In this photo taken on January 18, 2024, Dr. Irene Flores, clinical head, shows the comparison between a BPaL regimen for the drug resistant tuberculosis (L) and the current regimen treatment for tuberculosis (R), at a hospital in San Fernando, Pampanga.
MANILA, Philippines — Tuberculosis patients are facing treatment delays and interruptions as public health centers run short of anti-TB medicines.
Disruptions in government purchases of TB medicines have affected the supply chain since late 2023, according to medical groups and health professionals. Repeated failed bidding processes contributed to shortages, and the government had projected that national stocks of first-line TB medicines could run out beginning in April 2026.
The impact has varied by area. Some health facilities still had older stocks, while others were able to buy emergency supplies locally.
Health advocates and community workers said patients in areas with shortages have been forced to buy medicines themselves, look for supplies elsewhere or interrupt treatment.
The problem is especially serious in the Philippines, which has the third-highest share of the global TB burden, according to the World Health Organization’s 2025 Global Tuberculosis Report.
In 2024, the Philippines accounted for 6.8% of TB cases worldwide, with an estimated 625 people developing TB for every 100,000 population.
Treatment interruptions
When public health centers run out of TB medicines, newly diagnosed patients face delays in starting treatment, while those already undergoing therapy risk interruptions in their prescribed regimen, according to health professionals and community workers interviewed for this story.
Dr. Emmanuel Gutierrez of the TB HIV Innovations and Clinical Research Foundation emphasized the importance of completing the prescribed treatment regimen.
“Kapag hindi nila nainom nang maayos or hindi nila natapos ‘yung gamutan, pwedeng bumalik ‘yung TB,” Gutierrez said in a June interview with Probe Productions.
(If they do not take their medicines properly or fail to finish the treatment, the TB can return.)
In this photo taken on March 14, 2024, a medical worker readies the sputum sample for storage during a tuberculosis screening at a health centre in Valenzuela. AFP / Jam Sta Rosa
Stopping TB medicines prematurely or taking them improperly can allow the bacteria to develop resistance to standard antibiotics, making the disease more difficult to treat, the doctor explained.
He said treatment interruptions therefore pose risks not only to patients but also to broader efforts to control TB transmission.
“Kapag ang isang pasyente ay nakakahawa, kaya niyang makapanghawa ng 10 or more na pasyente, isang kaso lang ‘yun. ‘Yun po ‘yung dahilan din kung bakit natin ginagamot ang TB ng anim na buwan,” Gutierrez said.
(When a patient is infectious, a single case can infect 10 or more people. That is also one reason why we treat TB for six months.)
Citing WHO data, Gutierrez said the country also faces a substantial burden of drug-resistant TB, making continuous and proper treatment critical.
For Florita Danida, a registered nurse and founder of the community-based patient support group TB HEALS, delayed or interrupted treatment can also mean patients remain infectious for longer.
“Kaya po ‘yung mga pasyente natin na may TB, tuwing sila ay magsalita, uubo, babahing, kakanta or maghihikab or in short, basta may lumabas na hangin galing sa kanilang baga, pwede silang makapagkalat ng TB bacteria,” Danida said in a separate Probe interview.
(That is why when our TB patients speak, cough, sneeze, sing or yawn, they can potentially spread TB bacteria through the air.)
Patients shoulder costs
TB medicines are provided free through government health facilities, but health workers said supply gaps can force some patients to buy the medicines themselves.
Romeo Christopher Valenzuela, a health worker in Tondo, Manila, said some patients arrive at health centers only to be told that medicines are unavailable.
In this photo taken on March 14, 2024, a medical worker uses an ultraportable x-ray machine on a woman during a tuberculosis screening at a health centre in Valenzuela. AFP / Jam Sta Rosa
“Paano na lang ‘yung mga walang pambili?” he added. (What about those who cannot afford to buy them?)
Danida recounted a similar case involving a patient from a private facility who was referred to a government health center for free TB medicines, only to find that there was no available supply.
“Kaya po ang ating mga pasyente, pagka gano’ng sitwasyon, na-delay ang start or umpisa ng kanilang mga gamutan. ‘Yung iba naman ay napuputol ang kanilang pag-inom ng gamot,” Danida said. (That is why, in those situations, our patients experience delays in starting treatment. Others have their treatment interrupted.)
Procurement hold raises new concerns
In this photo taken on March 14, 2024, a medical worker shows an x-ray result during a tuberculosis screening at a health centre in Valenzuela. AFP / Jam Sta Rosa
Against this backdrop, health advocates have warned that Department of Health’s July 24 order to freeze P3.225 billion in planned 2026 TB commodity purchases could prolong or worsen the existing shortages.
Then-Health Secretary Jose Pujalte Jr. said he temporarily stopped the procurement to review the proposed purchases. He said the review was meant to check the quantity, quality and safety of the medicines, ensure that procurement rules were followed and prevent waste or misuse of public funds.
Pujalte denied deliberately delaying the procurement.
Health advocates challenged the decision and filed a complaint against him before the Office of the Ombudsman on August 6. They asked the anti-graft body to investigate Pujalte and place him under preventive suspension while the allegations were being examined.
Days later, President Ferdinand Marcos Jr. appointed Edwin Mercado as health secretary on August 10, replacing Pujalte, who stepped down for what Malacañang described as “health reasons.”
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This report was made in partnership with Probe Productions and Tsek.PH, the first fact-checking and anti-disinformation network in the Philippines.