July. Jean-luc Anglade, Doctors Without Borders Head of Mission in the Philippines, described the different phases of the project.
First, we will have active case finding activities (ACF) with our own mobile x-ray truck and a dedicated team, in order to improve TB case detection. Through this activity, we aim to assess the feasibility and practical implementation of the use of Digital x-ray and Computer-Aided Detection (CAD). Next, through this partnership, Doctors Without Borders has made a donation of Tuberculosis Prevention Treatment (TPT) drugs to the ten health centers of District 1 during the last quarter of 2021. Doctors Without Borders teams together with health centers’ TB navigators will conduct contact investigation and TPT initiation.Jean-luc Anglade, Head of Mission
The mobile x-ray truck is a key element in the partnership, and highlighted in today’s event with a ribbon-cutting ceremony.
Access is the key to a TB-free future
One of the biggest challenges of addressing TB is diagnosis. Stijn Deborggraeve, Diagnostics Advisor to MSF Access Campaign, says, “TB programmes in many countries struggle to access the WHO-recommended GeneXpert Ultra test from Cepheid because it’s too expensive and requires fragile equipment that is hard to operate in remote settings.”
This is why access to the tests is one of the pillars of the project. According to Anglade, “We are working to increase the access to GeneXpert as a primary diagnostic tool for TB. The GeneXpert-10 Color will remain at the Tondo Foreshore laboratory for the duration of the project. Finally, across our support activities on TB, we aim to promote a patient-centered approach, and are already providing psychological support specifically for DR-TB patients in agreement with the organization Philippines Business for Social Progress (PBSP). We envision this project to continue over five years, starting from July 2021.”
Jean-luc Anglade, Doctors Without Borders Head of Mission in the Philippines, stands inside the mobile x-ray truck with Dr. Arnold Pangan, RSW, City Health Officer, Manila Health Department. Manila, Philippines, 2022. © MSF / Regina Layug Rosero
In his inspirational message, Dr. Arnold Pangan, RSW, City Health Officer, Manila Health Department, said, “As you know, because of the pandemic, we had a lot of challenges. So we would like to thank Doctors Without Borders for being our partner in curbing this disease. Today we are commemorating World TB Day, but in the future, with this partnership, we will call it World No-More-TB Day.”
Doctors Without Borders works to end TB through various projects all over the world. Some projects concentrate on integrating HIV and TB services, such as in South Africa and Kenya; others offer treatment to patients suffering from DR-TB, as in Uzbekistan and Georgia; others reach out to particular populations who have little access to medical care, such as migrants in Thailand.
