Abstract Background Timely, accurate tuberculosis (TB) diagnostics and strong laboratory networks are critical for providing high-quality TB care. In the Western Pacific Region, available resources, TB burdens, and access to TB testing vary dramatically between countries. To understand the current regional situation, we described TB diagnostic test availability and laboratory services in seven countries with high TB burdens in the Western Pacific Region: Main text In 2024, World Health Organization’s (WHO) Western Pacific Regional Office conducted an assessment of TB diagnostic test availability and laboratory services in seven countries with high TB burdens: Cambodia, China, Lao People’s Democratic Republic, Mongolia, Philippines, Papua New Guinea, and Viet Nam. Standardised surveys were sent to members of country national tuberculosis programmes, and follow-up interviews were conducted. An in-person workshop was attended where preliminary findings were presented and updated, if necessary. The exercise revealed a high uptake of WHO-endorsed rapid molecular tests for TB detection, although the use of smear microscopy persists in most countries’ remote areas. Regarding drug susceptibility testing, both molecular and phenotypic methods are employed. Testing for first-line TB drug resistance is generally available, but currently, testing capacity for new and re-purposed drugs remains limited. Most countries provide TB testing at district-level facilities in conjunction with well-established specimen transport networks, with laboratories utilising a mix of paper and electronic databases. Comprehensive TB and drug-resistance testing at peripheral settings remains a rarity. Conclusions The Western Pacific Region has invested significantly in TB testing and laboratory services. To ensure everyone in the region has access to TB diagnostics, these efforts must be maintained.
Availability and access to quality laboratory diagnostics at the primary healthcare (PHC) level are critical to achieving universal health coverage. However, significant access disparities still exist. This evaluation aimed to understand the current laboratory capacity and infrastructure for communicable diseases testing at the PHC level and identify systemic challenges affecting access. This evaluation was conducted in eight low-middle-income countries (Cambodia, China, Lao PDR, Malaysia, Mongolia, PNG, Philippines, and Solomon Islands) in the WHO Western Pacific Region. Data were collected by reviewing existing WHO and country-level policies, guidelines, and reports on laboratory services for communicable diseases at the PHC level, as well as virtual interviews with participants at various levels of healthcare. Most countries are progressing well towards improving laboratory access at all levels. Activities contributing to improved access include point-of-care testing, integrated sample transport systems to facilitate referral of samples, community engagement, and efforts towards combating stigma and discrimination. Vertical disease programs supported by development partners bridge the funding and capacity gaps for several high-priority public health problems, but these support streams are dynamic and often diminishing. The systemic challenges identified were categorized into three thematic areas: (1) weaknesses in primary healthcare systems; (2) limited community and individual engagement; and (3) persistent socio-economic barriers. Potential solutions and recommendations should include a stepwise approach customized for each country’s context in collaboration with all stakeholders. Despite the progress already achieved, most countries in the region still face significant challenges in improving access to essential laboratory services for communicable diseases at the PHC level.
This report describes how the Philippines used the World Health Organization’s intra-action review methodology to assess progress in the country’s response to the mpox public health emergency of international concern. It describes the methodology used, the focus areas of the review, and recommendations resulting from the intra-action review.
OBJECTIVES:Tuberculosis (TB) is the leading cause of death from an infectious disease, with the Western Pacific (WPR) and South-East Asia (SEAR) regions accounting for almost two-thirds of the global burden. Despite TB being a major cause of maternal mortality and adverse neonatal outcomes, no consensus exists on routine pregnancy-related data collection in national TB programmes (NTPs). This study aimed to map current practices, priorities, and perspectives regarding pregnancy data collection in TB surveillance across WPR and SEAR. STUDY DESIGN:We conducted a cross-sectional, mixed-methods survey of NTPs across WPR and SEAR. METHODS:The survey assessed the landscape of pregnancy data collection, including existing and recommended practices, perceived importance and impact, barriers, and resource needs. Prioritization of indicators was evaluated using 5-point Likert scales. Quantitative data were analysed as categorical variables, and qualitative responses were thematically analysed. RESULTS:Of 47 countries/territories invited, 31 (66.0%) responded: 26 from WPR (26/36; 72.2%) and five from SEAR (5/11; 45.5%). Seven (22.6%) routinely collect pregnancy status in TB surveillance. Indicators most recommended were pregnancy/postpartum status at TB diagnosis (80.6%) and TB treatment (61.3%), as well as pregnancy (61.3%), neonatal (61.3%), and maternal outcomes (61.3%). Perceived importance of pregnancy data collection was high (median 4, IQR 3-5), as was anticipated impact on policy change (median 4, IQR 3-4). Key barriers identified included absence of international guidelines, insufficient training, and resource constraints. CONCLUSIONS:Despite broad recognition of its importance, routine collection of pregnancy-related data in TB surveillance remains uncommon. Addressing barriers through development of international guidelines, targeted training, and strengthened health information systems could better quantify the burden of TB in pregnant and postpartum women and drive solutions to improve maternal and neonatal outcomes.
Although the socioeconomic gradients of health are widely documented, little is known about the extent and drivers of education-related inequalities in health status among older adults in the Philippines, a lower-middle income country transitioning to an ageing society. This is the first study to decompose the contribution of social determinants of health (SDH) to inequalities in health among lower- and higher-educated older Filipinos. Using nationally representative survey data on 5,209 Filipinos aged 60 + from the 2019 Longitudinal Study of Ageing and Health in the Philippines, Oaxaca-Blinder decomposition analysis is performed based on linear models of self-rated health, functional limitation, and depressive symptoms. There are substantial gaps in older Filipinos’ health outcomes across education groups, and SDH explain more than half of the gap in self-rated health and depressive symptoms. Health systems factors—primarily distance to health facility and unmet healthcare needs—account for 21
