Philippines Faces Worsening TB Drug Shortage Amid Government Procurement Failures

Health groups and affected communities in the Philippines are sounding the alarm over continuing shortages of tuberculosis (TB) medicines, urging the Department of Health (DOH) to develop efficient solutions to prevent delays in healthcare delivery. The issue, which has been ongoing since the last quarter of 2023, is attributed to multiple failed and canceled TB drug bidding processes by the DOH. Florita Dalida, founder of TB HEALS (TB Health Education and Livelihood Support Community, Inc.), stated that shortages or stockouts of TB medicine should be treated as a national emergency due to TB's highly contagious nature. She highlighted that the Philippines is the third-highest contributor to TB cases globally, underscoring the potential for widespread transmission while patients await treatment. Mass shortages or stockouts of first-line medications for drug-susceptible patients have been reported since late 2023. These procurement failures, despite rebiddings, have amounted to approximately P2 billion (around $34 million USD). Dalida emphasized that the DOH is responsible for purchasing all allocations of first-line drugs, making procurement issues a national concern. Chris Muñoz, president of the Philippine Alliance of Patient Organizations (PAPO), suggested that the DOH recalibrate its drug distribution process to prioritize local government units (LGUs) and strengthen reimbursements from the Philippine Health Insurance Corporation (PhilHealth). He also stressed that patients should have the choice of where to seek care, not healthcare facilities. The Philippines has consistently had the highest number of TB infections per 100,000 population in Southeast Asia since 2013, and in 2024, it ranks third globally. Ironically, TB is preventable and treatable, with treatment being free at all government-run health facilities. However, medicine unavailability can force patients to pay out-of-pocket and increase transmission risks. Louie Zepeda-Teng, president of TBPeople Philippines and a TB survivor, reported encountering TB drug shortages in various regions, including Tondo in Metro Manila, Rizal, Cavite, Bicol, Tacloban, Tawi-Tawi, and Cotabato. In some areas, health centers have become hesitant to screen for TB due to a lack of available medication. Zepeda-Teng urged the DOH to strengthen its commitment to reducing TB cases as per its eradication roadmap, stating, "When we commit to this being free, you're supposed to make sure that no one will die." TBPeople Philippines has submitted an "urgent" appeal letter to the DOH, calling for improvements in the procurement schedule of first-line drugs, enhanced coordination with regions for accurate supply reporting, stronger mandatory notification, increased preventive treatment, and encouraging LGUs to plan for universal healthcare funds to avoid relying solely on national delivery. Dalida added that the DOH should realign with concerned agencies to address bureaucracy, identified as the root cause of the shortages, and prioritize TB patients.