Philippine Multi-Disease Elimination Plan 2024-2030

© Republic of the Philippines – Department of Health 2023

Suggested citation. Philippine Multi-Disease Elimination Plan 2024-2030. Philippines:

Department of Health. 2023
Table of Contents

ACKNOWLEDGEMENTS
ACRONYMS 4
ABOUT THE DOCUMENT 8
INTRODUCTION 9
VISION 16
GOALS 16
STRATEGIES AND MILESTONES 17
1. Surveillance and Information Systems 17
Component 1.1 A comprehensive, multi-disease surveillance and
integrated programmatic HIS that can obtain data needed to estimate the
burden of disease and determine risk factors of the diseases for
eradication/elimination 18
Component 1.2 Engagement of all stakeholders, especially the private
sector, in mandatory reporting of notifiable diseases and events 19
Component 1.3 Strengthen compliance of all disease reporting units (DRU)
in reporting notifiable diseases to the national surveillance systems 20
2. Access to Laboratory Services 22

Component 2.1 Strengthening the public health laboratory network

through the implementation of the Philippine Health Laboratory System 22
Component 2.2 Ensure quality assurance mechanisms are in place for
laboratory services 24
3. Service Delivery 26
Component 3.1 Vaccination services 27
Component 3.2 Vector control 29
Component 3.3 Mass drug administration (MDA) / preventive
chemotherapy (PCT) 31
Component 3.4 Intensified Case Management 32
Component 3.5 Ensure access to screening and diagnostic tests 33
Component 3.6 Health Care Provider Network 34
Component 3.7 Continuous Quality Improvement and Supportive
Supervision 35
4. Safe and Quality Medicines, Vaccines, and Technology 36
Component 4.1: Facilitate the process of standard setting and Clinical
Practice Guidelines development 36
 Component 4.2 Ensure that regulatory and legal requirements on
commodities are facilitated and enforced 37
Component 4.3 Ensure agile and responsive processes on the
procurement of commodities 38
Component 4.4 Prepositioning and uninterrupted supply of high-quality
medicines and other commodities at the facility through supply chain
management 39
5. Human Resource and Capacity Building 41
Component 5.1 Align medical and allied health curriculum with the
continuum of care of diseases for elimination 41
Component 5.2 Capability building and supportive supervision for primary
care providers and facility-based health workers for effective delivery of
services 42
6. Environment and Social Determinants of Health 44
Component 6.1 Improve health promotion activities directed towards
diseases for elimination through social behavior change communication
and demand generation activities 45
Component 6.2 Strengthen multisectoral collaboration and coordination at
all levels to address common environmental and social determinants of
health 46
7. Stewardship and Finance 48

Component 7.1 Stewardship through a multi-sectoral oversight committee 48

Component 7.2 Develop evidence-based policies 49

Component 7.3 Secure sufficient government and non-government

financial resources in support of elimination strategies 50
8. Research 52
Component 8.1 Systematized identification of research needs 52
Component 8.2 Strengthening of research that supports new innovations
supporting diseases for elimination and eradication 52
Component 8.3 Propose, recommend, and conduct quality and
representative surveys, studies, and serosurveys based on international
standard methodologies 53
MONITORING AND EVALUATION 55
BUDGET 57
REFERENCES 64
 ACKNOWLEDGEMENTS

The Department of Health acknowledges all who contributed to the development of the
Philippine Multi-Disease Elimination Plan including the Disease Prevention and Control
Bureau leadership through Dir. Razel Nikka M. Hao, Dir. Jose Gerard B. Belimac, Dr.
Raffy A. Deray and Dr. Kim Patrick S. Tejano. Special thanks goes to USAID’s Act to End
Neglected Tropical Diseases - East program implemented by RTI International, and the
Global Fund through the Pilipinas Shell Foundation, Inc. and APMargin that all helped to
facilitate the consultation workshops and provided technical assistance to the DOH in
the development of this document. Gratitude is also extended to the following technical
working group members: Dr. Maria Rosario Sylvia Uy, Ms. Sheen Angelou Juangco, Ms.
Faye Yorainne Ebana, Ms. Camille Baladjay, Dr. Allan Fabella, Ms. Mary Joy Morin, Mr.
Roland Sardan, Dr. Clarito Cairo, Jr., Mr. Vincent Sumergido, Mr. Gerald John Paz, Dr.
Mara Jean Almazora-Millar, Dr. Ann Ysabel Andres, Dr. Janis Asuncion Bunoan-Macazo,
Ms. Zenaida Recidoro, Ms. Dulce Elfa, Mr. Ken Borling, Dr. Diana Jean Vasquez, Ms.
Princess Mhyco Esguerra, Dr. Roderick Poblete, Dr. Antonio Bautista, Mr. Ray Angluben,
Ms. Kate Lopez, Ms. Veronica Vitug, Ms. Emmalyn Tugas and representatives from the
Epidemiology Bureau, Office for Health Laboratories, Centers for Health Development,
Research Institute for Tropical Medicine, University of the Philippines, Philippine
Dermatological Society, Culion Foundation, World Health Organization and UNICEF.
ACRONYMS

AFP Acute flaccid paralysis

AO Administrative Order

APP Annual Procurement Plan

ASEAN Association of Southeast Asian Nations

BD Birth dose

BOD Burden of disease

CESU City Epidemiology Surveillance Unit

CHD Center for Health Development

CHED Commission on Higher Education

CPAB Child protected at birth

CPG Clinical Practice Guidelines

CRS Congenital rubella syndrome

CSR Corporate social responsibility

cVDPV Circulating vaccine-derived poliovirus

DA Department of Agriculture

DA-BAI Department of Agriculture - Bureau of Animal Industry

DILG Department of Interior and Local Government

DO Department Order

DOH Department of Health

DPCB Disease Prevention and Control Bureau

DPRI Drug price reference index

DRU Disease reporting unit

EB Epidemiology Bureau

EDCS Epidemic Prone Disease Case Surveillance

EMTCT Elimination of mother-to-child transmission

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EO Executive Order

EREID Emerging and Re-Emerging Infectious Diseases

ESR Event-based surveillance and response report

FDA Food and Drug Administration

FHSIS Field Health Services Information System

G2D Grade-2 disability

GIDA Geographically isolated and disadvantaged areas

HBsAg Hepatitis B surface antigen

HBV Hepatitis B virus

HCPN Health Care Provider Network

HFAP Health for All Policies

HHRDB Health Human Resource Development Bureau

HIB Haemophilus influenzae type B

HIS Health information system

HIV Human Immunodeficiency Virus

HRH Human resources for health

HSRA Health Sector Reform Agenda

HTA Health technology assessment

HTAC Health Technology Assessment Council

IACEH Inter-Agency Committee on Environmental Health

IRS Indoor residual spraying

KMITS Knowledge Management and Information Technology Service

LB Live birth

LDIs Learning and development interventions

LF Lymphatic Filariasis

LLIN Long-lasting insecticide net

LPEP Leprosy post-exposure prophylaxis

LQMS Laboratory quality management system

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MAH Marketing Authorization Holder

MCV Measles containing vaccines

MDA Mass drug administration

MDEP Multi-Disease Elimination Plan

MDT Multi-Drug Therapy

MESU Municipal Epidemiology Surveillance Unit

MMR Measles, Mumps, and Rubella

MNTE Maternal and Neonatal Tetanus

MTCT Mother-to-Child Transmission

NEQAS National External Quality Assessment Scheme

NPG National Practice Guidelines

NRLs National Reference Laboratories

OHG Omnibus health guidelines

OHL Office for Health Laboratories

PCPN Primary Care Provider Network

PCT Preventive chemotherapy

PEP Post-exposure prophylaxis

PESU Provincial Epidemiology Surveillance Unit

PHC Primary Health Care

PHE Public Health Emergencies

PhiICZ Philippine Inter-Agency Committee on Zoonoses

PhilGEPS Philippine Government Electronic Procurement System

PhilHealth Philippine Health Insurance Corporation

PHLS Philippine Health Laboratory System

PHTLs Provincial Health Team Leads

PIDSR Philippine Integrated Diseases Surveillance and Response

PIR Program implementation review

PrEP Pre-exposure prophylaxis

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QA Quality assurance

QI Quality improvement

QMS Quality management system

RA Republic Act

RESU Regional Epidemiology Surveillance Unit

RITM Research Institute for Tropical Medicine

RPHLs Regional Public Health Laboratories

SCH Schistosomiasis

SCM Supply chain management

SDG Sustainable Development Goals

SDR Single-dose rifampicin

SHF Special Health Fund

SNLs Subnational Reference Laboratories

STAG Scientific and Technical Advisory Group

TAS Transmission assessment survey

TWG Technical Working Group

UHC Universal Health Care

UNICEF United Nations Children's Fund

UNOPS United Nations Office for Project Services

USAID US Agency for International Development

VPDs Vaccine Preventable Diseases

WHO World Health Organization

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 ABOUT THE DOCUMENT

Equitable use of limited resources is a challenge faced by public health programs

including funding and human resources for health. By integrating health system
components as an opportunity to address the problem, the Disease Prevention and
Control Bureau (DPCB) integrated the strategies of selected vaccine preventable and
infectious diseases to streamline efforts on disease elimination through the first
Philippine Multi-Disease Elimination Plan (MDEP). The plan was developed by disease
experts and health systems strengthening specialists through a series of consultations
and workshops from July 2022 to July 2023.

The plan covers the years 2024-2030, in line with the Sustainable Development Goals
(SDG). It shall be reviewed and updated periodically every three years by a technical
working group (TWG), guided by a high level scientific and technical advisory group
(STAG). The plan shall be used by implementers as a guide for planning and evaluation.
Partners, researchers, the academe, and other interested individuals & organizations
may use the document to understand the Department of Health’s priority areas for
support.

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 INTRODUCTION

Disease elimination supports the attainment of SDG 3, of ensuring healthy lives and
promoting well-being for all at all ages by reducing global maternal and neonatal
mortality ratio through the (i) elimination of mother-to-child transmission of human
immunodeficiency virus (HIV), Syphilis, and Hepatitis B, (ii) ending the epidemics of
neglected tropical diseases and other communicable diseases, and (iii) achieving
universal health coverage through financial risk protection, access to quality essential
health care services, access to safe, effective, quality, and affordable essential
medicines and vaccines for all.

There are challenges in eliminating these diseases in a devolved health care system set
up. Many efforts were initiated including the development of the Health Sector Reform
Agenda (HSRA), adoption of Primary Health Care (PHC) approach, the creation of the
Universal Health Care (UHC) Law, and the latest with the issuance of the Department of
Health’s (DOH) 8-Point Agenda, not only for diseases for elimination but for other public
health programs as well.

National public health programs of the DOH were historically organized by individual
diseases, resulting in varied levels of success. In recent years, the DOH started
exploring technical, managerial, and financial integration through a life stage approach,
strengthening the coordination with other sectors such as environmental and animal
health and recommending expansion on the inclusion of the primary care benefit
package. The Department of Health is eager to test a new approach through an
integrated service delivery framework that addresses the convergence of multiple

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diseases. This approach strategically groups related diseases and identifies areas of
potential collaboration resulting in a comprehensive service package. This optimizes
the allocation of essential human, material and financial resources, ensuring their
efficient utilization.

In 2022, the Disease Prevention and Control Bureau (DPCB) extensively reviewed 36
diseases for elimination and identified 13 priority diseases based on a set of criteria
that included the review of disease burden and discussion on the feasibility of
elimination or significant reduction of disease burden by 2030.

Table 1. MDEP diseases and 2022 status

Disease Status as of 2022
Following global treatment protocols, the program adapted the
multi-drug therapy (MDT) which resulted in the downward trend of
prevalence rate from 7.2/10,000 cases in 1986 to 0.9/ 10,000 cases
Leprosy in 1998; leading to elimination of leprosy as a public health
problem. However, the Philippines remains as number one for
leprosy in the Association of Southeast Asian Nations (ASEAN) up
to today.
In 2022, 44 out of the 46 provinces have stopped mass drug
Lymphatic
administration. The two remaining provinces are Sultan Kudarat
Filariasis (LF)
and Zamboanga del Norte.
In 2022, 81 out of 82 provinces reported zero indigenous cases and
66 provinces declared as Malaria free. Palawan is the only province
Malaria
reporting active transmission with 32% of its barangay (95 out of
292) with indigenous cases.
By 2017, the Philippines achieved its validation for MNT
Maternal and Elimination. However, child protected at birth (CPAB) from tetanus
Neonatal Tetanus coverage declined from 86% in 2018 to 60% in 2019 and 2020
(MNT) which further declined in 2021 to 54%. The number of neonatal
tetanus cases increased from 14 cases in 2021 to 33 cases in 2022.
In 2009, the immunization program implemented a two-dose
measles containing vaccine: MCV 1 (monovalent measles at 9-11
months old) and MCV 2 (MMR at 12-15 months). Surveillance for
measles and rubella cases is in place. Cases are reported regularly
Measles
through the Epidemic Prone Disease Case Surveillance (EDCS).
Despite the initiatives, data for routine measles coverage in the
past 10 years showed the achievement below the 95% coverage
target and the number of measles cases in 2022 is 370.

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Mother-to-Child Out of the mothers screened from 2019-2022, the proportion of
Transmission those positive for syphilis and hepatitis B ranges from 3%-6%.
(MTCT) of HIV, Screening of pregnant women for HIV also started in 2019. The
Syphilis, and accomplishment for Hepatitis B birth dose remains to be below
Hepatitis B 75% from 2011-2022.
There is an 11% decline in the number of acute flaccid paralysis
(AFP) cases reported in 2022 (580 AFP cases) as compared to the
Poliomyelitis 2021 report. The Philippines was certified polio free in October
2000 and remains polio free until 2018. However, a vaccine derived
poliomyelitis outbreak occurred in 2019.
In the Philippines, a law was passed (RA 9482 also known as
Anti-Rabies Act of 2007) to accelerate the control and elimination
of human and animal rabies. The law mandates that a National
Rabies Prevention and Control Program should be implemented
through a multi-sectoral/multi-agency and chaired by the
Department of Agriculture. Dogs are the principal reservoir of
rabies in the Philippines. Animal Bite Treatment Center had been
Rabies set up in strategic areas. These centers provide post exposure
prophylaxis (human anti-rabies vaccine and Immunoglobulin).
Individuals working in high-risk environments are given
pre-exposure prophylaxis (PreP). A significant decline in the
number of human rabies cases reported was noted in 2020. In
2022, Region 9 (51 cases), Region 6 (29 cases) and Region 11 (19
cases) reported the greatest number of cases. A total of 284
deaths due to rabies were reported in 2022.
Rubella Immunization coverage below 95%, rubella cases below 100
An assessment of the program that covers the period of 2011-2017
showed that 12 regions, 28 provinces, 190 municipalities, 20 cities
and 1,609 barangays are endemic to schistosomiasis. Focal survey
Schistosomiasis
showed a prevalence of 4% with 302 barangays with zero
(SCH)
prevalence, 222 barangays with low prevalence, 435 barangays
with moderate prevalence and 479 barangays with high
prevalence.

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 In 2017, the Philippines was declared the 14th country endemic for
yaws. Information on the existence of Yaws in the Philippines
came from 2 studies:
1) A cross sectional survey in elementary school in Liguasan Marsh
done in 2017; 2) a case detection survey in Luzon and Visayas
Island. The cross-sectional survey detected 4 children aged 5-10
years and confirmed secondary Yaws. Majority of serologically
reactive cases (n=10) were adults without active yaws skin lesions
Yaws
(8 latent cases, 2 past/treated cases). The case detection survey
was conducted in 5 remote villages (3 in Luzon and 2 in Visayas).
Two indigenous communities were included in the study: Aetas of
Quezon and Dumagat of Rizal. The study detected 19 cases among
the 35 Aetas: 5 active cases (4 children, 1 adult); 2 latent cases (1
adult); 12 past cases (1 child, 11 adults) . Currently, Yaws is not
included in the surveillance system. There is no program
instituted for the prevention and control of Yaws.

The Department of Health aims to significantly reduce the burden of these diseases
and achieve elimination by 2030, so alignment of activities among key stakeholders and
standardization of the indicators of success were considered in the development of
this plan.

Table 2. MDEP diseases and targets

Disease Local Elimination Target International Elimination Target
120 countries with zero new autochthonous
cases

70% reduction in annual number of new

cases detected
Zero new autochthonous
Leprosy
cases
90% reduction in rate per million population
of new cases with grade-2 disability (G2D)

90% reduction in rate per million children of

new child cases with leprosy
Number of countries (58 =81%) validated for
National: All endemic
elimination as a public health problem
provinces passed TAS 3
Lymphatic (defined as infection sustained below
Filariasis transmission assessment survey threshold
Sub-national: Endemic
for at least four years after stopping mass
provinces passed TAS 1
drug administration availability of essential

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 package of care in all areas of known
patients)
Reduce malaria mortality rates globally by at
least 90% as compared
with 2015
Reduce malaria case incidence globally by
Zero Indigenous Malaria
at least 90% as compared
Cases for at least 5 years in all
with 2015
Malaria provinces

Eliminate malaria from countries with

Sub national declaration
transmission (35 countries)

Prevent re-establishment of malaria in all

countries that are malaria free
Achieve MNT elimination (defined as <1
neonatal tetanus case/1000 live births in
<1 NT case per 1,000 live
Maternal and each district) in the Region; and
births per year in every
Neonatal Tetanus
province/city
Maintain MNT elimination in every country
and area.
Absence of endemic measles
transmission in the country
for ≥12 months in the Zero incidence of measles due to endemic
Measles
presence of a measles virus infection
well-performing surveillance
system
0% of HIV-exposed infants born in the past
0% of HIV-exposed infants
12 months who are infected with HIV
born in the past 12 months
who are infected with HIV
Number of congenital syphilis cases per 100
000 live births per year
< 50 neonatal syphilis per
= < 50 (2030)
100,000 live birth (LB)
Mother-to-Child
Hepatitis B surface antigen (HBsAg)
Transmission of HBV EMTCT: ≤0.1% HBsAg
prevalence of 0.1% among children younger
HIV, Syphilis, and prevalence in <5-year-olds;
than 5 years old
Hepatitis B
< 2% MTCT rate (where use of
Percentage of newborns who have
targeted HepB-BD)
benefitted from a timely birth dose of
hepatitis vaccine and from other
Hepatitis B birth dose
interventions to prevent the vertical
immunization coverage: >
(mother-to-child) transmission of hepatitis
95%
B virus

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 Permanently interrupt all poliovirus
transmission in endemic areas

Zero incidence of polio from Stop cVDPV transmission and prevent

Poliomyelitis
any type of polio virus outbreaks in non-endemic countries

Zero incidence of polio due to any type of

poliovirus infection (regional target)
Zero indigenous human
Rabies mediated rabies and dog Zero human dog-mediated rabies deaths
rabies for at least 3 years
Absence of endemic rubella
transmission in the
Philippines for ≥12 months
Zero incidence of rubella due to endemic
Absence of congenital rubella virus infection;
Rubella
syndrome (CRS) cases
associated with endemic Zero cases of domestically acquired CRS.
transmission in the presence
of a well-performing
surveillance system
< 1% proportion of heavy
Number of countries (78) validated for
intensity schistosomiasis
elimination as a public health problem
Schistosomiasis infection
(currently defined as < 1% proportion of
heavy intensity schistosomiasis infection)
zero snail infection rate
Zero new autochthonous 194 countries
Yaws
cases (100%) certified free of transmission

The MDEP supports the DOH’s sectoral primary health care strategic plan for 2023-2028
and the integrated disease prevention and control through primary care strategic plan
2023-2028. Shown below are the areas of alignment:

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 INTEGRATED DISEASE PREVENTION AND CONTROL
SECTORAL PRIMARY HEALTH CARE
THROUGH PRIMARY CARE STRATEGIC PLAN
STRATEGY 2023-2028
2023-2028

Accessible, Evidence and

Healthy and
Comprehensive Data-in- formed Self-sufficient Enabling
MDEP STRATEGIC PILLAR Safe Policies &
Primary Care for Response at All
Quality Access
Primary Care Mechanism
Settings
every life stage Levels

Surveillance and
Information Systems ✔ ✔ ✔
Access to Laboratory
Services ✔ ✔ ✔
Service Delivery ✔ ✔ ✔
Safe and Quality
Medicines, Vaccines, and
Technology ✔ ✔ ✔ ✔
Human Resource and
Capacity Building ✔ ✔ ✔
Environment and Social
Determinants of Health ✔ ✔
Stewardship and Finance ✔ ✔ ✔ ✔ ✔
Research ✔ ✔ ✔

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 VISION

Philippines with zero/reduced number of new infections of priority diseases for

elimination through an effective health care system by 2030

GOALS

Goal 1: Eradication
Maintain zero indigenous case of polio and contribute to the global eradication
of the disease.

Goal 2: Elimination of Infection

Achieve zero indigenous case of yaws, measles, rubella, malaria, leprosy and
rabies.

Goal 3: Elimination of Disease as a Public Health Problem

Reduce the number of new infections of lymphatic filariasis, schistosomiasis,
mother-to-child transmission of HIV, syphilis, and hepatitis B, and maternal and
neonatal tetanus below the threshold of being considered a public health
problem.

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 STRATEGIES AND MILESTONES

1 Surveillance and Information Systems

Box 1: Challenges/Gaps

● Legal mandates for reporting notifiable diseases does not include some of the
diseases for eradication/elimination leading to data quality issues like late reports;
incomplete reports. RA 11332 (Mandatory Reporting of Notifiable Diseases and Health
Events of Public Health Concern) covers five priority diseases for eradication or
elimination (poliomyelitis, measles, neonatal tetanus, rabies, malaria); AO 2021-0057
(Revised PIDSR Guidelines) does not specify certain diseases for elimination
● Data needs of diseases for elimination not in the present surveillance and
information system – congenital syphilis, CRS, yaws
● Post validation surveillance for filariasis, and schistosomiasis not in place
● Diseases for elimination are captured by different information systems in place and
may lead to inconsistency in the data reported, and double reporting
● Under reporting of cases are sometime observed (e.g. leprosy)
● Need to strengthen coordination across the human and animal disease surveillance
and information system, case investigation (rabies, schistosomiasis)
● Monitoring system for non-canine rabies, and for syphilis not in place (case-based
surveillance system for syphilis)
● Need for capacity development for core surveillance processes
● Inadequate proper maintenance of existing IS leading to weak functionality of
systems (iClinicSys)
● Insufficient manpower to perform core function in IS management
● Inadequate utilization of the IS at the local level
● Inadequate data sharing mechanism among stakeholders for all priority diseases

Disease surveillance is the continuing, systematic collection, management, analysis,

interpretation and timely dissemination of health-related data (human, animal and
environmental) to enable planning, implementation and evaluation of disease control
and prevention measures. Because the goal is to eradicate or eliminate these 13
infectious diseases, it is important to detect suspected cases early and track
importation of cases (local and international) from endemic to non-endemic areas
(re-emergence/re-introduction); investigate and validate reported suspect cases for
immediate actions to mitigate the spread of infection; and measure trends and
characterize the diseases for eradication/elimination. Surveillance data will illuminate
changes in infectious and environmental agents which can be used in directing
eradication/ elimination strategies. The Epidemiology Bureau (EB) leads and provides
technical direction and guidance for all surveillance and response activities in the
Philippines. At present, the country implements the Philippine Integrated Disease
Surveillance and Response (PIDSR) framework, which encompasses Epidemic Prone
Disease Case Surveillance (EDCS) and Event Based Surveillance and Response (ESR),
monitoring both notifiable disease and other health related events of public health
importance, to guide the implementation at all levels of the health care delivery system

17
in both public and private sectors. The EB is currently working on the preparations to
implement the proposed reporting flow to eliminate the ladderized reporting of cases
with the aim of having information at all levels as soon as they are encoded in the
system, regardless of its entry point.

As cited in DOH Administrative Order No. 2018-0028 (Guidelines for the Inclusion and
Delisting of Diseases, Syndromes, and Health Events in the List of Notifiable Diseases,
Syndromes and Health Events of Public Health Concern), the current list of notifiable
diseases shall undergo periodic assessment for inclusion or exclusion from the list
based on the criteria set by the Technical Advisory Group for the Inclusion and Delisting
for Notifiable Diseases, Syndromes, and Health Events of Public Health Concern
(TAG-NDEPH).

In addition to disease surveillance, other programmatic health information systems

(HIS) provide data needed to measure processes and activities critical to disease
eradication and elimination such as human immunization coverage for vaccine
preventable diseases. Data for immunization coverage for vaccine preventable
diseases are being reported to the Field Health Services Information System (FHSIS).
Various programmatic HIS which may lead to inconsistency of data reported by the
different HIS, and too many HIS being implemented at the local level burden the
implementers collecting the data.

On the animal health side, the Philippine Animal Health Information system, under the
Department of Agriculture - Bureau of Animal Industry (DA-BAI), covers information on
diseases and data for regulatory purposes. It mirrors the World Animal Health
information system.

Component 1.1. A participatory, digitally transformed, and action-oriented system for

public health surveillance to trigger timely and effective public health response

Vigilance in detecting all possible and suspect cases is important in disease eradication
and elimination, but prompt action on confirming and implementing control measures
to prevent spread or reintroduction of these diseases must follow detection. A
surveillance and response framework provides direction for local health units on the
flow of case investigation and response for detected suspect cases. Border control
guidelines covering air, land, and sea transport systems both locally and internationally
should be implemented at the local level to prevent re-introduction of cases in disease
free areas. Proficient contact tracing systems should identify exposed and at-risk
individuals. For zoonotic diseases, joint case investigation and data sharing with the
DA-BAI and DENR at the local level should lead to holistic investigation of
environmental, human and animal factors. Capacity building of local health staff on
surveillance, data management and response action on each of the 13 diseases is

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important. Provincial and regional epidemiology surveillance units (PESU/RESU) may
provide technical support to the municipal and city epidemiology surveillance units
(MESU/CESU) during investigation and response.

Desired Outcome

Responsive, participatory, and localized surveillance system for data needs and
enables quick action at a local level

Milestones

2024
1. Inclusion of all thirteen diseases in the list of notifiable diseases and events of
public health concern (NDEPH)
2. Veterinary Public Health Unit established within DOH

2025
1. Cadre-based training of public health workers to include use of surveillance
data in public health decision-making
2. Inclusion of animal and environmental data for priority diseases in surveillance
system dashboards

Component 1.2 Engagement of all stakeholders, especially the private sector, in

mandatory reporting of notifiable diseases and events

Timely, complete, and accurate data from all disease reporting units is essential. All
disease reporting units should be equipped to collect and report data for eradication
and elimination as mandated by Republic Act (RA) 11332 on notifiable disease reporting
and DOH Administrative Order (AO) 2021-0057 on the revised PIDSR guidelines.
However, not all 13 diseases are being reported in the existing surveillance system. Also,
RA 11332 and AO 2021-0057 did not include the following priority disease – Leprosy,
Rabies, Filariasis, Schistosomiasis, MTCT – Hepatitis B, Syphilis and HIV in the
mandatory reporting of notifiable diseases. With the on-going revision on PIDSR, these
priority diseases should be included in the case-based surveillance or ESR to enhance
the timely reporting and compliance of disease reporting units. At the Regional level,
advocacy should be conducted to local government units on passing a resolution on
mandatory reporting of the priority diseases. At the local level, strengthening of local
Epidemiology and Surveillance Units shall improve the capacity of the system to
receive, process, and flag signals related to the priority diseases. In addition to a policy
endorsement of mandatory reporting, hardware and software resources should be in
place in every disease reporting unit to ensure timely reporting. Human resource
augmentation and capacity building for data management should be in place at the
national, regional, and provincial levels. Logistic resources for a digitized system

19
(hardware, maintenance of the system) of reporting may be a burden at the local level
due to limited resources. A regulatory mechanism can be explored to enforce
compliance and maintenance of the HIS.

To maximize the use of participatory surveillance and to widen the scope of

surveillance, engagement with communities, settings such as schools, workplaces, and
correctional facilities, points of entry, and the private sector is paramount as an
incentive mechanism to
complement enforcement of sanctions for failure to report.

Desired Outcome

100% functional and compliant DRUs in reporting of notifiable diseases for

elimination

Milestones

2025

Joint DOH-DA-DILG Administrative Order and Operations Manual on integrated health

information system disseminated to all 17 Centers for Health Development

2026 - 2030

100% of RESUs and PESUs / HUC ICC CESUs attaining targets for reporting rate for
non-measles, non-rubella, and non-acute flaccid paralysis by 2030

Component 1.3 A comprehensive public health data strategy and information

architecture that allows timely access and use of high-quality information (including
burden of disease, risk factors, and supply chain management) for public health
action

A multi-source (vector, human, animal health, environmental) and digitally transformed

disease surveillance system should be in place to generate reliable information for the
burden of disease and risk factors of priority diseases for elimination. Although various
surveillance and information systems capture the 13 diseases for eradication and
elimination, they only focus on human health data. EB is undergoing reassessment and
revision of the public health surveillance framework and strategy. Priority activities
under this include revision of the Philippine Integrated Diseases Surveillance and
Response (PIDSR) framework, on-going changes in the surveillance information system

20
to add other diseases for elimination, and continuing capacity development for burden
of disease (BOD) estimation.

Currently, there are two existing Inter-agency Committees, the Philippine Inter-Agency
Committee on Zoonoses (PhiICZ) and the Inter-Agency Committee on Environmental
Health (IACEH). Lessons learned in inter-agency linkages can be adapted in developing
a multi-source disease surveillance. Managing different programmatic HIS requires
resources (human and logistics) which can lead to delayed reports, data quality checks
not done, and electronic systems not working at the facility level. EB and the
Knowledge Management and Information Technology Service (KMITS) of the
Department of Health is working on integrating the different programmatic HISs and
ensuring functionality of the system at the local level. Additionally, to ensure that all
data needed for elimination indicators are captured, the Epidemiology Bureau in
coordination with DPCB is responsible for outlining all data needs of diseases for
eradication/ elimination.

Desired Outcome

In the strengthening of disease surveillance and epidemic response, the EB aims to

ensure that surveillance systems are digitally transformed while allowing a variety of
data collection methods to cover areas with poor internet access

Milestones

2024

1. 1 dissemination forum on the result of the disease surveillance and health

information system desk review with recommendations
2. Joint DOH-DA-DILG Administrative Order and Operations Manual on integrated
health information system

2026

Multi-source surveillance platform designated (human, vector, animal, and

environment)

2027

MDEP surveillance data used for immediate response and annual planning and
budgeting and the years after

21
 2 Access to Laboratory Services

Box 2: Challenges/Gaps

● Limited capacity for timely confirmatory testing for polio, measles, and rubella
● Insufficient animal laboratories for confirmatory testing of rabies
● Sustainability of the Subnational Laboratories for VPDs
● Other diseases for elimination need quality assessment and quality improvement
systems

In disease eradication/elimination, timely collection, submission, processing and

releasing of results is important since rapid disease detection mitigates transmission
by instituting timely control actions. Thus, diagnostic services should be available and
accessible to patients regardless of geographical location and financial capacity. DOH
Department Order (DO) 2021-0421 creates the Office for Health Laboratories (OHL)
which provides the overall direction, policies, programs, and plans including
infrastructure, equipment, supplies and investments in the development of the
Philippine Health Laboratory System (PHLS). In relation to its support to the MDEP, the
gaps in Box 2 will be addressed through two components of this strategic pillar.

Component 2.1 Strengthening the public health laboratory network through the
implementation of the Philippine Health Laboratory System

The Philippine Health Laboratory System is the overall system set up to deliver quality
clinical and public health laboratory services in a timely, sustainable, and efficient
manner to support the objectives of the Universal Health Care Act and respond to
future public health emergencies. The PHLS Framework shall provide strategic
direction, plans, policies, programs, and standards for the public health and clinical
laboratories. The PHLS Framework shall strengthen the National Health Laboratory
Network. Within this framework, laboratories are categorized into:

1. National Reference Laboratories (NRLs), by virtue of DO 2020-0820, the highest

level of laboratory in the country performing complex procedures including end
confirmatory testing not commonly performed by the lower level of laboratory.
NRLs also train laboratory personnel and perform technical evaluation of
In-Vitro Diagnostic Medical Devices. NRLs are the responsible entity for
facilitating the National External Quality Assessment Scheme (NEQAS) to ensure
compliance of quality standards for regulation and licensing of all laboratories in
the Philippines.

22
 2. Subnational Reference Laboratories (SNLs) are reference laboratories with a
geographic subnational catchment area that perform complex procedures,
including selected confirmatory testing, surveillance, research, training, and
roll-out of Laboratory Quality Assurance Programs within their catchment areas.

3. Regional Public Health Laboratories (RPHLs) are laboratories providing research

and limited diagnostic services for communicable and non-communicable
diseases or other conditions of public health importance within their regional
catchment.

The MDEP includes plans for the sustainability of Vaccine Preventable Diseases (VPD)
Referral Laboratories that will help monitor and confirm VPDs, as well as shorten
turn-around times for specimen transport.

Desired Outcome

Diseases for elimination are incorporated in the public health laboratory network
through the implementation of the Philippine Health Laboratory System

Milestones

2024

1. Construction of Sub-National laboratories initiated (target is 3 years

construction)
2. Sustainability plan for Vaccine Preventable Diseases (VPD) Referral
Laboratories developed including human resource, training, and budget plans

2025

Implementation of the sustainability plan for VPD Referral Laboratories

2027

Training of selected laboratory personnel of SNL

2028

1. 100% of SNLs have the capacity to isolate/confirm priority diseases for

elimination
2. Policies on cross-linking/collaboration and referral mechanism on services of
VPD Referral Laboratories with the established SNL's under the Center for
Health Development (CHD) have been developed

23
 2029

100% of CHDs have Regional Public Health Laboratories

2030

PHLS institutionalized

Component 2.2 Ensure quality assurance mechanisms are in place for laboratory
services

Laboratory quality can be defined by the accuracy, reliability, and timeliness of test
results. Errors in diagnosis may lead to unnecessary expenditures of repeated tests,
loss of patients’ and staff time, and mismanagement of patients. Processes involved in
testing can be categorized into: pre-examination—selection of appropriate test based
on clinical symptoms, specimen collection and transport; examination—processing of
specimen; and post-examination—analysis and report (test result) release and record
keeping. Each process should be carried out according to a quality management
system. The essential components of a quality system in laboratories are a)
management commitment and quality policy; b) quality standards; c) training of human
resources; d) documentation; and e) assessment and accreditation. Although quality
assurance (QA) and quality improvement (QI) processes are already in place for malaria
and MTCT diseases, OHL together with WHO is developing the quality management
system (QMS) for the national reference laboratories that will ensure the QI process
covers other diseases for eradication/elimination. In addition, OHL prioritizes the
following interventions to ensure implementation and maintenance of quality
assurance mechanisms: 1) capacity development on QA/QI processes; 2) reinforcement
of training for NRLs and capacitate SNLs in quality assurance; and 3) conduct
proficiency testing for PHLS.

24
Desired Outcome

Accurate and timely laboratory confirmation and reporting, together with genotype
information (for all applicable diseases)

Milestones

2024

1. Laboratory Quality Management System (including QA/QI) for identified

diseases for elimination developed
2. Assessment of the whole quality of laboratory (LQMS)

2025

Reinforcement of training for NRLs and capacitate SNL in QA/QI

2027

Pilot implementation of Quality Assurance Programs (e.g proficiency testing) for

selected laboratories in the PHLS

2028

Actual implementation of Quality Assurance Programs for all laboratories in the PHLS

25
3 Service Delivery

Box 3: Challenges/Gaps

In the context of immunization services, challenges have been identified that hinder optimal
immunization coverage. These challenges encompass:
● Inadequate dissemination of information to the intended audience, leading to
vaccine hesitancy
● Accessibility issues stemming from geographical distances to vaccination sites, as
well as access problems arising from scheduling conflicts
● Timely administration of crucial immunizations, including challenges related to the
hepatitis B birth dose
● Complexities in setting accurate targets for immunizations initiatives

In the domain if vector-borne diseases, particularly malaria, the following issues have come to
the forefront
● Failure to achieve targeted utilization rates for long-lasting insecticide nets,
accompanied by concerns over quality assurance
● Insufficient supervisory mechanisms to ensure high-quality execution of spraying
operations
● Erosion of support from local government units for vector control activities
● Scarcity of communication volunteers available for the effective implementation of
vector-related interventions

For rabies control, the prevailing concern pertains to an inadequate budget allocation for dog
rabies vaccines

In the realm of mass drug administration and preventive therapy, several deficiencies have
been identified:
● Absence of clear policies for mass drug administration, particularly in the context of
malaria prevention
● Lack of established guidelines for pre-transmission surveys related to filariasis
control
● Question surrounding the sustainability of Post-exposure prophylaxis for newborns of
HIV-infected mothers and pre-exposure prophylaxis for individuals with substantial
risk factors
● Absence of mechanism for post-exposure immunoglobulin for newborns of mothers
infected with Hepatitis B

Case management presents its own set of challenges, including varying capabilities among
hospitals in managing human rabies cases. Additionally, instances have arisen where certain
healthcare providers were unable to adhere to the established standards of care treatment,
including appropriate follow-up for complications. The expansion of service delivery points
for Hepatitis B management is currently pending, albeit with accompanying guidelines.

Access to screening and diagnostic tests faces multifaceted obstacles:

● Suboptimal coverage in screening pregnant women for HIV, syphilis, and hepatitis B
● Disruptions in the supply of test kits at primary healthcare facilities
● Limited availability of qualified laboratory staff (medical technologists), leading to
non-specialized personnel performing laboratory tests
● Restricted access to laboratory services within geographically isolated and
disadvantaged areas (GIDAs)

26
 Lastly, the engagement of the private sector demonstrates variance across thirteen
diseases. Integration of services provided by the private sector has not been fully realized
within the program’s information system.

The implementation of critical activities focused on disease prevention, diagnosis, and

management is ensured through well-defined service delivery packages. While various
diseases are currently at different stages of elimination, it is feasible to identify
strategic convergence points for service delivery. For instance, prenatal care serves as
a platform for screening in the context of mother-to-child transmission (MTCT) of
diseases. Additionally, prenatal care offers a setting for conducting catch-up activities
to address immunization gaps.

The Omnibus Health Guidelines (OHG), organized according to different life stages,
established uniform standards spanning the continuum of care. These guidelines
ensure the provision of high-quality health services across diverse levels, ranging from
local to national, and within varied healthcare settings, including primary healthcare
facilities, hospitals, and both government and private healthcare sectors.

Component 3.1: Vaccination services

3.1.1 Routine and supplemental immunization

Clinical Practice Guidelines (CPGs) and operational guidelines provide actionable

frameworks for immunization. The local government units implement a one-day-a-week
immunization schedule. However, the challenge persists in achieving the objective of
attaining a national coverage rate exceeding 95%. The coverage for the Hepatitis B
birth dose remains notably low.

To counter vaccine hesitancy, the following strategies can be considered:

1. Customize vaccine-related messages (tailored communication) to address

specific concerns of different groups.
2. Acknowledge and dispel misinformation while emphasizing the benefits of
vaccination that will be given to families every facility/ home visit.

Furthermore, access issues, encompassing both geographic and service delivery

dimensions due to conflicting clinic hours, warrant meticulous attention. A promising
strategy includes integrating immunization activities into broader health service
outreach initiatives, thereby addressing these access impediments. Collaborating with
birthing clinics, irrespective of whether they belong to the public or private sector,
holds promise in minimizing missed immunization opportunities particularly birthing

27
clinics operating round the clock, as they extend the possibility of rendering services on
a flexible schedule, especially conducive for working mothers.

Digitalization of health service recording emerges as a transformative tool, poised to

streamline tracking mechanisms for defaulters and referrals, enhancing overall
program efficiency. The effectiveness of these strategies may vary depending on
cultural, social, and geographical contexts.

3.1.2 Pre exposure prophylaxis for individuals at high risk for rabies

Pre-exposure prophylaxis (PrEP) entails the administration of rabies vaccination at no

cost prior to any potential exposure to the rabies virus. This proactive approach is
particularly directed toward individuals at an elevated risk of contracting rabies due to
their professional roles and responsibilities. These roles include, but are not limited to,
laboratory staff, veterinarians, animal handlers, vaccinators, and other individuals
engaged in activities that involve direct or indirect exposure to the rabies virus.

PrEP holds significant value as a preventive strategy, acting as a safeguard against the
potential transmission of the rabies virus in occupational settings where the risk of
exposure is heightened. This preventive endeavor aligns with the broader spectrum of
rabies control strategies, contributing to the collective efforts aimed at reducing the
incidence and impact of rabies within vulnerable populations and the community at
large.

3.1.3 Dog vaccination for rabies

Ninety-nine percent of human rabies transmission is attributed to bites from rabid

dogs. Vaccinating dogs stands as a pivotal measure to interrupt the chain of rabies
transmission, both between dogs and from dogs to humans.

However, the insufficiency of budget allocations for procuring rabies vaccines,

dedicated to dog vaccination, is a challenge outlined in Box 3. Effective budget
allocation for dog vaccines necessitates accurate forecasting of vaccine requirements,
contingent upon the accurate registration of dogs. In light of these considerations, the
exploration of biological banks emerges as a potential solution for ensuring the
availability of safe, affordable, and high-quality dog vaccines. The collaboration
between the DA and DOH, facilitated by international agencies, can pave the way for
harnessing the resources of biological banks in this context.

A continued advocacy approach directed towards LGUs is pivotal in advocating for the
budgetary allocation dedicated to anti-rabies vaccines for dogs. Additionally, the
DA-BAI should forge collaborations with veterinary societies to access comprehensive

28
data concerning dog registration and vaccination practices conducted at private
veterinary clinics.
The synthesis of these strategies underscores a comprehensive approach aimed at
addressing the budgetary challenges, promoting vaccination awareness, and leveraging
available resources to bolster dog vaccination initiatives in the pursuit of rabies
elimination.

Desired Outcome (3.1.1-3.1.3)

1. 95% immunization coverage for vaccine preventable diseases

2. Zero outbreaks/incidence for vaccine preventable diseases

Milestones (3.1.1-3.1.3)

2024 - 2030

1. Incremental increase of immunization coverage by 2% per year for vaccine

preventable diseases beginning at 2% from baseline, starting in 2024, and
ending at 14% by 2030
2. Incremental decrease of outbreaks/incidence of vaccine preventable diseases
decreased by 1% from baseline, starting in 2024, and ending at 7% by 2030

2025 - 2030

Incremental increase of 10% per year of rabies high burden areas having a functional
rabies elimination task force, starting at 40% in 2025 and ending at 80% by 2030

2030

100% dog and cat anti-rabies vaccination coverage in 80% of the rabies high burden
areas

Component 3.2. Vector control

3.2.1 Mosquito-borne diseases

Vector control plays a pivotal role in the drive to eliminate infections transmitted by
mosquitoes. Within the spectrum of vector interventions, two prominent strategies
take precedence: the deployment of long-lasting insecticide nets (LLINs) and indoor
residual spraying (IRS). These interventions' implementation is rooted in a
comprehensive synthesis of epidemiological and entomological data, ensuring their
tailored applicability to each region's unique context.

29
In parallel, Box 3 outlines the prevailing challenges inherent to vector control
interventions. A critical stride toward optimizing LLIN utilization, with a target rate of
98% juxtaposed against the current 94.53%, entails identifying the underlying factors
driving this disparity.

Moreover, it is imperative to acknowledge that while IRS yields substantial dividends, a

notable aftermath is the emergence of insecticide resistance, casting a shadow over
the long-term efficacy of this approach. A rigorous initiative is underway—a
comprehensive insecticide resistance monitoring effort conducted within sentinel
sites in Palawan—to address this, spearheaded by the Research Institute for Tropical
Medicine (RITM).

3.2.2 Snail control for Schistosomiasis

In the Philippines, a range of targeted control measures aimed at snails, notably the
intermediate host snail Oncomelania, has been initiated as a pivotal component of the
comprehensive strategy against Schistosoma japonicum, the causative agent of
schistosomiasis. The collaborative endeavors of the DOH in conjunction with other
governmental bodies and collaborative partners, encompass a range of strategic
initiatives aimed at curbing the snail population and curtailing schistosomiasis
transmission.
Of paramount significance is the implementation of comprehensive measures designed
to restrain the intermediate host snails. This includes a repertoire of strategies such as
habitat modification, biological control, and the judicious application of molluscicides.
Notably, the Philippines employs niclosamide as the molluscicide of choice.
Administered primarily within water bodies, including rice fields and irrigation
canals—environments conducive to snail breeding—this intervention is strategically
designed to diminish snail populations and decisively disrupt the transmission cycle.

In addition, with molluscicidal efforts, the deployment of environmental management

strategies is manifest. This dimension encompasses measures designed to reconfigure
snail habitats, rendering them less conducive to the propagation of intermediate host
snails. Noteworthy tactics entail techniques like "block chain dragging" and "cementing
of irrigation and drainage canal," which contribute to altering snail habitats and
curtailing the viability of breeding sites.

Desired Outcome (3.2.1-3.2.2)

Integrated vector management in high at-risk population

30
 Milestones (3.2.1-3.2.2)

2025

At least 80% of malaria, lymphatic filariasis, and schistosomiasis high burden

endemic areas have updated vector maps

2026

100% of malaria, lymphatic filariasis, and schistosomiasis high burden endemic areas
have updated vector maps

2027 - 2029

Incremental increase of 10% per year of malaria, lymphatic filariasis, and

schistosomiasis high burden endemic areas with updated vector maps perform
integrated vector management all-year round, beginning at 80% in 2027 and ending at
100% by 2029

Component 3.3 Mass drug administration (MDA) / preventive chemotherapy (PCT)

Preventive chemotherapy involves administering doses of medication at regular

intervals to interrupt transmission and prevent development of disease. Success
depends on the proper identification of endemic areas and subsequent administration
of recommended medicines to either the entire eligible population or the most
vulnerable subsets. To achieve optimal coverage, behavior change communication,
close supervision, and monitoring should be in place. This strategy is also referred to as
mass drug administration.

Currently, MDA is being implemented for lymphatic filariasis and schistosomiasis in the
Philippines.

In 2018, the World Health Organization (WHO) endorsed the adoption of leprosy
post-exposure prophylaxis (LPEP) using single-dose rifampicin (SDR) to reduce the
incidence of new cases within endemic communities. In the Philippines, Administrative
Order No. 2021-0004, titled "Updated Guidelines on the Treatment and Prevention of
Leprosy in the Philippines," as well as the Philippine Leprosy Clinical Practice
Guidelines, have already incorporated provisions for LPEP. However, the
implementation of these guidelines has not yet been fully realized.

Depending on exposure frequency and duration, MDA could also be considered for
malaria, administered prior to, during, and post-exposure to malaria transmission. The
MDEP also includes plans to sustain and promote both pre-exposure and post-exposure

31
antiretroviral medications for newborns born to HIV-infected mothers. This initiative
demonstrates the commitment to enhance prevention and management of
mother-to-child transmission of HIV.

Desired Outcome

50% reduction of new cases from baseline

Milestones

2024

Rifampicin (for leprosy) and Azithromycin (for yaws) included in the Philippine National
Formulary

2025 - 2030

Incremental increase of 2% per year for MDA, PreP, and PEP coverage beginning at
75% in 2025 and ending at 85% by 2030

Component 3.4 Intensified Case Management

Specialized care guidelines for tetanus and polio exist, but comprehensive policies for
the case management of all 13 priority diseases should be prioritized. This includes
service mapping and development of complication management strategies to ensure
holistic and comprehensive healthcare provision for each disease. Intensified case
management include will include processed for:

1. Prompt diagnosis for timely treatment. This necessitates robust communication

to heighten awareness and proactive measures for disease detection.

2. Vigilant community engagement by elevating community awareness and

orchestrating active case detection through surveys or contact tracing.

3. Correct treatment by facilitating access to safe, high-quality medicines and

ensuring their administration under the guidance of trained healthcare
professionals.

4. Comprehensive complication management including handling stigma and

preventing disability, readily accessible to all patients.

32
 Desired Outcome

50% improvement on disease outcome from baseline

Milestones

2025

All 13 diseases have standards of care

2026 - 2030

Incremental increase of 10% per year of standards of care cascaded to high burden
areas beginning at 30% in 2026 and ending at 70% by 2030

Component 3.5 Ensure access to screening and diagnostic tests

Screening and diagnostic tests should be accessible and available to primary

healthcare providers. While primary healthcare facilities are equipped to conduct
fundamental laboratory tests, it is important for them to also understand the
capabilities of the broader laboratory network within their locality. This understanding
facilitates referral of specimens to designated testing facilities for further evaluation
and analysis. This collaborative approach ensures that patients receive accurate and
timely diagnosis, thereby optimizing healthcare outcomes.

Desired Outcome

50% improvement on screening and diagnostic test access from baseline

Milestones

2025

Screening and diagnostic tests included in the Primary Care Benefit Package

2026

Screening incorporated in the primary and secondary school enrollment

2027

Screening incorporated in annual medical examination

33
 2028

Screening incorporated in pre-employment medical examination

Component 3.6 Health Care Provider Network

The MDEP framework is rooted in the adoption of a primary health care approach,
emphasizing comprehensive health solutions in a single healthcare visit. By integrating
the management of various health concerns, this approach optimizes healthcare
delivery and enhances patient experience. The Health Care Provider Network (HCPN)
functions as an interconnected network of public and private healthcare providers
spanning primary to tertiary levels. The HCPN collaboratively addresses individuals'
holistic well-being, efficiently attending to multiple health needs during one healthcare
encounter. Under the UHC, there are three HCPN types based on ownership: Public
HCPN, linking public providers in a province or city; Private HCPN, comprising private
providers; and Mixed HCPN, involving both public and private providers. The structure
includes two key components:

1. Primary Care Provider Network (PCPN): Serving as the foundation, the PCPN
offers initial patient contact, coordinating primary care services and facilitating
broader network collaboration.

2. Hospital Network: Providing secondary and tertiary healthcare, this segment

enhances HCPN capabilities. The apex referral hospital adheres to DOH-set care
and quality standards.

Each HCPN is connected to an apex referral hospital, while various facilities offer
specialized care.

Desired Outcome

100% functional and efficient health care provider network for diseases for
elimination

Milestones

2025

Specialists for each disease mapped

34
 2026

Referral network established

2027 - 2029

Incremental increase of functional referral network by 20% per year starting at 60%
in 2027 and ending at 100% by 2029

Component 3.7 Continuous Quality Improvement and Supportive Supervision

Quality of care stands as a cornerstone within the framework of universal health care.
Its significance extends beyond the delivery of health services and includes
empowerment of health practitioners, performance enhancement, and the fortification
of health systems at large. In this context, the strategic intervention of supportive
supervision assumes a pivotal role in elevating the standards of care provided.

In this context, supportive supervision, a facet of quality assurance, embodies a

comprehensive process marked by guidance, assistance, training, and motivational
measures directed towards health care personnel. The ultimate objective is the
continuous refinement of their performance and ensuring the consistent delivery of
high-quality services. Supportive supervision is a dynamic practice that transpires
on-site, manifesting in both formal and informal settings. It takes shape during
one-on-one meetings or peer discussions and assumes particular significance when
health workers collectively review their own performance vis-à-vis established
benchmarks.

Desired Outcome

50% improvement on disease outcome from baseline

Milestone

One (1) Program Implementation Review (PIR) conducted per year, from 2024-2030
(related to stewardship pillar)

35
 4 Safe and Quality Medicines, Vaccines, and Technology

Box 4: Challenges/Gaps

● Administrative Order No. 2023-0002 or the Institutionalization of the Expanded

National Practice Guidelines has yet to achieve widespread circulation
● Some diseases targeted for elimination do not have Clinical Practice Guidelines
● The process leading up to the recommendations from the Health Technology
Assessment Council is protracted and intricate
● The availability of a local Marketing Authorization Holder (MAH) is contingent upon
having a company holding authorization granted by local medical device regulatory
authority
● Within the procurement system, the mechanisms in place are often convoluted, and
adherence to designated timelines can be challenging
● Delays in procurement processes and transportation logistics frequently culminate in
stockouts
● International procurement avenues are limited in their scope
● Drug Price Reference Index (DPRI) stipulates lower prices compared to prevalent
local market rates, undermining cost-effectiveness
● Warehouse infrastructure and capacity at all levels remain insufficient
● Bottlenecks in delivery and distribution pipelines contribute to extended timelines.

Medical treatments, vaccines, and health technologies are thoroughly assessed and
validated through health technology assessment (HTA) by the Health Technology
Assessment Council (HTAC). The objective is to establish their appropriateness for
application in disease elimination efforts spanning prevention, screening, diagnosis,
treatment, and management. HTA also examines the clinical, economic, social,
organizational, and ethical effects of these health technologies.

This strategic pillar also includes efficient supply chain management, ensuring the
availability of accessible health commodities by upholding meticulous protocols in
procurement and compliance with regulatory requirements.

This pillar stands as an indispensable enabler, fortifying disease elimination endeavors

by facilitating the deployment of cutting-edge technologies that undergo rigorous
assessment, ensuring they align with the broader objectives of enhancing health
outcomes and minimizing societal burdens.

Component 4.1: Facilitate the process of standard setting and Clinical Practice
Guidelines development

CPGs provide benchmarks of care, formulated based on the recommended actions,

interventions, or processes delineated within the National Practice Guidelines (NPGs).
Developed in collaboration with professional societies and academic institutions, CPGs
undergo systematic evidence review based on the schedule identified by the Disease

36
Prevention and Control Bureau and assessment of benefits and risks. This meticulous
process yields recommendations that equip healthcare practitioners with actionable
insights for enhancing the quality of care across various clinical scenarios
encompassing screening, diagnosis, management, and monitoring.

Desired Outcome

Standards of care determined based on the recommended actions, interventions, or

processes in the NPGs
NPGs include OHG, DOH-approved CPGs, and other equivalent standard guidelines
including interim public health and clinical guidance documents for Public Health
Emergencies (PHE) and Emerging & Re-Emerging Infectious Diseases (EREID)

Milestones

2024

Mapping of MDEP 13 diseases in terms of current available standard of care

2025

Updated standard of care for priority diseases for elimination with existing standards
(connected to component 3.4)

2027-2030

Priority diseases for elimination have regularly updated standard of care (connected
to component 3.4)

Component 4.2 Ensure that regulatory and legal requirements on commodities are
facilitated and enforced

Regulation involves government measures to control the quality, safety, and efficacy of
health products and services. The National Health Insurance Act (RA 10606) mandates a
rigorous process for health products, including medicines and vaccines, involving
Health Technology Assessment, Health Technology Assessment Council (HTAC)
recommendations, and Food and Drug Administration (FDA) certifications.

Technology appraisals are crucial to evaluate clinical and economic value, guiding
decisions on their integration into the healthcare system. Administrative Order
2016-0034 outlines the Philippine National Formulary System guidelines, requiring
thorough benefit-risk assessments for medicine inclusion based on safety, efficacy,
cost-effectiveness, affordability, and public health relevance.

37
The creation of the FDA through RA 9711 empowers it to oversee drug registration and
licensing.

Collaborating with development partners or research institutions can facilitate

provisional usage of medicines and technologies during pilot phases, especially for
diagnostic and patient-care innovations and health emergencies.

Government commitment, with national and international partners, is key to uphold

these policies, ensuring safe and high-quality health technologies. This collective
vigilance safeguards public health and integrates advanced health interventions
seamlessly into the healthcare system.

Desired Outcome

All medicines, vaccines, and other health technologies that are registrable and
requires HTA have authorization and HTAC recommendations and FDA certifications

Milestones

2030

95% of technologies submitted for HTA are timely and of high quality
95% of applications for permits and licenses to FDA processed within allowable
timelines

Component 4.3 Ensure agile and responsive processes on the procurement of

commodities

Box no. 4 highlights procurement challenges that cause stock-outs. Ensuring

continuous availability of drugs and vaccines is vital for eliminating the 13 target
diseases. Traditional procurement methods are time-consuming. Exploring agile
procurement as an alternative model is promising. Agile methods focus on adaptability,
collaboration, and continuous improvement. Strong stakeholder and supplier
relationships are key for ensuring value. Involving stakeholders in solutions can resolve
bottlenecks.

Supplier relationships yield competitive pricing, risk reduction, supply continuity, and
innovation. Improved communication through supplier experience management fosters
transparency and aligned goals. The government uses the Philippine Government
Electronic Procurement System (PhilGEPS) platform for procurement services. To
address gaps, commodities for treatment and prevention must be registered, included

38
in the Annual Procurement Plan (APP), and aligned with roles and timelines. Accurate
commodity forecasting informs budget estimates.

Creating a comprehensive funding landscape considering internal, local government,

and donor resources is crucial. Allocating funds for commodity augmentation until
LGUs can fully procure is prudent. Exploring international procurement via
development partner platforms like United Nations Office for Project Services (UNOPS),
Wambo, United Nations Children's Fund (UNICEF) is also useful.

Desired Outcome

Available, accessible, and sufficient commodities with support from international

procurement

Milestones

2024

Dedicated funding for multi-disease elimination program at all levels

2026

LGU pooled procurement

2030

LGU full procurement

Component 4.4 Prepositioning and uninterrupted supply of high-quality medicines

and other commodities at the facility through supply chain management

Supply Chain Management (SCM) encompasses the intricate process of harmonizing

supply and demand management, both internally within an organization and externally
across all stakeholders and channels within the supply chain. This orchestration is
aimed at ensuring seamless collaboration and efficiency among the various elements of
the supply chain. An optimized supply chain management framework offers significant
advantages to organizations, including the prevention of costly delays, mitigation of
quality issues, and avoidance of potential legal complications.

In the year 2020, through funding from the US Agency for International Development
(USAID), the DOH embarked on the development of the Procurement and Supply Chain
Management Strategic Plan. This involved a comprehensive situational analysis to

39
comprehensively assess the current state of affairs. This critical assessment unveiled
gaps within the existing supply chain management framework that required attention
and remediation.

Desired Outcome

No stock outs of commodities

Milestones

2024

Assessment of LGU capacity on efficient and effective supply chain management

2026-2028

At least 80% of commodities are prepositioned with 10% buffer, increasing at 10%
per year until 100% prepositioned with 10% buffer by 2028

2029

Maintained efficient and effective prepositioning with buffer and the years after

40
 5 Human Resource and Capacity Building

Box 5: Challenges/Gaps

● Existing allied medical programs do not encompass all diseases targeted for
eradication/elimination
● A scarcity of subject matter experts equipped to revise curriculum content
● Deficiency in subject matter experts for the development of comprehensive training
manuals
● Inadequate funding allocated for capacity-building initiatives
● Insufficient human resources to facilitate training sessions
● Non-availability of and outdated training modules tailored for specific disease
elimination (rabies, mother-to-child transmission, leprosy)
● Limited dissemination of clinical pathways (i.e. leprosy)

Human Resources for Health (HRH) are medical and allied professionals working as part
of the healthcare system. From preventive to palliative care, HRH exists at all levels of
healthcare, including in public and private sectors.

Uneven distribution of healthcare providers remains a challenge in the Philippines.

Around 20% of active medical practitioners handle 70% of healthcare needs, with most
concentrated in urban areas, leading to inequitable access. The Health Human
Resource Development Bureau (HHRDB) addresses this through the National Health
Workforce Support System, implementing programs to bolster HRH. HHRDB's strategic
interventions contribute significantly to achieving equitable access to health care by
augmenting and managing HRH.

Component 5.1 Align medical and allied health curriculum with the continuum of care
of diseases for elimination

Ensuring an adequate and competent healthcare workforce is crucial for MDEP's

success. Healthcare workers need to possess skills to manage the 13 priority diseases,
including responding to resurgences. Devolution adds complexity, allowing local
governments to hire healthcare workers without specific public health knowledge.
Inconsistent onboarding and selection for DOH training by LGUs can lead to uneven
proficiency nationwide, exacerbated by high turnover.

A solution is to update the pre-service curriculum so that future health workers are
prepared to manage diseases for elimination before their entry in the workforce. This
aligns with the DOH Academy's HHRDB framework, under platform 3 for partnering with
higher education. Collaboration with around 15 universities is already established, with
potential to integrate specialized disease skills into allied courses. Coordination

41
meetings involving the Commission on Higher Education (CHED), University Presidents,
Chancellors, and Administrators can initiate this process.

Desired Outcome

Medical and allied health graduates equipped with diseases for elimination
prevention, control, and management competencies

Milestones

2025

Meeting with CHED and College/University Administration

2026

Enhanced curriculum on diseases for elimination and maintained & updated in the
years after

Component 5.2 Capability building and supportive supervision for primary care
providers and facility-based health workers for effective delivery of services.

Ensuring healthcare personnel, both health care professionals and direct service
providers, stay updated with evolving guidelines and technologies through continuous
skill enhancement is important. Although disease-specific training manuals exist for
conditions like Malaria, Leprosy, Polio, and MTCT-HIV, there's a critical need to
modernize these resources. This ensures proficiency for effective elimination activities
is embedded in educational materials. Moreover, the demand for training modules
covering all priority diseases is evident. While some diseases have been addressed
individually, an integrated approach calls for comprehensive modules covering disease
clusters like morbidity management and disability prevention of leprosy and lymphatic
filariasis. These modules can be integrated into the DOH Academy, utilizing blended
learning. Healthcare workers engage in online didactic components followed by
practical field training, creating a strong mix of theory and hands-on experience.

The DOH Academy's E-Learning Program provides convenient remote courses for HRH
competency enhancement without compromising healthcare service delivery.
Development partners like WHO and USAID offer specific courses, and other local and
international partners can likewise contribute to enhance expertise in specific topics.
Beyond initial training, ongoing supportive supervision enhances real-world application
of skills. Regular feedback, guidance, and mentoring foster continuous improvement,
bridging theory and competence. This comprehensive approach aligns with the goal of

42
sustaining a skilled healthcare workforce equipped to tackle the challenges posed by
the 13 priority diseases.

Desired Outcome

HRH competent in preventing, controlling, and managing diseases for elimination

Milestones

2025

Learning gap identified

2026

Learning and development interventions (LDIs) developed

2027

LDI pilot tested

2028 - 2030

% of HRH capacitated, starting at 80% in 2028 and reaching 100% by 2030

43
 6 Environment and Social Determinants of Health

Box 6: Challenges/Gaps

● Administrative Order No. 2023-0002 or the Institutionalization of the Expanded

National Practice Guidelines has yet to achieve widespread circulation
● Some diseases targeted for elimination do not have Clinical Practice Guidelines
● The process leading up to the recommendations from the Health Technology
Assessment Council is protracted and intricate
● The availability of a local Marketing Authorization Holder (MAH) is contingent upon
having a company holding authorization granted by local medical device regulatory
authority
● Within the procurement system, the mechanisms in place are often convoluted, and
adherence to designated timelines can be challenging
● Delays in procurement processes and transportation logistics frequently culminate in
stockouts
● International procurement avenues are limited in their scope
● Drug Price Reference Index (DPRI) stipulates lower prices compared to prevalent
local market rates, undermining cost-effectiveness
● Warehouse infrastructure and capacity at all levels remain insufficient
● Bottlenecks in delivery and distribution pipelines contribute to extended timelines.

Social determinants include the conditions in which individuals are born, grow, live,
work, and age, all of which impact their health status and health-seeking behaviors. A
range of communication channels tailored to specific diseases or health programs have
been employed to reach the public, but low health literacy and health-seeking behaviors
persist.

Community engagement involves collaborative efforts with groups sharing geographic

proximity, special interests, or similar situations to address issues that impact their
well-being. This approach is a potent catalyst for effecting environmental and
behavioral changes, often involving partnerships and coalitions to mobilize resources
and influence systems. Community engagement takes various forms and includes a
diverse range of partners, including organized groups, agencies, institutions, and
individuals.

Viewed as a continuum of community involvement, community engagement spans

health promotion, research, and policy-making domains.

44
Component 6.1 Improve health promotion activities directed towards diseases for
elimination through social behavior change communication and demand generation
activities

Health promotion efforts do not necessarily lead to immediate changes in health

seeking behavior. In the context of the 13 priority diseases, addressing each disease
individually through health promotion efforts can result in a multitude of messages and
materials, often leading to information overload for the public. This highlights the need
for a more streamlined and integrated approach in the form of a comprehensive
communication plan for MDEP.

Developing an integrated communication plan requires a deep understanding of the

epidemiological characteristics of each disease. By identifying common environmental
and social factors across these diseases, it becomes possible to create messages and
materials that are relevant to multiple conditions. Furthermore, tailoring health
messages and promotional activities to at-risk groups can enhance the effectiveness of
communication strategies, as messages can be crafted to align with the
characteristics and preferences of the intended audience and work towards reducing
stigma and discrimination.

Consider the example of an integrated communication plan aimed at preventing

vector-borne diseases such as malaria and lymphatic filariasis. These diseases share
common vectors and environmental risk factors, making it feasible to develop a unified
message that emphasizes the importance of mosquito control and personal protective
measures. By targeting both diseases with a single set of messages, the public can be
better educated on effective preventive measures without being inundated with
redundant information.

Forging partnerships with educational institutions, such as schools, can be a strategic

approach. Integrating disease prevention measures into the school curriculum ensures
that students are equipped with knowledge about health and hygiene from an early age.

Incentivizing and recognizing efforts in disease elimination can serve as a motivating

factor for local government units. The incorporation of elimination targets into LGU
scorecards can foster political commitment and financial support for elimination
activities.

The integration of health promotion efforts within the MDEP requires a strategic and
multi-faceted approach. By identifying common factors among diseases, tailoring
messages to specific age groups, addressing stigma, collaborating with educational
institutions, and implementing recognition and incentives, a comprehensive
communication plan can effectively inform and engage the public, leading to improved

45
health seeking behavior and ultimately contributing to the successful elimination of the
13 priority diseases.

Desired Outcome

50% improvement on social behavior towards diseases for elimination from baseline

Milestones

2026

Two studies on social behavior towards diseases for elimination (client-focused and
provider-focused)

2027

One multi-sectoral stakeholder meeting conducted

2028

Communication plan developed and disseminated to all 17 Centers for Health

Development

Component 6.2 Strengthen multisectoral collaboration and coordination at all levels

to address common environmental and social determinants of health

In the context of public health, a myriad of environmental, economic, and social factors
exert influence over health behaviors and outcomes. Through the active engagement of
multiple partners, each contributing their distinct resources, expertise, and
perspectives, the complexity of these factors can be more effectively tackled.

The MDEP TWG will be composed of DPCB technical staff representing the diseases for
elimination, representatives from other DOH offices, other sectors and academe. The
TWG will be overseeing the implementation of the MDEP which includes activities
addressing the environmental and social determinants affecting the 13 priority
diseases.

The engagement of civil society organizations, academic institutions, and private

sectors adds depth and diversity to the collaborative effort. Civil society organizations
can mobilize communities and advocate for policies that prioritize health and
well-being. Academic institutions can provide evidence-based research to guide
decision-making, while the private sector can leverage innovation and resources to
implement practical solutions.

46
The underlying principle of multisectoral collaboration is the recognition that
challenges affecting health are often interconnected and multifaceted. A collaborative
approach taps into the strengths of various sectors and harnesses their collective
capacity to drive change. By aligning objectives, sharing knowledge, pooling resources,
and implementing coordinated strategies, multisectoral collaboration becomes a
powerful tool for addressing complex health issues and achieving meaningful and
sustainable outcomes for the overall well-being of communities and populations.

Desired Outcome

Disease elimination prioritized and well-funded through multi-sectoral collaboration

Milestones

2026

Inclusion of diseases for elimination in various existing inter-agency and private

sector councils/technical working groups, as appropriate

2024-2030

Annual stakeholders’ meeting

47
 7 Stewardship and Finance

Box 7: Challenges/Gaps

● Overlapping functions of oversight bodies

● Establishing permanent representation
● Scheduling conflicts
● Hesitations on the level of commitment
● Decision-making processes
● Unexplored territory
● Challenges in finding common ground
● Limited coverage in PhilHealth benefit package
● Insufficient funding for other diseases
● Lack of mechanisms for fund pooling

Stewardship involves leadership and governance. Every government must have

strategic policy frameworks and direction combined with effective oversight, coalition
building, regulation, attention to system design and accountability, practice judicious
use of resources and sustainability of the plan.

Finance ensures that all Filipino citizens have access to a comprehensive set of health
services without financial hardship.

Component 7.1 Stewardship through a multi-sectoral oversight committee

The 13 priority diseases may be grouped into vaccine preventable, vector-borne,

neglected tropical disease and mother-to-child transmission. The prevention and
control activities need involvement of other sectors (DA, academe, professional
societies) and other bureaus within the DOH. A multi-sectoral oversight committee is
necessary to establish processes, implement more effectively and efficiently monitor
progress. A review and mapping of existing oversight committees is crucial to
determine the possibility to adapt existing ones and learn from their success or
failures. The MDEP TWG oversees the implementation of the MDEP. A scientific
technical advisory group will be formed to provide technical advice and serve as
external audit, composed of experts from international partners and professional
societies. The MDEP TWG will work on the operations while the STAG will provide expert
guidance based on evidence.

48
 Desired Outcome

Multi-disease elimination guided by and overseen by functional groups with members

various key sectors coming from both public and private organizations including
societies

Milestones

2024

Joint AO establishing the diseases for elimination scientific technical advisory group
(STAG) and technical working group (TWG)

2025-2030

Annual STAG meeting and quarterly TWG meetings

Component 7.2 Develop evidence-based policies

Developing evidence-based policies is a fundamental pillar within any disease

elimination framework. While administrative orders and executive orders (EOs) have
been employed as mechanisms for institutionalization, the prevailing trend has been
the formulation of disease-specific AOs or EOs. However, the challenge lies in crafting
policies that are not only evidence-based but also inter-sectoral, transcending the
confines of single diseases to achieve holistic health outcomes.

To address this challenge, the Health for All Policies (HFAP) approach becomes
paramount. This approach emphasizes identifying and maximizing co-benefits across
different health domains, promoting synergy among sectors beyond healthcare. In the
context of the MDEP, the TWG spearheads this endeavor by convening a panel of
disease experts. This panel is entrusted with the task of crafting integrated and
evidence-based policies that transcend singular diseases, fostering a comprehensive
approach to health improvement.

A critical step in policy development is the meticulous mapping and review of existing
CPGs within the NPGs. By conducting this review, policymakers can identify gaps and
areas in need of updating or new guideline development. This process ensures that
policies are aligned with the latest evidence and best practices in healthcare.

Desired Outcome

High quality, evidenced-based policies on diseases for elimination

49
 Milestones

2024

Mapping of MDEP 13 diseases in terms of current available standard of care (part of

component 4.1)

2025 - 2030

Annual stakeholder’s meeting (integrated in the same event in component 6.2)

Component 7.3 Secure sufficient government and non-government financial

resources in support of elimination strategies

This component involves a series of strategic approaches aimed at ensuring sustained

government and non-government funding for the successful execution of disease
elimination efforts.

A prominent strategy entails reinforcing the representation of the DOH in the

development and formulation of the Special Health Fund (SHF). This entails working
collaboratively with relevant stakeholders to advocate for increased LGU financing
directed towards health services. By actively engaging in the development of this fund,
the DOH aims to bolster financial support for health programs, thereby contributing to
the effective implementation of disease elimination initiatives.

Another critical avenue for securing financial resources is by maximizing the utilization
of PhilHealth packages through the HCPN. This involves leveraging the established
network of healthcare providers to ensure that Philippine Health Insurance Corporation
(PhilHealth) packages are effectively utilized, thereby channeling financial resources to
the health services required for disease elimination. By optimizing the coverage and
utilization of these packages, the program aims to create a sustainable funding stream
that supports the comprehensive delivery of healthcare services.

Furthermore, achieving financial sustainability involves harmonizing government and

partner funding dedicated to disease elimination efforts. By coordinating the allocation
of funds from various sources, including both government and non-government
entities, the program can ensure a more efficient and effective utilization of available
resources. This alignment of financial support across stakeholders helps prevent
duplication of efforts and optimizes the impact of each contribution towards the
overarching goal of disease elimination.

50
Desired Outcome

1. Active involvement of Provincial Health Team Leads (PHTLs) in disease

elimination
2. Reduction of patients’ out-of-pocket expenses for services related to diseases
for elimination
3. Secured and augmented funding for diseases for elimination from DOH up to
LGU

Milestones

2024

1. Inventory of existing Philhealth packages, accredited facilities and existing

health care provider network
2. Map of NGOs and private sector with corporate social responsibility (CSR) that
can provide funding support

2025

1. Single line-item budget for diseases for elimination

2. 100% of PHTLs oriented on MDEP

2025 - 2030

Annual stakeholder’s meeting (integrated in the same event in component 6.2 and 7.2)

2028

100% of LGUs have local ordinance on resource mobilization for diseases for
elimination

2030

Diseases for elimination have Philhealth packages, provided that all have CPGs

51
 8 Research

Box 8: Challenges/Gaps

● Fragmented processes in initiating research studies

● Fragmented research ecosystem
● Insufficient local research studies focusing on zoonotic diseases
● Inadequate high-quality research activities relevant to diseases for elimination
aligned with the research agenda

Research forms the scientific foundation for shaping strategic directions and crafting
policies based on solid evidence. This knowledge ensures that policies and strategies
are well-informed, effective, and adaptable to the evolving nature of diseases and their
surrounding environment.

Challenges in box 8 need to be addressed to ensure priority research is conducted and

findings utilized for policymaking.

Component 8.1 Systematized identification of research needs

Moving away from the disjointed process of initiating research studies, the MDEP aims
to evolve towards a unified approach that identifies research requirements spanning
various bureaus and agencies. By embracing an integrated method for identifying
research needs, the MDEP ensures that the collective expertise of various entities is
harnessed to pinpoint the most pertinent research areas. Ultimately, transitioning to
this integrated model empowers the MDEP to drive evidence-based strategies through
a more cohesive and coordinated research effort.

Component 8.2 Strengthening of research that supports new innovations supporting

diseases for elimination and eradication

Enhancing research efforts to bolster innovations involves generating novel ideas and
solutions that are subjected to local research studies before being integrated into
policies. By conducting rigorous research on these innovations, their efficacy,
feasibility, and potential impact can be thoroughly assessed within the local context.

This approach not only ensures that new interventions are evidence-based but also
promotes a seamless transition from research to policy implementation. Furthermore,
the focus on innovations extends to animal health technologies, acknowledging the
interconnectedness of human and animal health in disease transmission dynamics.

52
By strengthening research in this manner, the MDEP fosters a dynamic environment for
continuous improvement and progress in advancing the goals of disease elimination
and eradication.

Component 8.3 Propose, recommend, and conduct quality and representative

surveys, studies, and serosurveys based on international standard methodologies

This component revolves around proposing, recommending, and conducting robust

surveys, studies, and serosurveys using internationally recognized methodologies,
ensuring the utilization of their outcomes. The focus is on enhancing the capabilities of
relevant agencies, including national and local entities as well as academic institutions,
to proficiently carry out diverse research endeavors.

The aim is to empower these stakeholders with the skills required to design, execute,
and analyze various types of research, fostering a culture of evidence-based
decision-making. By adhering to internationally accepted standards, the results
generated from these endeavors gain credibility and reliability, contributing to informed
policies and strategies for disease elimination and eradication.

53
Desired Outcome (8.1-8.3)

80% increase in the utilization of high quality local researches as evidence for policy,
guidelines, or standards of care development from baseline

Milestones (8.1-8.3)

2024

1. Research agenda and operational plan to include capacity building (individual,

and multi-center institutional) for research endorsed by the STAG
2. One public research forum to facilitate a review of past and ongoing
researches and identify which research can be translated into policy already
3. Budget for 2025-2030 research included in the operational plan

2025

1. Approved research agenda for diseases for elimination

2. Compendium of research on diseases for elimination from the academe and
other research institutions

2025-2030

1. Bi-annual research forum among academic and research institutions

2. 20% annual reduction on research gap
3. Translation of at least one research into policy per year

54
 MONITORING AND EVALUATION

Monitoring and evaluation are management tools designed to assess the extent to
which the program/project is attaining the expected outcomes (measurement of
performance). Monitoring is defined as a continuing function that systematically
collects data on specified indicators to provide management and relevant stakeholders
of an on-going development intervention with indication of the extent of progress and
achievement of objectives and progress in the use of allocated funds. Evaluation is the
process of determining the worth or significance of development activity, policy,
program to determine the relevance of objectives, the efficacy of design and
implementation, the efficiency or resource use and sustainability of result. (World Bank)
Other terminologies that are important in monitoring and evaluation:

● Reporting is the systematic provision of essential information at periodic

intervals.
● Outputs are specific products and services that emerge from processing inputs
● Outcomes are changes in development conditions that the program aims to
achieve
● Lesson learned is an instructive example based on experience that is applicable
to a general situation rather than to specific circumstance.

Monitoring Tools and Mechanisms

Field visits

Field visits can be joint efforts —regional, provincial, local partners—other agencies (DA)
and in some circumstances, international development partners, to validate reported
results by observing the progress being made towards attainment of results (outcome
and outputs) that are contributing to the goals of MDEP. An integrated monitoring
checklist should be developed that covers areas and skills to be observed, data to be
reviewed/validated and compliance to monitor. At the end of the field visit, a debrief
meeting with the staff should be conducted to discuss findings, draw out
difficulties/problems or challenges encountered by the health staff and provide
recommendations. A written feedback report should be delivered to the health unit for
filing (documentation of the field visit), which will also serve as the starting point of the
next field visit.

55
Multi-sectoral meeting

Quarterly, one-day multi-sectoral meetings will be led by the MDEP TWG together with
the STAG. The TWG chair initiates the multi-sectoral meeting and should ensure
representation of all agencies, local and international partners. During the meeting,
status of the indicators is presented against targets. Each strategic pillar will be
discussed, including the status of work plan implementation, challenges encountered,
actions taken, and potential risks assessment.

Performance Implementation Review

A performance implementation review (PIR) will be held annually. The purpose is to

assess progress towards results and focus discussion on recurring
problems/challenges identified during quarterly multi-sectoral meetings and to guide
the review and adjustments of the work plan for the following year. One of the
byproducts of the PIR will be the annual progress report.

Results Tracking

A separate monitoring team will be identified by the MDEP TWG. Progress on cross
cutting indicators for health systems strengthening and impact indicators for each
disease will be shared by the monitoring team to the MDEP TWG during the
multi-sectoral meetings.

56
 BUDGET

The budget below estimates the funding requirement from 2024-2030. It does not include budget requirements for the procurement of
medicines, vaccines, test kits, and other commodities, and excludes the budget for construction of laboratories because funding for
construction is incorporated in the strategic plan of the OHL.

Funding source is not indicated and is open for collaboration and co-funding among stakeholders.

Strategy 2024 2025 2026 2027 2028 2029 2030 TOTAL

Surveillance and Information Systems
Small group meetings 10,000.00 10,000.00 10,000.00 10,000.00 10,000.00 10,000.00 10,000.00 70,000.00
Dissemination forum on the
result of the disease surveillance
and health information system
desk review 500,000.00 - - - - - - 500,000.00
Development and maintenance
of a multi-source surveillance
platform and service information
system - 1,500,000.00 5,000,000.00 1,500,000.00 1,500,000.00 1,500,000.00 1,500,000.00 12,500,000.00
Training on the use of the
multi-source surveillance
platform and service information
system - - 3,000,000.00 3,000,000.00 3,000,000.00 3,000,000.00 12,000,000.00
Monitoring and supervisory
visits - - 200,000.00 200,000.00 200,000.00 600,000.00
TOTAL 510,000.00 1,510,000.00 5,010,000.00 4,510,000.00 4,710,000.00 4,710,000.00 4,710,000.00 25,670,000.00

57
 Strategy 2024 2025 2026 2027 2028 2029 2030 TOTAL
Access to Laboratory Services
Development of sustainability
plan for Vaccine Preventable
Diseases (VPD) Referral
Laboratories including human
resource, training, and budget
plans 2,000,000.00 - - - - - - 2,000,000.00
Assistance in the
implementation of the
sustainability plan for VPD
Referral Laboratories - 1,000,000.00 1,000,000.00 - - - - 2,000,000.00
Training of selected laboratory
personnel of SNL - - - 1,500,000.00 1,500,000.00 1,500,000.00 1,500,000.00 6,000,000.00
Development of policies on
cross-linking/collaboration and
referral mechanism on services
of VPD Referral Laboratories
with the established SNL's under
the Center for Health
Development (CHD) - - 1,000,000.00 - - - - 1,000,000.00
Assessment of the whole quality
of laboratory and development
of Laboratory Quality
Management System (including
QA/QI) for identified diseases for
elimination 2,000,000.00 - - - - - - 2,000,000.00

58
 Strategy 2024 2025 2026 2027 2028 2029 2030 TOTAL
Reinforcement trainings for
NRLs and capacitate SNL in
QA/QI - 1,500,000.00 1,500,000.00 1,500,000.00 1,500,000.00 1,500,000.00 1,500,000.00 9,000,000.00
Pilot implementation of Quality
Assurance Programs (e.g
proficiency testing) for selected
laboratories in the PHLS - - - 3,000,000.00 - - - 3,000,000.00
Actual implementation of Quality
Assurance Programs for all
laboratories in the PHLS - - - - 10,000,000.00 10,000,000.00 10,000,000.00 30,000,000.00
Monitoring and supervisory
visits - - 200,000.00 200,000.00 200,000.00 600,000.00
TOTAL 4,000,000.00 2,500,000.00 3,500,000.00 6,000,000.00 13,200,000.00 13,200,000.00 13,200,000.00 55,600,000.00

Service Delivery
Small group meetings 10,000.00 10,000.00 10,000.00 10,000.00 10,000.00 10,000.00 10,000.00 70,000.00
Development of vector maps and
regular updating - 15,000,000.00 5,000,000.00 5,000,000.00 5,000,000.00 5,000,000.00 5,000,000.00 40,000,000.00
Review, updating, and
dissemination/training on
integrated vector management
activities - - - 5,000,000.00 3,000,000.00 3,000,000.00 3,000,000.00 14,000,000.00
Development and updating of
standards of care for all 13
diseases - 24,500,000.00 21,000,000.00 - - - - 45,500,000.00

59
 Strategy 2024 2025 2026 2027 2028 2029 2030 TOTAL
Cascading of the standards of
care, with priority to high burden
areas - - 3,000,000.00 4,000,000.00 5,000,000.00 6,000,000.00 7,000,000.00 25,000,000.00
Mapping of specialists for each
disease - 3,000,000.00 - - - - - 3,000,000.00
Establishment and maintenance
of a functional referral network - - 3,000,000.00 3,000,000.00 3,000,000.00 3,000,000.00 3,000,000.00 15,000,000.00
Meetings with stakeholders to
incorporate screening and
diagnosis in the Primary Care
Benefit Package, school
enrollment, annual medical
examination, and
pre-employment 10,000.00 10,000.00 10,000.00 10,000.00 10,000.00 10,000.00 10,000.00 70,000.00
Development and orientation of
integrated checklist 1,000,000.00 500,000.00 1,500,000.00
Monitoring and supervisory
visits - - 200,000.00 - 200,000.00 - 200,000.00 600,000.00
144,740,000.0
TOTAL 1,020,000.00 43,020,000.00 32,220,000.00 17,020,000.00 16,220,000.00 17,020,000.00 18,220,000.00 0

60
 Strategy 2024 2025 2026 2027 2028 2029 2030 TOTAL
Safe and Quality Medicines, Vaccines, and Technology
Small group meetings 10,000.00 10,000.00 10,000.00 10,000.00 10,000.00 10,000.00 10,000.00 70,000.00
Assessment of LGU capacity on
efficient and effective supply
chain management 3,000,000.00 - - - - - - 3,000,000.00
TOTAL 3,010,000.00 10,000.00 10,000.00 10,000.00 10,000.00 10,000.00 10,000.00 3,070,000.00

Human Resource and Capacity Building

Small group meetings 10,000.00 10,000.00 10,000.00 10,000.00 10,000.00 10,000.00 10,000.00 70,000.00
Updating of pre-service
curriculum, development of
learning materials and
monitoring & supervision - 5,000,000.00 1,000,000.00 1,000,000.00 1,000,000.00 1,000,000.00 1,000,000.00 10,000,000.00
HRH learning gap analysis - 2,500,000.00 - - - - - 2,500,000.00
Development of LDIs, pilot
testing, and full dissemination - - 10,000,000.00 2,000,000.00 3,000,000.00 4,000,000.00 5,000,000.00 24,000,000.00
TOTAL 10,000.00 7,510,000.00 11,010,000.00 3,010,000.00 4,010,000.00 5,010,000.00 6,010,000.00 36,570,000.00

Environment and Social Determinants of Health

Small group meetings 10,000.00 10,000.00 10,000.00 10,000.00 10,000.00 10,000.00 10,000.00 70,000.00
Two studies on social behavior
towards diseases for elimination - - 5,000,000.00 - - - - 5,000,000.00

61
 Strategy 2024 2025 2026 2027 2028 2029 2030 TOTAL
Feedback and stakeholder
meeting - - - 3,000,000.00 - - - 3,000,000.00
Development, dissemination,
and monitoring & supervision of
communication plan to all 17
Centers for Health Development - - - - 3,000,000.00 3,000,000.00 3,000,000.00 9,000,000.00
TOTAL 10,000.00 10,000.00 5,010,000.00 3,010,000.00 3,010,000.00 3,010,000.00 3,010,000.00 17,070,000.00

Stewardship and Finance

Annual STAG meeting and
quarterly TWG meetings 1,000,000.00 1,000,000.00 1,000,000.00 1,000,000.00 1,000,000.00 1,000,000.00 1,000,000.00 7,000,000.00
Annual program implementation
review 5,000,000.00 5,000,000.00 5,000,000.00 5,000,000.00 5,000,000.00 5,000,000.00 5,000,000.00 35,000,000.00
Inventory of existing Philhealth
packages, accredited facilities
and existing health care provider
network 500,000.00 - - - - - - 500,000.00
Development of annual report
and learning stories 300,000.00 300,000.00 300,000.00 300,000.00 300,000.00 300,000.00 1,800,000.00
Map of NGOs and private sector
with corporate social
responsibility (CSR) that can
provide funding support 500,000.00 - - - - - - 500,000.00
44,800,000.0
TOTAL 7,000,000.00 6,300,000.00 6,300,000.00 6,300,000.00 6,300,000.00 6,300,000.00 6,300,000.00 0

62
 Strategy 2024 2025 2026 2027 2028 2029 2030 TOTAL

Research
Research forum 3,000,000.00 - - - - - - 3,000,000.00
Development of a research
agenda and research operational
plan 3,000,000.00 - - - - - 3,000,000.00
Development of a compendium
of researches on diseases for
elimination - 1,000,000.00 - - - - - 1,000,000.00
Annual research forum among
academic and research
institutions - 1,500,000.00 1,500,000.00 1,500,000.00 1,500,000.00 1,500,000.00 1,500,000.00 9,000,000.00
TOTAL 6,000,000.00 2,500,000.00 1,500,000.00 1,500,000.00 1,500,000.00 1,500,000.00 1,500,000.00 16,000,000.00

63
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