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Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

SEVENTEENTH (17™) CONGRESS
Third Regular Session

House Bill No. &814

Introduced by REPRESENTATIVE ERIC L. OLIVAREZ

EXPLANATORY NOTE

Tuberculosis (TB) is a contagious disease caused by infection
with Mycobacterium tuberculosis (Mtb) bacteria. It typically affects
the lungs but it can also extend to other parts of the body such as
the kidney, spine, and brain. TB is spread through the air when a
person with TB disease of the lungs of throat coughs, speaks or sings,
and when people nearby breathe in these bacteria and become
infected.!

Despite its contagiousness, TB is known to be a preventable and
curable disease. With proper prevention measures, management and
treatment, TB can actually be controlled and eliminated. And yet, TB
remains to be the leading infectious cause of death worldwide.
According to the World Health Organization (WHO), in 2017, 10
million people became ill with TB, and 1.6 million of those died,
including 230,000 children. Over the past two centuries, TB has
claimed the lives of more than one billion people - more death than
from malaria, influenza, smallpox, HIV/AIDS, cholera, and plague
combined; And although TB treatment does exist, drug resistance is
still a continued threat.?

2 {bid, citing data from the World Health Organization.


In the Philippines, TB is indeed a major health problem, it being
the sixth leading cause of death and illness here. In 2011, WHO
recorded 28,000 deaths out of the 260,000 recorded TB cases in the
Philippines; And consistent with the global trend, drug resistance is
found on 10,600 patients, particularly, marginalized groups such as
senior citizens, and the urban poor, as well as those experiencing
health issues from smoking and conditions like HIV, diabetes, and
malnutrition, among others.

The Philippines has achieved a major milestone in this plight of
eradicating TB in the country. In 2016, it has enacted Republic Act
10767, otherwise known as the "Comprehensive Tuberculosis
Elimination Plan Act", although the implementation of the said law
is yet to be fully achieved.

In September 2018, the first United Nations General Assembly
(UNGA) High-level Meeting on TB took place in New York, with the
overall theme being "United to end tuberculosis: An urgent global
response to a global epidemic". In his address before the said body,
Health Secretary Francisco Duque III stressed the Philippines’
commitment to accelerate action to fight and ultimately eliminate
tuberculosis. He emphasized that our country is "pursuing business
‘not-as-usual' in its fight against TB."

From the foregoing, it can be seen that the momentum to end
TB in the Philippines, and indeed worldwide, has never been
stronger. Thus, it is only timely to introduce certain amendments to
the aforementioned RA 10767 in order to further strengthen the
same.

While RA 10767 can be considered a landmark legislation, there
is a need to prioritize the TB patients who belong to the marginalized
sector, especially those who are experiencing intersecting and
multiple vulnerabilities. There is also a need to impose penalties for
violations of certain provisions to make the Act more compelling and
effective. For example, penalty of fine or imprisonment, or both, is
being proposed for violating the "no-prescription, no TB drugs" policy

> Information from the Department of Health.


so that the drug-resistance phenomenon which has been setting
back the efforts of countries in fighting TB, can be reversed and
countered.

Furthermore, this proposition zeroes-in on the need of the
country to have a systematic and updated TB Database System
reflecting data of TB cases which are properly disaggregated by sex,
age, disability if applicable, and geographical region, among other
factors. A database is very crucial in developing new policies, to end
TB, or improving those already existing. It is also helpful in
identifying priority patients, and in effectively responding to their TB-
related needs, issues, and concerns. Finally, a Monitoring and
Evaluation System must also be established and regularly
maintained in order to assess the impact of our current TB programs
and determine whether there is a need to bolster or make certain
changes in our on-going efforts. These matters are not emphasized
in the current law, but are deemed highly important if we want to
achieve our ultimate objective of ending this global pandemic that is
tuberculosis.

Bae LY

ERIC OLIVAREZ


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

SEVENTEENTH (17™) CONGRESS
Third Regular Session

8814
House Bill No.

Introduced by REPRESENTATIVE ERIC L. OLIVAREZ

AN ACT
STRENGTHENING THE FIGHT TO END TUBERCULOSIS,
AMENDING FOR THE PURPOSE REPUBLIC ACT (R.A.) 10767
OTHERWISE KNOWN AS THE "COMPREHENSIVE
TUBERCULOSIS ELIMINATION PLAN ACT"

Section 1. Section 4 (a) and (e) of R.A. 10767 are hereby
amended to read as follows:

"Sec. 4 Comprehensive Philippine Plan of Action to Eliminate
Tuberculosis - The Secretary of the Department of Health shall
establish a Comprehensive Philippine Plan of Action to Eliminate
Tuberculosis, in consultation with appropriate public and private
entities. The Philippine Plan of Action shall consist of the following:

(a) The country's targets and strategies in addressing
disease, with appropriate workable timelines.

(b) xxx

(c) xxx


(d) xxx

(e) The establishment of a review and monitoring system to
gather data disaggregated by sex, age, geographical
region, as well as disability if applicable, and monitor the
progress in the elimination of tuberculosis; and

(f) 2oxx. "

Sec. 2. Section 6 (c) and (d) of R.A. 10767 are hereby amended
to read as follows:

"Sec. 6. Research, Demonstration Projects, Education and
Training. - The Secretary of Health shall, directly or through
grants to public or non-profit private entities, perform the
following activities:

(a) xxx
(b) xxx

(c) Conduct nationwide public information campaign and
education programs, prioritizing high-risk and remote
areas, and primarily targeting people who are part of the
marginalized sectors such as the urban poor, people in
far flung areas and provinces, women, children, persons
with disabilities, senior citizens, among others.

(d) Undertake regular education, training, capacity-
building, and clinical skills improvement activities for health
care providers, taking into account established
international standards on tuberculosis prevention, care
and treatment, as well as innovations and good practices
world-wide.

() xx
(f) xxx"


Sec. 3. Section 8 of R.A. 10767 is hereby amended to read as:

"Sec, 8. Education Programs - The Commission on
Higher Education (CHED), in coordination with the
Secretary of Health shall mandate the administrations and
faculties of schools of medicine, nursing and medical
technology, of all colleges and universities and their other
allied health institutions and hospitals - except the
University of the Philippines, although its Board of Regents
is encouraged - to intensify information and education
programs, including the development of curricula, to
significantly increase the opportunities for students and for
practicing providers to learn the principles and practices of
preventing, detecting, managing and controlling tuberculosis."

baat > com b d

Sec. 4. Section 9 of R.A. 10767 is hereby amended to read as
follows:

"Sec. 9. Inclusion in Basic Education - The Department
of Education (DepEd), in coordination with the Department
of Health, shall work for the inclusion of modules on the
principles and practices of preventing, detecting, managing and
controlling tuberculosis in the health curriculum of every
public and private elementary and high school.

Sec. 5. Section 10 of the same Act is hereby amended to read
as follows:

"Sec. 10. Media Campaign - The Philippine Information
Agency, in coordination with the Department of Health,

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shall partner with media outlets to launch a media campaign
on tuberculosis control, treatment, and management, using all
forms of multimedia and other electronic means of
communication."

Sec. 6. Section 12 of R.A. 10767 is hereby amended to read as
follows:

Sec. 12. Mandatory Reporting of TB Cases - All public
and private health centers, hospitals, and facilities shall
observe the national protocol on TB management and shall
submit a comprehensive annual report to the DOH of all TB
cases received by the said institutions within the year,
which shall be systematically disaggregated by the
patients’ sex, age, disability if applicable, as well as the
type of tuberculosis suffered or acquired, and other crucial
data_and information as may be prescribed by DOH.
Provided, however, that the names and any other form of
identification of patients shall not be reported or disclosed
to the public or to any third person without the consent of
the patient, and without valid and compelling reason to do
so. Provided further, that the reports shall be in conformity
with the rules and applicable provisions under the Manual
of Procedures of the National TB Program and the Philippine
Plan of Action on Tuberculosis Control.

Sec. 7. An additional provision is hereby inserted, to be
numbered as the new Section 13, in relation to the above-amended
Section 12. It shall read as:

"Sec. 13. Creation and Regular Updating of a TB
Database - The Department of Health, in collaboration with
the Philippine Statistics Authority (PSA), and other

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relevant government agencies, shall create, and from there
onwards regularly update, a TB database system reflecting
the disaggregated data from the reports submitted by the
public and private health centers, hospitals, and facilities
on the number of TB cases received by them, as mandated
under Section 12 of this Act (as amended). The TB Database
shall be made easily accessible/available to the public
except the names of the patients, ideally through the DOH
website and other effective media."

Sec. 8. Further to the foregoing, a new section pertaining to the
establishment of Monitoring and Evaluation mechanism is hereby
added, to be numbered as the new Section 14, and shall read as:

"Sec. 14. Establishment of a Monitoring and
Evaluation (M&E) System, and Conduct of Impact
Assessment Studies on TB-related programs - The DOH
shall establish an effective M&E system, and as far as
practicable, regularly conduct impact assessment studies
of its major TB-related programs and initiatives, the
outcome/result of which shall be utilized to develop or
improve existing polices and guidelines on the prevention.
control, management and treatment of TB in the country,
among other legitimate purposes."

Sec. 9. Another section is hereby added, to be numbered as the
new Section 15, and shall read as:

"Sec. 15. Penalty - Any pharmacy, drugstore, and
corporate health agencies, facility or institutions found to
have violated the "No prescription, no Anti-TB drugs"
policy enunciated under Section 11 of this Act, shall pay a
fine of not less than thirty thousand pesos (Php 30,000.00)
but not more than fifty thousand pesos (Php 50,000.00) and
its proprietors, officers and members of the Board of

8


Directors, as the case may be, shall suffer the penalty of
fine in the amount of Twenty Thousand Pesos (Php
20,000.00) and/or imprisonment of not less than ten (10)
days, or both fine and imprisonment, at the discretion of
the proper court and its pharmacists or sales crew shall
suffer the penalty of fine in the amount of Five Thousand
Pesos (Php 5,000.00) and/or imprisonment of not less than
five (5) days, or both fine and imprisonment, as may be
determined by the proper court. Furthermore, the business
permit and license to operate of the said entity shall be
suspended, or revoked and cancelled altogether, depending
on the gravity of the violation.

Any concerned person who is found to have willfully,
or by gross negligence, violated the National Protocol on TB
Management shall be penalized with a fine of not less than
twenty thousand pesos (Php20,000.00) but not more than
fifty thousand pesos (Php50,000.00) or imprisonment of not
less than one (1) month but not more than six (6) months,
or both fine and imprisonment, at the discretion of the
proper court. Administrative sanctions may also be
imposed upon the erring persons and health proffesionals
by the Professional Regulation Commission, the Civil
Service Commission, among other applicable licensing
agencies, to which the person is subject to.”

Sec. 10. In light of the new provisions added, Sections 13 to 19
of R.A. 10767 are hereby renumbered as Sections 16 to 22,
respectively.

Sec. 11. Implementing Rules and Regulations - The DOH, in
consultation with the DEPED and CHED and other concerned
agencies and entities, shall issue the rules and regulations
implementing the provisions of this Act within ninety (90) days from
its effectivity.


Sec. 12. Separability Clause - If any provision of this Act is
declared invalid or unconstitutional, other provisions hereof which
are not affected thereby shall remain valid, and in full force and
effect.

Sec. 13. Repealing Clause - All laws, orders, decrees, rules and
regulations and other parts thereof which are inconsistent with the
provisions of this Act are hereby repealed, amended or modified.

Sec. 14. Effectivity - This Act shall take effect fifteen (15) days
after its publication in the Official Gazette or in two (2) newspapers
of general circulation.

Approved.

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