Diana Alcantara-Payawal, MD, MSc, FPCP, FPSG, FPSDE

President , Hepatology Society of the Philippines

Executive Council, Asian Pacific Study of the Liver

Breaking Barriers in Hepatitis Vaccination, Liver

Cancer Prevention

FUNDING RESOURCESWays and Means

EDUCATIONContinuing

medical education

Training program

Public health education

ResearchResearch education

and trainingPJG

Government policyGlobal network

We are the lead national organization committed to the study of the liver in health and in disease involved in research, education, advocacy and formulation of health policies and in partnership with the global community

membership

membership

HSP Strategic Focus

Supporting change through

policy development:

• Advocacy – an independent

voice to

– Call for better responses to viral hepatitis

across the region

– Work in partnership with other

stakeholders, civil society and

governments

• Education - knowledge

– Build advocacy and policy knowledge and

capacity at local levels

– Support local advocates with tools to help

their advocacy

• Policy Development –

evidence

– Conduct research to address knowledge

and data gaps

– Generate knowledge to inform the

development of hepatitis related public

policy

5/02/2014

To reduce the

significant health, social

and economic burden of

Liver diseases in

the Philippines

Major Stakeholder - WHO

• World Health Assembly Resolution WHA63.R18 – May 2010

• WHO Implementation Strategy – made public October 2011

• WHO Framework for Global Action released December 2012

• HSP’s Strategic Plan closely aligned

5/02/2014 4

Private Public Partnership Approach

WHO Strategic

Axis

1. Partnership,

mobilization &

communication

2. Data for policy

and action

3. Prevention of

transmission

4. Screening, care

and treatment

HSP strategic plan:

FOCUS ON POLICY

LEVERS:

1. Advocacy

2. Education &

Capacity Building

3. Policy Development

5

Coordination with national government and private firms

The 4 Axes in the

WHO Framework for

Action

Raising awareness, promoting

partnerships and mobilizing

resources

Evidence-based policy and data for

action

Prevention of transmission

Screening, care and treatment

Axis 1: Raising Awareness, Promoting

Partnerships and Mobilising Resources

Partnership,

mobilization

and

communication

Network of

collaborating

centres

Civil society

collaborations

Resource

mobilization

strategy

External

communication

strategy

Strengthening World

Hepatitis Day activity

Hep B and C

Screening

Fly ABalloon

Lay Fora

– Ensuring that communities understand and support hepatitis related activities

– Developing partnerships between clinical, patient, communities

– Sustainable resourcing/funding for hepatitis related activity.

Vaccination Project in cooperation with

Rotary Club at Juan Luna Elem. School

Axis 2: Evidence-Based Policy and Data for Action

Disease burden

estimates

Impact

assessment

tools

Surveillance and

outbreak

investigation

standards

Country profiles

Research agenda

*

Data for

policy and

action

Axis 2 - Data for Policy and Action

– What data is available?

– What are the gaps in data?

– Is this data accessible to everyone with a stake in hepatitis?

– Is the data written in ways that people can understand and use?

• Tap into available

data banks

• Establish

surveillance systems

• Cost-benefit systems

• 2 014 HSP

consensus guideline

for Hepatitis B and C

Axis 3: Prevention of Transmission

Guidance and tools for immunization for A, B

Safe health care standards and tools

Harm reduction tools for injection drug users

Safe food and water strategies

Safe sexual practice guidance

Prevention

of

transmission

Axis 3 - Prevention of Transmission

– While vaccination programs are implemented, where are there gaps?

– Are there barriers to needle and syringe programs? Does stigma affect access?

– Is there a national infection control policy?

Despite Republic Act 10152 (An Act Providing for Mandatory Basic Immunization Services for Infants and Children:• timely birth dose coverage in the

Philippines was only 40%.• no catch-up program for unimmunized

children beyond the age of 24 months• only 57% and 70% of preterm neonates

and low-birth weight neonates were vaccinated.

Republic Act 7719 National Blood services Act of 1994, was enacted to encourage voluntary blood donation, upgrade blood donation services and facilities, and phase out commercial blood banks to prevent blood contamination.• vigilant surveillance is still necessary

There are up to 18,000 injecting drug users : high risk of needle sharing/ solution

Axis 4: Screening, Care and Treatment

Screening and

counseling resource

package

Diagnostic standards

Care and treatment

guidelines for B andC

Training package for

health care providers

Equity in access to

treatment and drugs

Screening, care and treatment

Axis 4 - Screening, Care and Treatment

– Are there barriers to testing? Payment? Confidentiality?

– Is there accessible health promotion information for people with hepatitis?

– Treatment - Funding? Limits on funding?

– What barriers are there to people accessing treatment?

• limited up-to-date information on the national prevalence of hepatitis B and C, as well as its prevalence in vulnerable groups.

• Screening is currently not covered by thePhilHealth. Stigma towards these infections prevents at-risk individuals from getting screened.

• Hepatitis B and C is undertreated in the Philippines, mostly because of the advanced stage of disease upon diagnosis, and the high cost of treatment.

• Policies against employment and workplace discrimination are inadequately implemented either because many employers are not aware of the Department Of Labor and Employment (DOLE) Department Advisory No. 05 (Series of 2010) or because of the lack of punitive action on violators.

Barrier

LACK OF RESOURCES

LACK OF PUBLIC

AWARENESSS

LACK OF PROVIDER

AWARENESS

Cross-

government

approach with

industry

support

•Carefully crafted

messages based

on what people

wanted/needed to

hear

•Policy report

galvanised political

will

THE GREAT WALL