Celebrating 30 years of Leadership in Field Epidemiology

The Philippine government through the Department of Health (DOH) is ramping-up the implementation phase of the COVID-19 vaccination program. Currently, the country has received 77,410,640 doses of seven (7) different brands of vaccines with the goal of inoculating the target population of 77,139,058 at the end of 2021. As of November 2021, the coverage rate of fully vaccinated individuals in the country is at 28.51%.

The DOH-led NVOC together with the Department of Information and Communications Technology (DICT), Department of Interior and Local Government (DILG), Food and Drug Authority (FDA), Armed Forces of the Philippines (AFP), Presidential Communications Operations Office (PCOO), Philippine National Police (PNP) and the National Task Force (NTF) Against COVID-19 has started its operations since 1 February 2021 with the active support of WHO, UNICEF and private sector.

As the complexities of vaccine roll-out relies heavily on coordination of different levels of governance and reporting, it is essential that NVOC strengthen its current capacity to provide technical assistance in the field and efficient data management including end to end inventory of vaccines for timely provision of analysis to decision-makers and implementers.

In January 2022, the World Health Organization (WHO) Philippines engaged the Field Epidemiology Training Program Alumni Foundation, Inc. (FETPAFI) under an Agreement for Performance of Work (APW) contract to provide technical assistance in strengthening the operations of the National Vaccination Operations Center (NVOC) for COVID-19 vaccines in the regional and national level.

For the next 6 months, FETPAFI will gather the manpower to provide needed data management and technical support in strategic areas/offices of the DOH specifically at the Field Implementation and Coordination Teams (FICT) and Supply Chain Management Service (SCMS) to comply with the objectives of the vaccination roll-out, through the recruitment, training and supervision of field coordinators in Luzon, Visayas and Mindanao, and data managers/analysts in NVOC and SCMS.

Determining the Prevalence and Behavioral Factors of HIV and STI in the Philippines through the conduct of the Integrated HIV Behavioral and Serologic Surveillance (IHBSS)

The IHBSS is a study primarily conducted by the Epidemiology Bureau that aims to determine the prevalence of HIV-AIDS and STD in the country, and to better understand behavioral factors that lead to such prevalence. The 2018 IHBSS is the seventh round of the surveillance, whose implementation has been granted to the non-government organization, the Field Epidemiology Training Program Alumni Foundation, Inc. (FETPAFI).

FETPAFIis tasked to handle the administrative and field operation aspects of the project, in partnership with the Epidemiology Bureau, the STI/AIDS Cooperative Central Laboratory (SACCL), and the Philippine National AIDS Council (PNAC) of the Department of Health (DOH). The project fund is managed by the Philippine Council for Health Research and Development of the Department of Science and Technology (PCHRD-DOST) under the Advancing Health through Evidence-Assisted Decisions with Health Policy and Systems Research (AHEAD-HPSR) program.

The 2018 IHBSS (Year 1) was conducted between April 2018 to April 2019, across 13 sentinel sites, including the cities of Angeles, Baguio, Cagayan De Oro, Cebu, Davao, General Santos, Iloilo, Mandaue, Pasay, Quezon, Taguig, Talisay (Cebu) and Zamboanga covering both males who have sex with males (MSM) and transgender women (TGW) using time location sampling (TLS). The IHBSS among female sex workers (FSW) was done within the 10 of the 13 sentinel sites (excluding Taguig City, Mandaue City and Talisay City) using systematic sampling.

The 2018 IHBSS (Year 2), April 2019 – June 2021 focused on the analysis and interpretation of the 7^th IHBSS round and conduct of Formative Assessments among key population. The activities comprised of dissemination activities (i.e. CAPE, Community Engagement, Data Dissemination and Utilization), AIDS Epidemic Modeling (AEM) workshops and consultative meetings, exploratory study on the risks and barriers to service uptake among WLHIV and online survey among males and  transgender women who have sex with males.

The 2018 IHBSS also considered the need to measure emerging risk behaviors among key population groups (i.e. chemsex), changes in social and sexual networks (i.e. online/social media networks), and innovations in HIV strategies for prevention and testing (i.e. condom access points, community-based HIV screening [CBS], etc.).

The next round of the IHBSS will be in 2022.

For more details about the methodology, results, key findings and recommendation of the 2018 IHBSS, please refer the technical report found in the Resources/ Reports tab.

Rabies, a horrific but preventable disease, kills over 200 people annually in the Philippines. The National Rabies Prevention and Control Program in the Philippines has catalysed control efforts with some provinces now aiming to declare freedom from rabies. However, outbreaks continue and human deaths still occur. While access to lifesaving post-exposure prophylaxis (PEP) for rabid bite victims has improved and has reduced mortality, it has proven expensive. Rising PEP use has put a strain on local and national budgets, even as rabies circulation has declined, raising the question of how these efforts can be sustained. Meanwhile, routine rabies surveillance in the Philippines has shortcomings and is not sufficiently sensitive for international agencies to recognize rabies-free areas or to rapidly respond to incursions which remain a risk while rabies circulates in other provinces in the country. As a result, surveillance needs strengthening and use of PEP needs rationalizing for the Philippines to fully benefit from rabies control measures that are currently underway. 

Integrated Bite Case Management (IBCM) has been identified as a potential strategy that can sufficiently enhance surveillance to enable verification of rabies freedom and rapid detection of incursions for effective outbreak responses to maintain rabies freedom. Operationalizing IBCM as a key component of enhanced surveillance should have immediately beneficial applications within the Philippines and could more broadly benefit the global campaign to eliminate human rabies deaths by 2030. SPEEDIER`s aim is to deliver a cost-effective, epidemiologically robust, enhanced surveillance and response package to guide and sustain the elimination of rabies from the Philippines. 

Specific objectives are to: 

1. Assess the impact of IBCM on increasing case detection of rabies and thereby enabling rapid and effective outbreak responses to maintain rabies freedom;
2. Assess the potential for IBCM to improve patient care, by identifying and treating persons bitten by suspect rabid dogs who would otherwise be overlooked by the health system; 
3. Assess the impact of judicious protocols for administration of rabies PEP and therefore the potential for generating cost savings
4. Determine whether IBCM and judicious PEP can be implemented as intended in different local contexts, identifying facilitators and barriers to successful implementation and sustainable roll out;
5. Develop best practices for delivering enhanced surveillance to support rabies elimination, bridging research to policy and implementation;
6. Develop decision support tools and guidance for risk assessment, outbreak response and maintaining rabies freedom in the Philippines.

The study design comprises a feasibility study followed by an implementation study of IBCM with the active advocacy for rationalized use of PEP in the low socio-economic class provinces of Romblon and Oriental Mindoro, that include geographically isolated and disadvantaged communities. Through this implementation research we will develop best practice for an enhanced surveillance approach using IBCM as a strategy to detect rabid animals, with risk assessment of bite patients triggering epidemiological investigations and informing PEP use.

Strengthening of ASEAN Preparedness and Response to Biological Threats.

In the past 20 years, the world has been scourged by emerging and reemerging infectious diseases, diseases that are public health emergencies of international concern. The Philippines has had its share of outbreaks, including SARS (2003), Ebola Reston in nonhuman primates and pigs (2008), pandemic influenza A(H1N1) in 2009, MERS (2014), Zika (2016) and vaccine preventable diseases such as measles, dengue and poliomyelitis. The key to mitigation of the devastating effects is a preparedness plan with an evidence- based program to predict possible outbreaks.

In 2014, to enhance ASEAN risk assessment capability to track and detect emerging infectious diseases and other relevant potential threats through the use of Biodiaspora, a project was launched with the Philippines as the lead country. The ASEAN Biodiaspora Program is a real-time web-based risk assessment tool, linking multiple datasets. The objective is to build regional capacity in data analytics, visualization and communication that strengthen ASEAN’s epidemic and pandemic preparedness and response capabilities to naturally occurring or man- made biological threats.

In 2 years, the ASEAN Biodiaspora project aims to reach this goal through four main strategies:

1. Establish Regional Virtual Center for Biodiaspora
2. Strengthen the network of existing national and regional (ASEAN) capacity for big data analytics and visualization
3. Continuous development and maintenance of the system
4. Establish a policy framework for project sustainability

Technical Assistance to Support the Implementation of Health Resources Availability Monitoring Systems (HeRAMS) in Mindanao during COVID-19 Response

The Health Resources and Services Availability Monitoring System (HeRAMS) is an online platform that aims to provide decision-makers and health sector actors with critical and up-to-date information on the availability of essential health resources and services at the different levels of the health system. It promotes standardization across the health sector response from both a resource- and a policy- point of view, and contributes towards improving intra- and intersectoral collaboration. Dubbed as a “surveillance system of health systems”, it has been successfully deployed in developing countries such as Yemen. The overall goal of the project is to activate HeRAMS as part of the COVID-19 response in Mindanao, Philippines to support the monitoring of health resources and services and ensure their continuity throughout health emergencies such as the pandemic.

From November 2020 to August 2021, FETPAFI is tasked to build and strengthen the capacity of the rural health units (RHUs) and hospitals and infirmaries (HAIs) in the six regions comprising Mindanao in monitoring health resources and services availability through the HeRAMS platform and to establish HeRAMS baseline data from the trained RHUs and HAIs.

For more information about the HeRAMS Platform, you may visit the official website:

https://www.herams.org