Communicable & Non-communicable diseases & COVID-19 in the Philippines
Communicable Diseases
Common communicable diseases in the Philippines include measles, dengue fever, polio, and diphtheria.
Measles: In October 2019, the Department of Health (DOH) reported 42,400 cases of measles, with 560 deaths (Modesto, 2019). Measles is a growing problem in the Philippines, as the DOH reported 18,407 cases in 2018 and 2,428 cases in 2017 (World Health Organization, 2019). Challenges to the prevention and control of measles in the Philippines is due to several factors, which include, low immunization coverage, accessibility to healthcare services in rural areas of the country, less than optimal number of immunization sessions at the primary care level, and distrust in vaccines following a dengue vaccine (Dengvaxia) issue that occurred in the country (World Health Organization, 2019). The percentage of children fully immunized against the measles vaccine dropped from 91% to 40% in the past five years, leaving an estimated 3.7 million Filipino children under the age of five, susceptible to the measles infection (International Federation of Red Cross and Red Crescent Societies (IFRC), 2020). In order to control the spread of measles, the DOH conducted a nationwide immunization drive for unvaccinated infants, children from kindergarten to sixth grade, and adults (Modesto, 2019).
Polio: In September 2019, the DOH reported the re-emergence of polio, specifically vaccine-derived poliovirus (VDPV) in the Philippines, which came almost 20 years after the Philippines was declared polio free in 2000 (IFRC, 2019). Six human cases and 13 environmental samples confirmed genetically related VDPV, which is rare strains of genetically mutated poliovirus derived from oral polio vaccines (IFRC, 2019). Challenges to the control of the spread of VDPV in the Philippines, include the low vaccination coverage, and poor hygiene sanitation, which is a problem in urban areas of the Philippines (Modesto, 2019). In order to control the spread of VDPV, the DOH issued a travel advisory for travelers going to and from the Philippines to get the inactivated polio vaccination, in addition to launching a polio vaccination campaign, with the aim of vaccinating 95% of the population, per the World Health Organization’s recommendation (Modesto, 2019).
Red regions show the areas of the Philippines where high numbers of measles cases were reported in 2019.
Reported cases of dengue fever in 2019 from January to July.
Diphtheria: In 2019, the DOH reported more than 200 cases of diphtheria, with a reported 40 deaths, which is a 47% increase from 2018 (Makati Medical Center, 2020; Modesto, 2019). In 2018, the DOH saw 122 cases and 30 deaths due to diphtheria (NewsDesk, 2019). The growing number of diphtheria cases in the Philippines, like measles and polio, is largely due to the growing number of unvaccinated people in the country. Likewise, the DOH is urging the citizens of the Philippines to vaccinate their children against these preventable contagious diseases through campaigns, such as Back to bakUna Una sa Lahat ang Bakuna, aimed at educating the public about the importance of vaccinations (NewsDesk, 2019). The DOH does recognize that their efforts are challenged by the understaffing of the Philippines’ immunization programs (Rola, 2019). The cases of diphtheria are being monitored regularly by the Epidemiology Bureau of the Philippines (Makati Medical Center, 2020).
Dengue fever: The Philippines saw more than 400,000 cases of dengue fever and 1,600 deaths as a result of this disease in 2019 (NewsDesk, 2020). Dengue fever is caused by a mosquito bite from an infected Aedes species mosquito, which lays its eggs in standing water and feeds during the day and night (Centers for Disease Control and Prevention, 2019). Mosquitos are prevalent in the Philippines, especially during the rainy season, in which floods and standing water are common. Health officials in the Philippines have tried to combat the spread of dengue fever by sending hundreds of doctors and nurses to provincial and district hospitals and providing emergency funding to affection areas of the Philippines (Yeung, 2019). In addition, the DOH has urged for the augmentation of insecticides to combat mosquitos and issued insecticide treatment screens for dengue control in the country’s schools (Department of Health, n.d.).
Non-communicable Diseases
The top three non-communicable diseases in the Philippines are ischemic heart disease, cancer, and pneumonia.
Ischemic heart disease, as previously discussed in this website, occurs when the heart does not receive inadequate amounts of blood and oxygen due to narrowing of arteries. In 2016, 74,134 Filipino men and 29,662 women died of ischemic heart disease (Montemayor, 2018). Leading causes of ischemic heart disease in the Filipino community are cigarette smoking, alcohol use, high sugar and cholesterol intake, as well as poor stress management.
Cancer, is the presence of a malignant growth or tumor which results in abnormal cell division. Breast cancer, which affects both sexes in the country at 24.9%, is the leading type of cancer in the Philippines and lung cancer is the leading cause of cancer death in the Philippines (Montemayor, 2018). According to the Philippine Statistics Authority (PSA), out of 582,183 deaths in 2016, there were 60,470 cases of cancer, with an average of 30,954 of the cases being Filipino women (Montemayor, 2018).
Pneumonia is an infection of the lungs, and can be acquired within communities and in healthcare facilities. Pneumonia is the third leading cause of death amongst Filipinos and claims an average of 57,089 lives a year (Montemayor, 2018). In the Philippines, environmental pollution is a problem and a factor in contracting pneumonia for people whose immune systems are weakened or immunocompromised. In addition, many Filipinos have pre-existing conditions such as being diabetics, on dialysis, and older age, which put them at greater risk for contracting pneumonia (Montemayor, 2018).
One barrier to the control of non-communicable diseases amongst Filipinos, is the fact that Filipinos only seek treatment for symptoms of their diseases when the symptoms are already severe (Montemayor, 2018). This is a problem with cancer patients, as they typically seek medical attention when symptoms are severe and their cancer has already progressed to later or advanced stages (Montemayor, 2018). There is an overall misconception amongst Filipinos that the cost for medical care is better used for food or education, as medical expenses are frequently costly, out-of-pocket expenses (Montemayor, 2018). In the Philippines, there is a large number of people who live in poverty and medical expenses can cripple a family’s finances greatly. Fixing the Philippines’ healthcare system could lead to lower mortality rates in the future (Montemayor, 2018).
Other risk factors that contribute to the growing number of non-communicable diseases amongst Filipinos is physical inactivity, smoking, hypertension, overweight, hypercholesterolemia, obesity, and diabetes mellitus (Philippine Academy of Family Physicians, 2009). An estimated 60.5% of adult Filipinos have low levels of physical activity, in relation to occupation, non-occupation, leisure and transportation (Philippine Academy of Family Physicians, 2009). The prevalence of smokers in the Philippines was previous discussed on this website under the title of “Health Indicators”. In addition, the risk factors of hypertension, overweight, hypercholesterolemia, obesity, and diabetes mellitus can be attributed to the dietary choices of Filipinos, which was also discussed under that section of this website.
In order to combat the growing rise of non-communicable diseases (NCD), the Philippines has joined the World Health Organization in a plan called the Western Pacific Regional Action Plan for NCD. The Western Pacific Regional Action Plan “provides a road map and a menu of very cost-effective interventions for all Member States and other stakeholders, to take coordinated and coherent action at all levels to attain the nine voluntary global target by 2025” (Shin & Varghese, 2014). The plan’s mission is to “ensure that quality prevention and control of NCD services are accessible to all Filipinos especially to the vulnerable and at-risk-population”, with the goal of “reducing the burden of disease and death due to NCD’s” (Philippine Academy of Family Physicians, 2009).
According to Shin & Varghese (2014), the objectives of the plan is as follows:
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To raise the priority accorded to the prevention and control of noncommunicable diseases in global, regional and national agendas and internationally agreed development goals, through strengthened international cooperation and advocacy.
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To strengthen national capacity, leadership, governance, multisectoral action and partnerships to accelerate country response for the prevention and control of noncom-municable diseases.
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To reduce modifiable risk factors for noncommunicable diseases and underlying social determinants through creation of health-promoting environments.
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To strengthen and orient health systems to address the prevention and control of noncommunicable diseases and the underlying social determinants through people-centred primary health care and universal health coverage.
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To promote and support national capacity for high-quality research and development for the prevention and control of noncommunicable diseases.
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To monitor the trends and determinants of noncommunicable diseases and evaluate progress in their prevention and control.
Coronavirus 19 (COVID-19)
What is Coronavirus 19?
Coronavirus 19, is a new strain of the coronavirus that originated from China in December 2019. COVID-19, as it is commonly called, is spread from person to person and is diagnosed with diagnostic tests and antibody tests (FDA, 2020; Sauer, 2020). Symptoms of the disease can be mild to severe and include cough, fever, chills, shortness of breath or difficulty breathing, muscle or body aches, sore throat, new loss of taste or smell, diarrhea, headache, new fatigue, nausea, vomiting, congestion, or runny nose; deaths have also occurred as a result of this disease (Sauer, 2020).
COVID-19 Impact on the Philippines
Image from the Philippine Government website showing the statistics for the country of the Philippines, as of 2000, August 25, 2020.
Response to COVID-19 in the Philippines
Statistics in regards to the impact of COVID-19 in the Philippines is shown in the table above, which was taken from the Philippine government website on August 27, 2020. As of August 7, 2020, the Philippines has the highest case load in eastern Asia, including the country of China (Morales & Portugal, 2020). In March 2020, in response to the growing number of cases of COVID-19 in the Philippines, President Rodrigo Duterte enacted the Bayanihan to Heal as One Act, also known as Bayanihan Act, granting him additional authority to combat the pandemic in the country (Philippine Government, 2020). Duterte appropriated 275 billion pesos (equivalent to $12,408,275,000 US dollars) towards pandemic efforts in the Philippines, which included 144 billion pesos (equivalent to $6,497,712,000 US dollars) to 17.9 million Filipino families who received 8,000 pesos for financial assistance (Parrocha, 2020). In March 16, 2020, President Duterte also passed laws controlling the price of basic needs and commodities, granted interest-free loans, distributed calamity funds, authorized important and receipt of donations, and distributed funds for hazard pay to public health workers and government officials in the fields of science and technology (Philippine Government, 2020). Outside of funding, President Duterte also instituted lockdowns, quarantines, travel restrictions, as well as closure of all non-essential private establishments in efforts to combat the spread of the virus to the citizens of the country (Philippine Government, 2020).
Healthcare workers in personal protective equipment in the Philippines.
References
Centers for Disease Control and Prevention. (2019). Dengue. Retrieved from https://www.cdc.gov/dengue/transmission/index.html
Department of Health. (n.d). Dengue. Retrieved from https://www.doh.gov.ph/Health-Advisory/Dengue
FDA. (2020). Coronavirus testing basics. Retrieved from https://www.fda.gov/consumers/consumer-updates/coronavirus-testing-basics
International Federation of Red Cross and Red Crescent Societies (IFRC). (2020). Philippines: Measles outbreak – operation update – re-emergence of vaccine preventable diseases. Retrieved from https://reliefweb.int/report/philippines/philippines-measles-outbreak-operation-update-re-emergence-vaccine-preventable
International Federation of Red Cross and Red Crescent Societies (IFRC). (2019). Philippines: Re-emergence of vaccine preventable diseases (polio) – operation update report. Retrieved from https://reliefweb.int/report/philippines/philippines-re-emergence-vaccine-preventable-diseases-polio-operation-update
Makati Medical Center. (2020). What is diphtheria and why should I care? Retrieved from https://www.makatimed.net.ph/news-and-exhibits/news/what-is-diphtheria-and-why-should-i-care
Modesto, C. (2019, December). 2019: Diseases spread, thousands dead. Retrieved from https://www.cnnphilippines.com/news/2019/12/23/health-dengue-polio-measles-Philippines-2019.html
Montemayor, M. (2018). Top 3 killer diseases in PH. Retrieved from https://www.pna.gov.ph/articles/1052723
Morales, N., Portugal, A. (2020). Philippines defends coronavirus response after soaring cases. Retrieved from https://www.reuters.com/article/us-health-coronavirus-philippines-cases/philippines-defends-coronavirus-response-after-soaring-cases-idUSKCN25311N
NewsDesk. (2019). Philippines reports increase in diptheria in 2019, prompts calls to ensure children are vaccinated. Retrieved from http://outbreaknewstoday.com/philippines-reports-increase-in-diphtheria-in-2019-prompts-calls-to-ensure-children-are-vaccinated-36155/
NewsDesk. (2020). Philippines reports 15K dengue cases in first weeks of 2020. Retrieved from http://outbreaknewstoday.com/philippines-records-15k-dengue-cases-in-first-weeks-of-2020/
Parrocha, A. (2020). Duterte seeks ‘more powers,’ urgent mesasures vs. Covid-19. Retrieved from https://www.pna.gov.ph/articles/1097429
Philippine Academy of Family Physicians. (2009). Retrieved from http://thepafp.org/website/wp-content/uploads/2017/05/2009-WHO-Lifestyle-Manual-module1-overview-NCD.pdf
Philippine Government. (2020). Retrieved from https://www.officialgazette.gov.ph/downloads/2020/03mar/20200324-RA-11469-RRD.pdf
Philippine Government. (2020). Retrieved from https://www.officialgazette.gov.ph/laginghanda/dagling-paliwanag-ano-ang-state-of-calamity/
Rola, A. (2019). Diphtheria cases also up in some parts of PH – Health dept. Retrieved from https://cnnphilippines.com/news/2019/9/24/Diphtheria-cases-Philippines-Department-of-Health.html?fbclid=IwAR1rtDLFVQRR17fhOmjp5kSEwwS5j2laSTC7I4MyQtAKe3LAijOy1bNeVsU%3Ffbclid
Sauer, L. (2020). What is coronavirus? Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus
Shin, H., Varghese, C. (2014, July). WHO Western Pacific regional action plan for the prevention and control of NCDs (2014-2020). Epidemiol Health 2014, 36. doi: https://doi.org/10.4178/epih/e2014007
World Health Organization. (2019). Questions and answers on the measles outbreak in the Philippines. Retrieved from https://www.who.int/philippines/news/feature-stories/detail/questions-and-answers-on-the-measles-outbreak-in-the-philippines
Yeung, J. (2019). Philippines declares a national dengue epidemic after 622 deaths. Retrieved from https://www.cnn.com/2019/08/07/health/philippines-dengue-epidemic-intl-hnk/index.html