SEVENTEENTH CONGRESS OF THE )

REPUBLIC OF THE PHILIPPINES )
Third Regular Session ) 18 Mh -4 P3232
. SENATE

S.B. No. 1864 RECE: ot im

Introduced by Senator Ana Theresia “Risa” Hontiveros-Baraquel

AN ACT PROVIDING POLICIES AND PRESCRIBING PROCEDURES ON
SURVEILLANCE AND RESPONSE TO NOTIFIABLE DISEASES, EPIDEMICS, AND
HEALTH EVENTS OF PUBLIC HEALTH CONCERN, AND APPROPRIATING FUNDS
THEREFOR, REPEALING FOR THE PURPOSE ACT NO. 3573 ENTITLED, “AN ACT
PROVIDING FOR THE PREVENTION AND SUPPRESSION OF DANGEROUS
COMMUNICABLE DISEASES AND FOR OTHER PURPOSES”

EXPLANATORY NOTE

The Constitution enshrines the right to health of every Filipino. Specifically, Article 2
Section 15 that provides that “State shall protect and promote the right to health of the
people and instill health consciousness among them.”

According to the World Health Organization (WHO), over 13 million people die each
year from infectious and parasitic diseases: one in two deaths in some developing
countries. Poor people, women, children, and the elderly are the most vulnerable.
Infectious diseases continue to be the world's leading killer of young adults and children.
In the Philippines, it has been reported that eight out of ten leading causes of morbidity
is due to communicable diseases (FHSIS, 2015).

The Philippine’s Act 3573 - Law on Reporting of Communicable Diseases, a law passed
on November 26, 1929 by the Philippine Legislature in an American occupied country,
is still being used as the basis for requiring all individuals and health facilities to report
notifiable diseases to local and national health authorities. Up to now, guidelines of the
Department of Health for reporting communicable diseases refer to this old law. Despite
significant advances in the science of medicine and the emergence of new diseases in
the past 90 years, the law has not been updated.

Notification, by the fastest means possible, of epidemic-prone diseases and health
events of public health concern is required for the State to appropriately assess the
health situation and respond quickly in order to prevent more people from getting
infected, control outbreaks, contain health events of public health concern, and prevent
mortalities.

This measure seeks the repeal of the archaic Act 3573, otherwise known as the “Law
on Reporting of Communicable Diseases” and the institution of new policies and
regulations pertaining to the reporting of important public health concerns and the
‘strengthening of disease surveillance systems at the national and local level.

In view of the foregoing, the immediate passage of this bill is earnestly sought.

andere pe
Ana Theresia “Risa” Hontiveros-Baraquel

1



SEVENTEENTH CONGRESS OF THE )

REPUBLIC OF THE PHILIPPINES )
Third Regular Session )
SENATE 18 WL -4 P3392
$.B.No1864

REE pf

Introduced by Senator Ana Theresia “Risa” Hontiveros-Baraquel

AN ACT PROVIDING POLICIES AND PRESCRIBING PROCEDURES ON
SURVEILLANCE AND RESPONSE TO NOTIFIABLE DISEASES, EPIDEMICS, AND
HEALTH EVENTS OF PUBLIC HEALTH CONCERN, AND APPROPRIATING FUNDS
THEREFOR, REPEALING FOR THE PURPOSE ACT NO. 3573 ENTITLED, “AN ACT
PROVIDING FOR THE PREVENTION AND SUPPRESSION OF DANGEROUS
COMMUNICABLE DISEASES AND FOR OTHER PURPOSES”

Be it enacted by the Senate and House of Representatives of the Philippines in
Congress assembled:

CHAPTER 1
GENERAL PROVISIONS

SECTION 1. Short Title. — This Act shall be known as the “Mandatory Reporting of
Notifiable Diseases and Health Events of Public Health Concern Act”.

SECTION 2. Declaration of Principles & Policies.

It is hereby declared the policy of the State to protect and promote the right to health of
the people and instill health consciousness among them. It shall endeavor to protect the
people from public health threats through the efficient and effective surveillance of
notifiable diseases including emerging and re-emerging infectious diseases, diseases
for elimination and eradication, epidemics, and health events of public health concem
and provide an effective response system in compliance with the 2005 International
Health Regulations (IHR) of the World Health Organization (WHO). The State
recognizes epidemics and other public health emergencies as threats to public health
and national security, which can undermine the social, economic, and political functions
of the State.

The State also recognizes disease surveillance and response systems of the
Department of Health (DOH) and its local counterparts, as the first line of defense to
epidemics and health events of public health concern that pose risk to public health and
security.

SECTION 3. Definition of Terms. — As used in this Act:

a. Disease refers to an illness due to a specific toxic substance, occupational
exposure or infectious agent, which affects a susceptible individual, either directly
or indirectly, as from an infected animal or person, or indirectly through an
intermediate host, vector, or the environment.

b. Disease control refers to the reduction of disease incidence, prevalence, morbidity
or mortality to a locally acceptable level as a result of deliberate efforts and
continued intervention measures to maintain the reduction.



Disease surveillance refers to the on-going systematic collection, analysis,

interpretation, and dissemination of outcome-specific data for use in the planning,
implementation, and evaluation of public health practice. A disease surveillance
system includes the functional capacity for data analysis as well as the timely
dissemination of these data to persons who can undertake effective prevention and
control activities.

|. Emerging or re-emerging infectious diseases refer to diseases that (1) have not

occurred in humans before; (2) have occurred previously but affected only small
numbers of people in isolated areas; (3) have occurred throughout human history
but have only recently been recognized as a distant disease due to an infectious
agent; (4) are caused by previously undetected or unknown infectious agents; (5)
are due to mutant or resistant strains of a causative organism; (6) once were major
health problems in the country, and then declined dramatically, but are again
becoming health problems for a significant proportion of the population.

. Epidemic or outbreak refers to an occurrence of more cases of disease than

normally expected within a specific place or group of people over a given period of
time.

Epidemiologic investigation refers to an inquiry to the incidence, prevalence,
extent, source, mode of transmission, causation of, and other information pertinent
to a disease occurrence.

. Health event of public health concern refers to either a public health emergency or

a public health threat.

. Infectious disease is a disease caused by pathogenic microorganisms, such as

bacteria, viruses, parasites or fungi. These diseases can be spread, directly or
indirectly, from one person to another or from animals to humans.

Mandatory reporting refers to the obligatory reporting of a condition to local or state
health authorities, as required for notifiable diseases, epidemics or public health
events of public health concern.

Notifiable disease refers to a disease that, by legal requirements, must be reported
to the public health authorities.

. Public health authority refers to the DOH (specifically the Epidemiology Bureau,

Disease Prevention and Control Bureau, Bureau of Quarantine and International
Health Surveillance, Health Emergency Management Bureau, Food and Drug
Administration, Research Institute for Tropical Medicine and other National
Reference Laboratories, and its counterparts at the DOH Regional Offices), the
local health office (provincial, city or municipality), or any person directly authorized
to act on behalf of the Department of Health or a local health office.

Public health emergency refers to an occurrence or imminent threat of an illness or
health condition that:

1. 1s caused by any of the following:

* bioterrorism;

* appearance of a novel or previously controlled or eradicated infectious
agent, or biological toxi
a natural disaster;

a chemical attack or accidental release;
a nuclear attack or accident; or
an attack or accidental release of radioactive materials.

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2. Poses a high probability of any of the following:

* alarge number of deaths in the affected population;

* a large number of serious or long-term disabilities in the affected
population;

* widespread exposure to an infectious pathogen or toxic agent that may
pose a significant risk of substantial harm to large number of people in the
affected population;

* potential for national or international spread; or

threatens the elimination or eradication of a disease.

Public health threat refers to any situation or factor that may represent a danger to
the health of the people. This includes diseases in animals that affect humans, and
environmental events that impact human health.

|. Response refers to the implementation of specific activities to control further

spread of infection, outbreaks or epidemics and prevent reoccurrence; to contain
or reduce the effect of a health event of public health concem; or to prevent
mortalities or disabilities. It includes verification, rapid assessment, case measures,
treatment of patients, conduct of prevention activities, and rehabilitation.

SECTION 4. Objectives. - This Act shall have the following objectives:

a.

To continuously update the list of nationally notifiable diseases and health events
of public health concern with their corresponding case definitions and reporting
mechanisms;

. To enforce mandatory reporting of notifiable diseases and health events of public

health concer to the DOH and its local counterparts;

. To continuously strengthen the capacity and collaboration of national and local

agencies in responding to epidemics and health events of public health concern;

. To ensure the establishment and maintenance of relevant, efficient, effective and

responsive disease surveillance and response systems and structures at the
national and local levels, including Epidemiology and Surveillance Units (ESU)
and public health laboratories;

. To provide sufficient funding to support operations needed to establish and

maintain epidemiology and surveillance units at the DOH, health facilities and
local government units; efficiently and effectively investigate outbreaks and
health events of public health concern; validate, collect, analyze and disseminate
disease surveillance information to relevant agencies or organizations; and
implement appropriate response;

To require public and private physicians, allied medical personnel, professional
societies, hospitals, clinics, health facilities, laboratories, pharmaceutical
companies, private companies and institutions, workplaces, schools, prisons,
ports, airports, establishments, communities, other government agencies, and
non-government organizations to actively participate in disease surveillance and
response;

|. To require the real-time reporting of, and immediate response to, public health

emergencies and health events of national and international concern;

. To strengthen reporting and response systems that ensure provision of accurate

and timely health information on notifiable diseases and health- events and



conditions of public health concer to citizens and health providers as an integral
part of response to epidemics and public health emergencies;-

i. To establish effective mechanisms for strong collaboration and communication
with national and local government health agencies and ensure that proper
procedures are in place to promptly respond to reports of notifiable diseases and
health events of public health concern. These include case and environmental
investigations, management and treatment of cases, risk assessment and
communication, control and containment, prevention interventions, community
mobilization, monitoring, evaluation and other follow up activities.

j. To expand health sector collaboration beyond traditional public health partners to
include others who may be involved in the disease surveillance and response,
such as the Department of Agriculture, Department of Environment and Natural
Resources, Department of Foreign Affairs, Department of Social Welfare and
Development, veterinarians, animal industry, law enforcement entities,
transportation agencies, among others;

k. To ensure that public health authorities have the statutory and regulatory
authority to implement mandatory reporting of notifiable diseases, conditions and
health events of public health concern, and immediately response to these
reports;

|. To respect to the fullest extent possible, the rights of people to liberty, bodily
integrity, and privacy while maintaining and preserving public health and security.

SECTION 5. Notifiable Diseases and Health Events of Public Health Concern. — The
Epidemiology Bureau, under the DOH, shall regularly update and issue a list of
nationally notifiable diseases and health events of public health concem with their
corresponding case definitions and reporting mechanisms, signed by the Secretary of
Health. The list of notifiable disease and health events of public health concem will
include emerging and re-emerging diseases and diseases for elimination and
eradication, among others. The selection and the deletion of diseases and health
events of public health concem shall be based on criteria established by the DOH.

SECTION 6. Mandatory reporting of notifiable diseases and health events of public
health concern. - The DOH, through the Epidemiology Bureau, shall issue the official
list of institutionalized public health disease surveillance and response systems for
mandatory reporting of notifiable diseases and health events of public health concem
provided in Section 5 of this Act. This official list shall include the Philippine Integrated
Disease Surveillance and Response (PIDSR) System with its Case-based Surveillance
and Event-based Sureeillance, and other duly institutionalized public health disease
surveillance and response systems of the DOH.

Under this Act:

a. The DOH and its local counterparts are mandated to implement the mandatory
reporting of notifiable diseases and health events of public health concern.

b. All public and private physicians allied medical personnel, professional societies,
hospitals, clinics, health facilities, laboratories, pharmaceutical companies,
private companies and institutions, workplaces, schools, prisons, ports, airports,
establishments, communities, other government agencies, and non-government
organizations are required to accurately and immediately report notifiable
diseases and health events of public health concer as issued by the DOH.



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g.

. The DOH and its local counterparts shall establish and maintain functional

disease surveillance and response systems, which include inter-agency and
intra-agency coordination mechanisms; implementation protocols for reporting,
data verification, data management, data analysis, and other surveillance and
response activities; measures for data security and confidentiality; and
procedures and provision to ensure safety of personnel conducting disease
surveillance and response activities.

|. The DOH and its local counterparts shall establish Epidemiology and

Surveillance Units in all localities and health facilities that has a yearly budget for
its operations and response to epidemics and public health emergencies;
adequate human resources trained in epidemiology, disease surveillance and
response; information and communication technology; appropriate infrastructure,
equipment and logistics for activities listed in Section 6i; transportation for quick
response; laboratory equipment, supplies and reagents; access to courier and
warehousing services; and personal protective equipment.

. The DOH and its local counterparts shall ensure that all surveillance and

response officers have adequate capacity for mandatory reporting of notifiable
diseases, risk assessment, epidemiology, disease surveillance, and response to
epidemics and health events of public health concern.

The DOH and its local counterparts shall ensure that the safety and protection of
all personnel directly involved in surveillance and response activities are upheld.
These personnel shall be provided with health insurance, personal protective
equipment and prophylaxis; provided treatment and hospital management when
exposed to toxins or infectious agents; and given pay and other benefits
commensurate to the hazard of their duties.

The DOH shall strengthen and expand public health laboratories and the
capacity for biosafety nationwide.

. The DOH, in collaboration with other public health partners, other government

agencies, local government units, the private sector and other partners listed in
Section 4j, shall establish and continually strengthen disease surveillance and
teporting systems; mechanisms for provision of accurate and timely information;
and strong coordination and communication systems for appropriate and
immediate response to reports of notifiable diseases, epidemics and health
events of public health concern.

To perform their disease surveillance and response functions, authorized health
Personnel from the DOH and its local counterparts have the statutory and
regulatory authority to enforce the following:

1. implement mandatory reporting of notifiable diseases, conditions and health
events of public health concern;

2. establish disease surveillance and response systems in private and public
facilities deemed necessary to protect the health of the population;

3. conduct epidemic and epidemiological investigation, outbreak investigation,
case investigation, patient interviews, review of medical records, contact
tracing, collection, storage, transport and testing of samples laboratory
investigation, risk assessments, population surveys, and environmental
investigation;



4. rapid containment, quarantine and isolation of persons suspected or
confirmed to have a notifiable disease and/or conditions that can compromise
public health, and limit movement to and from affected areas;

5. conduct of autopsies and disposal of dead bodies;

6. disease prevention and control measures including product recall; and,

7. response activities for health events of public health concer.

Information reported to the PIDSR and other official public health disease
surveillance and response systems are considered information necessary to
carry out the mandated public health function of the Department of Health. All
information shall be kept secure and confidential, and used for public health
Purposes only.

k. To fulfill the public health mandate of the DOH and its local counterparts, all
medical and allied medical personnel, health facilities, laboratories, and
institutions shall provide the DOH and its local counterparts access to necessary
personal information and pertinent medical records during outbreak
investigations, case investigations, and similar surveillance and response
activities.

|. All personnel of the DOH and its local counterparts, and all other individuals or
entities involved in conducting disease surveillance and response activities shall
respect, to the fullest extent possible, the rights of people to liberty, bodily
integrity, and privacy while maintaining and preserving public health and security.

SECTION 7. Declaration of Epidemic or Public Health Emergency — The Secretary of
Health shall have the authority to declare epidemics of national and/or international
concern except when the same threatens national security. In which case, the President
of the Republic of the Philippines shall declare a State of Public Health Emergency and
mobilize government and non-government agencies to respond to the threat.

Provincial, City or Municipal Health Offices may declare an outbreak within their
respective localities provided the declaration is supported by sufficient scientific
evidence based on disease surveillance data and epidemiologic investigation,
environmental investigation, and/or laboratory investigation. A province, city or
municipality cannot declare a public health emergency of national or international
concern.

SECTION 8. Establishment of Epidemiology and Surveillance Units. — The DOH
through the Epidemiology Bureau, Regional Epidemiology and Surveillance Units,
Bureau of Quarantine, and the National Reference Laboratories, in coordination with the
local government units, health facilities and laboratories, shall ensure that
Epidemiology and Surveillance Units (ESU) are established and functional at all levels
of DOH and its local counterparts, and in public and private health facilities and
laboratories as well as ports and airports in all provinces, cities and municipalities
throughout the country. The Epidemiology and Surveillance Units shall capture and
verify all reported notifiable diseases and health events of public health concern;
provide timely, accurate, and reliable epidemiologic information to appropriate agencies:
conduct surveillance and response activities; coordinate needed response; and facilitate
capacity building in the field of epidemiology, disease surveillance and response.

All ESU shall have an annual budget for its operations and response activities,
appropriate number of trained human resources, and provision of adequate resources
including information and communication technology, infrastructure, equipment,

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logistics, transportation, laboratory equipment, supplies and reagents, personal
protective equipment to fulfill and effectively perform its surveillance and response
functions listed in Section 6i.

All ESU staff should have the competencies and skills to effectively and efficiently
perform their surveillance and response duties and implement the conditions set by the
International Health Regulations.

SECTION 9. Prohibited Acts. - The following shall be prohibited under this Act:

a. Breach of privacy and confidentiality;

b. Tampering of records or intentionally providing misinformation;

¢. Non-performance of the operation of the disease surveillance and response
systems;

d. Non-cooperation of persons and entities that should report and/or respond to
notifiable diseases or health events of public health concern; and

e. Non-cooperation of the person or entities identified as having a notifiable disease
or affected by the health event of public health concern.

Disclosure of confidential information will not be considered a breach of confidentiality
and privacy if the Department of Health or its local counterparts is issued a legal order
by a Court of law.

SECTION 10. Penalties. — Any person or entity found to have violated Sec. 9 of this Act
shall be penalized with a fine of not less than Twenty thousand pesos (Php 20,000.00)
but not more than Fifty thousand pesos (Php 50,000.00) or imprisonment of not less
than one month, but not more than six months, or both such fine and imprisonment, at
the discretion of the proper court.

The Professional Regulation Commission shall include any violation of this Act as a
basis for suspension or revocation of the license to practice the profession.

The Civil Service Commission shall include any violation of this Act as a basis for
suspension or revocation have the authority to suspend or revoke the civil service
eligibility of a public servant who is in violation of this Act.

If the offense is committed by a public or private health facility, institution, agency,
corporation, school, or other juridical entity duly organized in accordance with law, the
chief executive officer, president, general manager, or such other officer in charge shall
be liable for the commission of the offense. Such offense shall be penalized by
cancellation of the facility's business permit and license to operate.

SECTION 11. Appropriations. - The DOH shall include in its program the
implementation of this Act, the funding of which shall be included in the annual General
Appropriations Act.

SECTION 12. Implementing Rules and Regulations. - The DOH shall issue
Implementing Rules and Regulations for this Act within one hundred and twenty (120)
days after the approval of this Act.

SECTION 13. Separability Clause. — If any part, section or provision of this Act is held
invalid or unconstitutional, other provisions not affected thereby shall remain in full force
and effect.

SECTION 14, Repealing Clause. — Act No. 3573 is hereby repealed. Alll laws, decrees,
orders, issuances and rules and regulations or parts thereof, inconsistent with the
provisions of this Act are hereby repealed or modified accordingly.

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SECTION 15. Effectivity. - This Act shall take effect fifteen (15) days after its publication
in the Official Gazette or in a newspaper of general circulation.

Approved,