Other than increasing PhilHealth funding, advocacy for increased TB budget will be undertaken at the national, regional and local levels. There will be two approaches for this. First, the capacity of key affected population (KAP) groups and civil society organizations (CSOs) to advocate shall be developed. This is discussed in more detail below. Second, to provide a venue for both civil society participation and multisectoral collaboration, coordinating committees shall be established at the national, regional and local levels. At the national level, the TB National Coordinating Committee (NCC) established in 2019 is a model that hopes to foster multisectoral accountability for TB elimination efforts. It is composed of various government agencies, private sector representatives, academia, development partners and KAP. Similar structures shall be established, including regional coordinating committees (RCCs) and provincial coordinating committees (PCCs). At the LGU level, advocacy will be directed towards securing counterpart budgets to support TB drugs and laboratory commodities. Participation of the private sector in the local coordinating committee shall also be advocated. The need to advocate for increased budgets for TB at the local level is timely due to the implementation of the Mandanas Ruling, wherein additional funds will be reallocated to LGUs. Given the prospective rise in LGU budgets, efforts should be in place to ensure that allocation for health and for TB is also proportionately increasing. Advocating for increased budgets will also require improvements in fund disbursement given the shift to a cash-based budgeting system. To ensure this, procurement processes will be streamlined and enhanced stock monitoring at all levels will be practiced. Finally, one of the specific agenda points at the national level is to utilize the multiyear obligation agreement (MYOA) framework for TB budgeting wherein up to three years of budget commitments can be secured. This will help ensure that the DOH commitment to funding the updated PhilSTEP1 is met.
Key milestones ➢ MYOA for TB budget 2021–2023 (2020) ➢ Establish NCC, RCCs (17) and PCCs for multisectoral accountability (2021) ➢ LGUs providing budgets for TB drugs and laboratory commodities, e.g. cartridge (2021–2023) ➢ PhilHealth benefit package includes screening by chest X-ray, TB rapid diagnostic test, notification by private practitioners, DS-TB and DR-TB drugs and TB preventive treatment (2023)
2. Adequate and competent human resource One of the challenges in implementing PhilSTEP1, with its enormous scale, is the presence of adequate and competent human resources. Currently, more than 775 health workers are supported by the Global Fund, with 88% in service delivery points and the rest in program management offices, according to the HRH2030 project report on GF HR Sustainability in 2019. An human resources analysis and sustainability plan has been developed, but it needs to be included in the HRH Masterplan of the Health Sector, which will be developed in line with UHC provisions. While the above is ongoing, advocacy and multisectoral accountability should be directed towards increasing the number of health workers based on an appraisal of required
HEALTH SYSTEMS AND CROSS-CUTTING INTERVENTIONS
23
