The Philippines case study

Most TB patients in the Philippines are treated by private practitioners who do not conform to the international standard of TB care.1 We established a private-public mix DOTS (PPMD) centre to engage private physicians in the DOTS strategy.2 The cure rate in new cases was 83.9% and failure was 0.01%, with corresponding rates in previously treated cases of 58.6% and 39.7%, respectively. All isolates from the treatment failures were MDR-TB, indicating failure of previous TB treatment outside DOTS. As a DOTS-Plus pilot project, the Green Light Committee (GLC) of the working group on multidrug-resistant TB provided this PPMD access to second-line anti-TB drugs (SLDs) and technical assistance. Our experience illustrates the challenges in MDR-TB management.