PCHRD Executive Director Jaime C. Montoya emphasizes the need for TB research

“TB research can be a powerful advocacy tool,” said Dr. Jaime C. Montoya, Executive Director of the Philippine Council for Health Research and Development (PCHRD) in the recent national health research forum of the University of the Philippines Manila – National Institutes of Health (UPM-NIH) last February 23, 2012.

 

 

Tuberculosis (TB) is the sixth leading cause of mortality in the country with 33 deaths per 100,000 population (Philippine Health Statistics 2003). TB is also ranked sixth in terms of morbidity with 137 cases per 100,000 population (Field Health Service Information System 2005).

 

 

Philippines ranks ninth among the 22 high burden countries in the world in 2009, from a previous 8th in 2003 and 7th in 2000.  In the Western Pacific region, the country ranks third from a previous second in 2003 (WHO Report 2007 & 2009).

 

 

How does TB research help in advocacy?

 

 

“TB Research can encompass any gathering of data or information, or use of scientific or analytical tools to inform advocacy efforts or inform policy deliberations,” said Dr. Montoya.

 

 

Two of the global TB research gaps identified include the need for new and effective drugs, diagnostics and vaccines to improve case detection and treatment of TB and the need to arm TB-affected individuals with appropriate knowledge on TB to reduce stigma and discrimination.

 

 

“In the Philippine National Health Research System (PNHRS), we make sure that TB control is integrated in the priorities of the National Unified Health Research Agenda (NUHRA),” Dr. Montoya stressed.

 

 

NUHRA specifies the areas and topics that need to be addressed in the next five years in line with global and national initiatives influencing the health sector. It serves as a guide for the health research community on the research studies that should be undertaken to address the health needs of the Filipinos.

 

 

Dr. Montoya shared that in the area of TB research, there are consultative meetings spearheaded by the Philippine Coalition Against Tuberculosis (PhilCAT) in 2008 and they came up with a list of priorities for TB prevention and control. Areas of TB research covers the whole continuum from fundamental or basic research to operational research.

 

 

From the gaps identified, Dr. Montoya proposed action points to advocate for TB research: 1) develop a coherent and comprehensive research roadmap towards TB elimination; 2) engage in more research collaborations on TB to accelerate the generation of new knowledge and new tools for TB prevention and control; and 3) mobilize resources and support for TB research.

Dr. Jaime C. Montoya, Executive Director of the Philippine Council for Health Research and Development of the Department of Science and Technology (PCHRD-DOST) acknowledged the need to step up and intensify collaborations and partnerships to combat cancer during the symposium “Global Call to Action: Public-Private Partnership of Cancer Care and Control” at the Diamond Hotel, Manila last February 3, 2012.

“Like any health problem, I believe solutions to the Big C will come from multisectoral cooperation – from prevention, detection, diagnosis, treatment, research to policymaking. The Global Call to Action is precisely what we need to accelerate research efforts so that Filipinos will have access to the best quality health care for the diagnosis, prevention and control of cancer,” Dr. Montoya said.

 

The Philippine Council for Health Research and Development (PCHRD) is a forward-looking, partnership-based national body responsible for coordinating all health research activities in the country. The core strategy of the Council is public-private partnership.

For instance, “In the area of research, we take cues from the ongoing work of the Union for International Cancer Control (UICC) and its member organizations. The group’s work has contributed substantially to what we now know in detection, prevention and treatment measures. We can tap from this reservoir of knowledge through collaboration and twinning arrangements. If we can organize our institutions in like manner and undertake joint research, we can certainly find solutions to stop the rise in new cancer cases in the country,” said Dr. Montoya.

 

Over the years, PCHRD has funded a number of research projects focused on identification of genetic predisposition to the leading forms of cancer in the country. It supported the University of the Philippines Manila - National Institutes of Health (UPM-NIH) on its researches on identification and analysis of genetic polymorphisms associated with certain forms of cancer like breast, lung and cervical cancer in high risk populations in the Philippines.  PCHRD also funds the ongoing Antibody Biotechnology and Molecular Oncology Research Program or AMOR 2 of the University of the Philippines Diliman (UP Diliman), a continuation research which aims to improve the low yields of antibody produced in AMOR 1 through the use of better culture vessels.

The Council recognized that availability of equipment and facilities is critical to encourage research and development in this field. Thus, support for the provision of equipment was given to research institutions like the UPM-NIH and UP Diliman.

“We have already installed a microarray facility at the National Institutes of Health which will enable us to screen populations or samples for specific genetic identifiers using microchip technology in record time.  We have also equipped the Science complex in UP Diliman with a Nuclear Magnet Resonance (NMR) which is critical in the study of arrangement and composition of protein molecules which may be targets for cancer diagnosis or therapy,” reported Dr. Montoya.

Dr. Montoya hopes to achieve more in the fight against cancer by intensifying public-private partnership.

“I believe we can do a whole lot more, if we have more partners and collaborators who will work with us. By working together, we can defeat cancer,” Dr. Montoya concluded.

The forum is a prelude to the nation’s observance of the World Cancer Day and a venue for the signing of the World Cancer Declaration. It was organized by the University of the Philippines Manila-Philippine General Hospital, Chevron Geothermal Philippines Holdings, Inc. and the Cancer Institute Foundation.

BIHC-DOH Director Maylene Beltran tackles Global Fund for AIDS, TB and Malaria

In a scientific conference during the 14th National Institutes of Health (NIH) anniversary, Director Maylene M. Beltran of the Bureau of International Health Cooperation of the Department of Health (BIHC-DOH) and the Executive Secretary of the Philippine Country Coordinating Mechanisms (CCM) emphasized the importance of Global Fund (GF) initiative for AIDS, TB and Malaria (GFATM) to support the Kalusugan Pangkalahatan (KP) program of the Aquino administration.

“Where does GF fit into our national health goal Kalusugan Pangkalahatan? Among the health-related goals of the Millenium Development Goals (MDGs) incorporated to KP is to improve maternal and child health and to halt the spread of communicable diseases like AIDS, TB and Malaria,” said Ms. Beltran.

In the 2010 United Nations programme report on HIV/AIDS (UNAIDS), Ms. Beltran cited that the Philippines is one of only seven countries with 25% increase in HIV cases from 2001-2009 and an average of six (6) new HIV cases per day or one (1) in every four (4) hours is reported in the country. In 2011, 64% of registered HIV cases came from National Capital Region (54%).

The DOH National AIDS and STI Prevention and Control Program (NASPCP) covers the Most-at-Risk Populations (MARPS) which include the freelance sex workers (FSW), men having sex with men (MSM), male sex workers (MSW), and persons who inject drugs (PWID), with a total MARPS of 177,597.

She added that HIV transmission among persons who inject drugs (PWIDs) is rapidly increasing from just seven reported cases in the last 22 years (1984-2006) to 147 cases in 2010 alone.

Ms. Beltran stressed, “Nationwide, we need an estimated total investment of 18.4 billion pesos for 2011-2016. In a year, we need 1.6 billion just to be able to address the MARPS.”

Given these scenario, Ms. Beltran explained how GFATM would be a great help in addressing the country’s concerns on AIDS, TB and Malaria.

The Global Fund is a unique global public/private partnership dedicated to attracting and disbursing additional resources to prevent and treat HIV/AIDS, tuberculosis and malaria.  It is a financial mechanism to provide funds to critical interventions against the three diseases.

The Philippines is one of the 20 countries in East Asia and the Pacific availing of the global fund opportunity.

GFATM promotes partnership among stakeholders through the Country Coordinating Mechanisms (CCM). These country-level multi-stakeholder partnerships develop and submit grant proposals to the Global Fund based on priority needs at the national level. After grant approval, GF oversee progress during implementation.

CCM include representatives from both the public and private sectors, including governments, multilateral or bilateral agencies, non-governmental organizations, academic institutions, private businesses and people living with the diseases.

Ms. Beltran reported that in the Philippines, there are three principal recipients (PR) of the GF: The Pilipinas Shell Foundation – PR for Malaria grant; DOH – PR for HIV grant, and Philippine Business for Social Progress – PR for TB grant.

Representatives from government, non-government organizations, private and academic sectors gathered in a roundtable discussion entitled: “Strengthening the Science-Based Herbal Industry in the Philippines: Issues, Challenges and Solutions” organized by the National Academy of Science and Technology (NAST) last February 15, 2012 at the Traders Hotel in Manila.

Existing Initiatives

Dr. Francis Vicente S. Ras, Education and Promotion Officer V of the Philippine Institute for Traditional and Alternative Health Care (PITAHC) shared the efforts of the Institute in developing herbal products. PITAHC is a government program set up in 1997 by the Department of Health (DOH) to accelerate the development of traditional and alternative health care in the country. Today, PITAHC manages four herbal processing plants in Cagayan, Leyte, Cotabato and Davao which are able to produce marketable herbal products, namely: lagundi tablet and syrup for cough and asthma, sambong tablet as anti-urolithiasis, tsaang gubat tablet as anti-colic or anti-spasmodic and herbal soaps from akapulko, cucumber, raddish, kamias, calamansi, guava, carrot and papaya.

Dr. Jaime C. Montoya, Executive Director of the Philippine Council for Health Research and Development of the Department of Science and Technology (PCHRD-DOST) presented the government roadmap for the development of science-based herbal products for health and wellness. He said that part of PCHRD’s drug discovery and development program includes the utilization of natural substances from terrestrial and marine sources that can be developed up to the pre-clinical stage for common infectious diseases and lifestyle-related disorders.

Dr. Gemiliano D. Aligui, President of Asian Foundation for Tropical Medicine, Inc. discussed two existing administrative orders which refer to confidence and public trust on herbal products. The A.O 184 s2004 refers to guidelines on the registration of traditionally-used herbal products while A.O. 172 s2004 indicates guidelines on the registration of herbal medicines. The A.O 184 s2004 limits the folkloric use of herbal medicines because this law requires manufacturers to state in the label any of the following statements applicable: 1) “The Traditional application/use of this product has not been evaluated by the Philippine Food & Drugs Administration”; 2) “If symptoms persist, consult your doctor”; or 3) “Not allowed for use in pregnant, lactating mothers, and children below 18 years.” On the other hand, the A.O. 172 s2004 establishes the clinical efficacy of herbal medicine because it subjects the manufacturer to report findings of the study from Galenical (Phase I) up to clinical trials (Phase III) of the herbal drugs prior to public use. It further states that herbal drugs should be validated by the National Integrated Research Program on Medicinal Plants (NIRPROMP) of the PCHRD-DOST or other competent research centers accredited and approved by the Philippine Food and Drug Administration (FDA).

Identified Challenges

Dr. Rainier B. Villanueva, Founding President of the Chamber of Herbal Industries of the Philippines, Inc. reported the issues and challenges of the natural product industry from the perspective of industry and the private sector. According to him, the herbal industry is confronting the following challenges: (1) lack of scientific claims to support product claims; (2) outdated policies of FDA on product registration; (3) no standardization of natural ingredients; (4) unscrupulous businessmen taking advantage of the popularity of natural and organic products by making claims at the expense of the consumers; (5) lack of integrated, inter-agency programs by the government to strengthen the industry like what China, Malaysia  and India are doing; (6) minimal implementation of good agricultural practices among the agriculture sector; (7) no clearing house or centralization of government-funded R&D studies; and (8) lack of laboratory dedicated to the natural product industry.

Dr. Lourdes B. Cardenas, faculty member of the Plant Biology Division of the University of the Philippines Los Banos (UPLB) tackled the issues relating to quality of raw materials for use in herbal products. According to her research, the following are needed to be subjected under quality control in order to address raw material and processing quality issues: (1) source material which refers to the correct variety, species, chemotype, ecotype, and part and stage development of the plant to be processed; (2) cultivation of the plant species; (3) post harvest handling; (4) storage (5) residues, heavy metals and microbial contamination; and (6) security of raw materials to radioactive isotopes.

Ms. Irene M. Villaseñor, faculty member of the Institute of Chemistry of the University of the Philippines Diliman identified the following issues on establishing quality parameters for herbal products: (1) patent protection; (2) data on chemical identity, purity and consistency; (3) information related to absorption, distribution, metabolism and elimination of drug metabolites; and (4) chemical standardization.

 

 

Proposed Solutions

Stakeholders came up with the following possible interventions to address the identified challenges and improve existing initiatives: 1) partnership among research institutes and organizations to generate more scientific evidences to substantiate and validate claims of natural products and ingredients; 2) technology transfer for sustainable organic farming and propagation; 3) acquisition and use of appropriate equipment and machinery to boost industry capacities; 4) provision of assistance to institutions in attaining various certifications accepted and recognized by international market; 5) investments in the development of natural products and ingredients industries; 6) promotion and distribution of  Philippine products in the foreign market through collaboration between Filipino and Filipino-foreign entrepreneurs and businessmen; 7) capacity building for experts in the field of Medicinal Chemistry; and 8) establishment of centralized facilities for R&D studies.

Liver care. (photo grabbed from fitness.com)

“People with chronic hepatitis B should make lifestyle choices that will help them live healthy,” said Dr. Eternity Labio, Gastroenterologist and Hepatologist during the General Assembly of the Yellow Warriors Society of the Philippines last 18 February 2012.

During her lecture, Dr. Labio emphasized the importance of having a healthy lifestyle among Hepatitis B patients to give their livers a break – a chance to heal, a chance to rebuild and a chance for new liver cells to grow.

Healthy lifestyle means avoiding bad habits that can directly affect the liver. This includes drinking alcohol, smoking and exposure to environmental pollutants such as fumes from paints and other aerosols.

The liver is the second largest organ of the body.  It plays a vital role in regulating life processes. It refines and detoxifies everything a person eats, breathes, and absorbs through the skin. It helps digest food and absorbs important nutrients, neutralizes and destroys poisonous substances and helps the body resist infections.

Hepatitis is an inflammation of the liver. Whenever the liver is inflamed or damaged, its functions are directly affected. “Thus, Hepatitis B patients must double the effort to stay healthy by avoiding everything that damages the liver. There is no special diet for chronic hepatitis B, but good nutrition in the form of a balanced diet may help liver cells to regenerate. Proper nutrition is an essential part of treatment,” explained Dr. Labio.

Meanwhile, the Hepatitis Foundation International warns Hepatitis B patients to be watchful on protein and calories intake. Too much daily protein may cause hepatic encephalopathy. This will occur when the amount of dietary protein is greater than the liver’s ability to use the protein. Excess calories in the form of carbohydrates, on the other hand, can also add liver dysfunctions and can cause fat deposits in the liver.

“With proper nutrition or balanced diet, regular exercises, enough rest, regular consultation with experts as well as good attitude and prayers – the burden of the disease will be alleviated, giving patients hope that life must go on,” said Dr. Labio.


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