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The Department of Health Relaunches the Botika ng Barangay

As part of the Duterte Administration’s thrust to provide quality, affordable and accessible healthcare services for Filipinos, the Department of Health (DOH) announced the revival of the Botika ng Bayan (BNB) Program during the launching of its first pilot site in San Mariano, Isabela last July 13 (Friday).

The launching was marked by the signing of the Memorandum of Agreement for joint implementation between the DOH and local officials, including Suquian District Representative Ana Cristina S. Go, Vice Mayor Dean Anthony G. Domalanta and Municipal Health Officer Dr. Almira L. Reyes. The DOH was represented by Undersecretary Enrique Domingo and Region II Director Rio Magpantay.

The Botika ng Bayan program will provide access to free essential medicines for common diseases in the community targeting indigents and the marginalized sectors of the population. The program aims to cover all 2,600 rural health units and other government centers to have Food and Drug Administration (FDA)-licensed BnB outlets that will provide quality outpatient pharmacy services by 2022.

“The DOH is relaunching anew the BnB program in partnership with our local government units (LGUs) to realize President Duterte’s vision that no Filipino should go home without free access to basic medicines when needed and that quality essential medicines should be accessible and affordable for all Filipinos,” said Undersecretary Enrique Domingo.

The BNB, a flagship program of the previous Arroyo Administration, was temporarily stopped by the DOH in 2011 to address issues on the lack of supervising pharmacists and an effective supply chain that could assure the constant availability of quality generic medicines in some 16,000 government-run community pharmacists established between 2001 to 2010.

“While the DoH earlier issued a moratorium on the establishment of more BnBs, the program served its purpose of spurring generic competition and providing more affordable access to medicines for our citizens. The BNB became a viable business model for generic pharmacies now spread out across the country bringing us toward the vision of more affordable medicines down to our villages,” revealed Undersecretary Domingo.

The DOH announced service enhancements to the BNB program such as more essential medicines available for common diseases in the community, like infections, skin ailments, asthma and chronic non-communicable diseases. The BNB medicines consist of antibiotics, topical ointments, anti-thrombotic, anti-inflammatory, vitamins, antacids and other essential drugs for asthma, hypertension, diabetes and dyslipidemia.

Patient education and counseling will also be provided by licensed pharmacists and trained pharmacy assistants to be hired by the DOH and some LGUs with existing human resources.

“More importantly, the medicines will be dispensed to patients for free to ensure no out-of-pocket expense for indigents as directed by President Rodrigo Roa Duterte,” the health undersecretary said.

The Botika ng Barangay previously sold low-priced generic home remedies, over-the-counter (OTC) medicines and two prescription antibiotics drugs (i.e. Amoxicillin and Cotrimoxazole) at prices at least 60% cheaper than those commercially available.

Under the new BNB program, soldiers and policemen and their families are also included as beneficiaries in partnership with the Armed Forces of the Philippines (AFP) and Philippine National Police (PNP).

“The DOH recognizes the service and heroism of our armed personnel in ensuring the security of our country, hence the BNB program was revitalized with a new variant that shall provide free access to essential medicines for them, the Botika ng Bayani outlets,” he also said.

"We emphasize our important partnership with the LGUs, recognizing that the task of providing quality, affordable and accessible health care services to Filipinos should be coordinated using the whole of government approach," Undersecretary Domingo concluded.

     The Philippines, led by the Department of Health (DOH), joined the global community in the celebration of the World Antibiotic Awareness Week (WAAW) held on November 14-20, 2016. The celebration aimed to increase awareness on global antibiotic resistance and to encourage best practices among the general public, health workers and policy makers so that further emergence and spread of antibiotic resistance can be avoided. The theme for the global campaign is “Antibiotics: Handle with Care” reflecting the overarching message that antibiotics are a precious resource and should be judicially used by patients and healthcare professionals.

     The DOH partnered with the National Telecommunication Commission (NTC) in sending text health messages to the public promoting the rational use of antimicrobials, prevention of infection and the importance of seeking the expertise of the medical doctors before taking antimicrobials. Social Media advocacy materials were also developed and disseminated in the official DOH Website and DOH Facebook pages to further communicate the campaign to the masses. Moreover, the DOH in collaboration with the WHO held a national competition to actively engage all sectors in the fight against AMR with the following categories: poster making for elementary students; storybook making for high school students; infomercial and infographics making for college students and young professionals.

     The national kick-off ceremony for the PAAW 2016 happened last November 15 , 2016 at the Manila Pavilion Hotel and was attended by the DOH Central Office, Inter-Agency Committee to Combat Antimicrobial Resistance (ICAMR), National Antibiotic Guidelines Committee (NAGCom), WHO, select professional medical societies, pharmaceutical industry, academe and patient organizations. The program commenced with corresponding messages from Assistant Secretary Agnette P. Peralta of the DOH Office for Health Regulation, Dr. Gundo Weiler, the WHO Country Representative, Undersecretary Ranibai Dilangalen of the Department of Agriculture and the Health Secretary Paulyn Jean Rossel-Ubial.

     The week-long celebration was also an opportunity to launch important initiative such as the ceremonial launching and handover of the Philippine Antimicrobial Stewardship (AMS) Program Toolkit to the stakeholders which included the AMS Manual of Procedures for Hospitals, Antimicrobial Use Monitoring Methods Guide and the National Antibiotic Guidelines. The AMS toolkit aims to guide health care professionals in the implementation of hospital interventions ensuring the optimization of antimicrobial treatment for all patients. By 2020, the AMS program will be part of the licensing standards for all hospitals so they are encouraged to start implementing the program immediately. Representative societies from the different sectors such as hospitals, infectious disease societies, pharmaceutical industries and patient organizations gave their message of support to strengthen the country’s commitment to wage the war against AMR.

     DOH Secretary Ubial and DA Undersecretary Dilangalen headed the awarding ceremony for the PAAW Competition. They awarded the 2016 AMR Warriors from nine (9) institutions coming from the healthcare and pharmaceutical industry which have the best practices to combat AMR and strongly advocate the responsible use of antibiotics. To conclude the event, a national press conference was held with the following panelists:

  • Sec. Paulyn Jean Rossel-Ubial – Secretary of Health
  • Usec. Ranibai Dilangalen – DA Undersecretary for Special Concerns
  • Dr. Gundo Weiler – WHO- Country Representative
  • Dr. Mediadora Saniel – National Antibiotic Guidelines Committee Chair
  • Dr. Celia C. Carlos - Head of the Antimicrobial Resistance Surveillance Program.

     The PAAW celebration was also participated in. by all DOH regional Offices across the country engaging the community through an advocacy walk, zumba exercise, public fora, community lecture, patient counselling and pledge signing. Various advocacy events were also organized by different student groups, universities, church-based organizations, trade associations, and professional societies across the nation.

 

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DOH and WHO Unite to Win the War Against Anti Microbial Resistance

    The Philippines joins the global movement to advocate the responsible use of antibiotics as the Department of Health (DOH) in collaboration with the World Health Organization (WHO) leads the celebration of the Philippine Antibiotic Awareness Week (PAAW) 2016. This week-long celebration launches the Antimicrobial Stewardship (AMS) Program today, in Manila Pavilion which aims to address the misuse of antibiotics driving the emergence of Antimicrobial Resistance (AMR) by making bacteria stronger that make them withstand the effect of antibiotics.

    The misuse of antibiotics in the clinical and community settings has been regarded as a major driver of AMR – a dangerous ability of microorganisms to withstand treatment with antibiotics which aggravate infections and even result in death. It is estimated that each year, globally 700,000 people die of infections due to antimicrobial resistance.

    “After the successful launching of the “Philippine Action Plan to Combat AMR – One Health Approach” in the 2015 AMR Summit, the DOH now brings the strategic framework and advocacy closer to the health care professionals and the public – by launching a set of operational tools that will help curb the rise of resistance: an AMS Manual of Procedures, the National Antibiotic Guidelines and the Antimicrobial Consumption Methods Guide,” Health Secretary Paulyn Jean B. Rosell-Ubial explains.

    The theme of the campaign, Antibiotics: Handle with Care, reflects the overarching message that antibiotics are a precious resource and should be preserved. The World Health Organization (WHO), World Organization for Animal Health (OIE) and the Food and Agriculture Organization of the United Nations (FAO) consider AMR a major threat in human and veterinary health which affects food and global health security, endangering the achievement of the sustainable development goals (SDGs).

    “Antibiotic resistance is one of the biggest threats to global health, food security, and development today. It can affect anyone, of any age, and in any part of the country. Antibiotics should be used to treat bacterial infections only when prescribed by a certified health professional. Antibiotics should never be shared and the full course of treatment must be completed–not saved for the future,” says Dr. Gundo Weiler, WHO Country Representative in the Philippines, “We have a long road ahead to overcome antibiotic resistance but we can combat this threat together. The Philippines has taken significant steps to address antibiotic resistance and we look forward to continuing our work with the Philippine Department of Health, Department of Agriculture and member institutions of the Inter-Agency Committee on AMR on this important issue.”

    In the Western Pacific Region, the Philippines is one of the leading countries that achieved the highest milestone in combating AMR. The health chief adds that dialogues and partnerships with the different government agencies, such as the Department of Education, Commission on Higher Education, Professional Regulation Commission, and private institutions and societies were made to facilitate understanding and involvement of everyone to address the growing concerns of AMR.

    “The challenge for us now is to sustain concerted multidisciplinary approach to institutionalize the AMS program across all health facilities in the country through strong commitment, leadership and instill rational use of antibiotics by every Filipino through advocacies and awareness events. The current Philippine Health Agenda calls for health security for all Filipinos by eliciting multi-sector, multi-stakeholder health support. With your help, let us win the war against and achieve our goal in attaining All for Health towards Health for All,” Secretary Ubial concludes

     Antimicrobial resistance (AMR) is now a significant public health threat that causes major health and economic consequences both in human and veterinary health. It claims lives, prolongs illnesses, increases healthcare costs and financial burden, and affects trade and global security. The global health community has identified irrational use/ misuse of antimicrobial medicines as a major driver of AMR which is associated with a variety of management and healthcare provider practices.

     With the support of the World Health Organization (WHO), the Department of Health (DOH) conducted the Antimicrobial Stewardship (AMS) Training for Level III hospitals last 6-9 December 2016 in Talisay City, Negros Occidental as a continuation of a series of AMS training-of-trainers workshops which have been initiated since 2015. The training serves to prepare the hospitals in implementing AMS programs in their setting as part of the hospital licensing requirement by 2018.

     The activity was participated in by infectious disease physicians, medical technologists, clinical pharmacists, and infection control nurses from 16 tertiary hospitals. The National AMS program is one of the DOH strategies to address the AMR problem in this setting wherein the antimicrobial use is rampant. It is the concerted implementation of systematic, multi-disciplinary, multi-pronged interventions in both public and private hospitals to ensure the appropriate use of antimicrobials, which is essential for preventing the emergence and spread of AMR.

     Lectures and interactive sessions were conducted which focused on the six AMS core pillars, namely: leadership, policies guidelines pathway, AMR surveillance, antibiotic restriction and pre-authorization, educational strategies, and performance and evaluation.

     The varying capacities of the hospitals in setting up their own AMS program became evident during the discussions and interactive sessions. Concerns on the hospital management to support and sustain the program, expand laboratory facilities, and strengthen the skills of the healthcare personnel were raised as important issues that need to be addressed by the participants. The vital role of the pharmacists in performing the legwork of the program and the importance of having strong coordination among the hospital staff were highlighted as well. A demonstration on how to navigate the WHONET which is an information system for global surveillance of bacterial resistance to antimicrobial agents and the excel-based tool that can determine the antimicrobial use within the facility was led by the Research Institute for Tropical Medicine (RITM) and the University of the Philippines College of Pharmacy (UPCP), respectively.

     The last day of training was spent in a tour around Corazon Locsin Montelibano Memorial Regional Hospital (CLMMRH), one of the lead AMS pilot sites in the country, to observe how the institution is implementing AMS in the hospital’s daily operations. Existing reporting forms and feedback mechanisms of CLMMRH were shown to the participants from other hospitals who also offered their suggestions in improving processes.

     Although there are numerous challenges in establishing AMS in hospitals, the participants committed to champion this DOH initiative once they are back in their respective facilities which in turn, will serve as AMS training hubs for other healthcare institutions across the country.

     The 8th edition of the Philippine National Formulary (PNF) Manual for Primary Healthcare was officially launched by the Formulary Executive Council (FEC) during the 62nd Annual Convention and Exhibit of the Association of Municipal Health Officers of the Philippines (AMHOP) held at The Oriental Hotel, Legazpi City, Albay on 08-11 April 2015.

     The ceremonial turnover of the PNF manual was led by the keynote speaker, Dr. Maria Minerva Calimag, who is presently the re-elected president of the Philippine Medical Association and the toxicologist expert of the Formulary Executive Council (FEC). Dr. Raul Echipare, past AMHOP National President and also a member of the FEC representing the municipal health officers (MHOs), likewise led the ceremonial turnover together with the editorial team represented by Ms. Joyce Anne Ceria, Mr. Mac Ardy Gloria and Ms. Johanna Mallari.  

     A short talk on the features of the PNF was delivered by Dr. Irene F. Fariñas, Medical Officer IV of the Pharmaceutical Division on the second day of the convention, in the stead of Dr. Marita B. Dantes, a neurologist expert of the FEC who led in the drafting of the PNF Manual for Primary Healthcare.

     The new and improved PNF manual for Primary Healthcare features more drug information such as indication, contraindication, dose, dose adjustments, precautions, adverse drug reactions, drug interaction, administration and pregnancy category. Likewise, to prevent the emergence and spread of antimicrobial resistance (AMR), a special section called “AMR Alert” was incorporated in the chapter of anti-infectives based on the latest report of the Antimicrobial Resistance Surveillance Program.

     Copies of the Formulary were given to MHOs. The MHOs were asked to answer the evaluation form, which aims to assess the acceptability and usefulness of the PNF manual in guiding their prescribing practice. As announced last year, the manuals are set to be delivered directly to the rural health units (RHUs) together with the Barangay Health Station kits and the DOH Compack.

     It is hoped that through these valuable developments in the PNF, rational and responsible use of medicines will be enforced among the healthcare providers.