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Dr diana payawal hb liver ca summit


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Dr. Diana Payawal
Hepatology Society of the Philippines

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Dr diana payawal hb liver ca summit

  1. 1. Breaking Barriers in Hepatitis Vaccination, Liver Cancer Prevention Diana Alcantara-Payawal, MD, MSc, FPCP, FPSG, FPSDE President , Hepatology Society of the Philippines Executive Council, Asian Pacific Study of the Liver
  2. 2. HSP Strategic Focus We are the lead national organization committed to the study of the liver in health and in disease involved in research, education, advocacy and formulation of health policies and in partnership with the global community membership EDUCATION Continuing medical membership education Government policy FUNDING RESOURCES Ways and Means Global network Research Research education and training PJG Training program Public health education
  3. 3. To reduce the significant health, social and economic burden of Liver diseases in the Philippines Supporting change through policy development: • Advocacy – an independent voice to – – • Call for better responses to viral hepatitis across the region Work in partnership with other stakeholders, civil society and governments Education - knowledge – – • Build advocacy and policy knowledge and capacity at local levels Support local advocates with tools to help their advocacy Policy Development – evidence – – 5/02/2014 Conduct research to address knowledge and data gaps Generate knowledge to inform the development of hepatitis related public policy
  4. 4. Major Stakeholder - WHO • World Health Assembly Resolution WHA63.R18 – May 2010 • WHO Implementation Strategy – made public October 2011 • WHO Framework for Global Action released December 2012 • HSP’s Strategic Plan closely aligned 5/02/2014 4
  5. 5. Private Public Partnership Approach WHO Strategic Axis 1. Partnership, mobilization & communication 2. Data for policy and action 3. 4. Prevention of transmission HSP strategic plan: FOCUS ON POLICY LEVERS: 1. Advocacy 2. Education & Capacity Building 3. Policy Development Screening, care and treatment Coordination with national government and private firms 5
  6. 6. The 4 Axes in the WHO Framework for Action Raising awareness, promoting partnerships and mobilizing resources Evidencebased policy and data for action Prevention of transmission Screening, care and treatment
  7. 7. Axis 1: Raising Awareness, Promoting Partnerships and Mobilising Resources Partnership, mobilization and communication Network of collaborating centres Civil society collaborations Resource mobilization strategy External communication strategy
  8. 8. Strengthening World Hepatitis Day activity Hep B and C Screening Fly A Balloon Lay Fora
  9. 9. Vaccination Project in cooperation with Rotary Club at Juan Luna Elem. School – Ensuring that communities understand and support hepatitis related activities – Developing partnerships between clinical, patient, communities – Sustainable resourcing/funding for hepatitis related activity.
  10. 10. Axis 2: Evidence-Based Policy and Data for Action Data for policy and action Disease burden estimates Impact assessment tools Surveillance and outbreak investigation standards Country profiles Research agenda *
  11. 11. Axis 2 - Data for Policy and Action – What data is • Tap into available available? data banks – What are the gaps • Establish surveillance systems in data? • Cost-benefit systems – Is this data accessible to everyone with a stake in hepatitis? • 2 014 HSP consensus guideline – Is the data written for Hepatitis B and C in ways that people can understand and use?
  12. 12. Axis 3: Prevention of Transmission Guidance and tools for immunization for A, B Safe health care standards and tools Prevention of transmission Harm reduction tools for injection drug users Safe food and water strategies Safe sexual practice guidance
  13. 13. Axis 3 - Prevention of Transmission – While vaccination programs are implemented, where are there gaps? – Are there barriers to needle and syringe programs? Does stigma affect access? – Is there a national infection control policy? Despite Republic Act 10152 (An Act Providing for Mandatory Basic Immunization Services for Infants and Children: • timely birth dose coverage in the Philippines was only 40%. • no catch-up program for unimmunized children beyond the age of 24 months • only 57% and 70% of preterm neonates and low-birth weight neonates were vaccinated. Republic Act 7719 National Blood services Act of 1994, was enacted to encourage voluntary blood donation, upgrade blood donation services and facilities, and phase out commercial blood banks to prevent blood contamination. • vigilant surveillance is still necessary There are up to 18,000 injecting drug users : high risk of needle sharing/ solution
  14. 14. Axis 4: Screening, Care and Treatment Screening and counseling resource package Diagnostic standards Screening, care and treatment Care and treatment guidelines for B andC Training package for health care providers Equity in access to treatment and drugs
  15. 15. Axis 4 - Screening, Care and Treatment – Are there barriers to testing? Payment? Confidentiality? – Is there accessible health promotion information for people with hepatitis? – Treatment - Funding? Limits on funding? – What barriers are there to people accessing treatment? • • limited up-to-date information on the national prevalence of hepatitis B and C, as well as its prevalence in vulnerable groups. Screening is currently not covered by the PhilHealth. Stigma towards these infections prevents at-risk individuals from getting screened. • Hepatitis B and C is undertreated in the Philippines, mostly because of the advanced stage of disease upon diagnosis, and the high cost of treatment. • Policies against employment and workplace discrimination are inadequately implemented either because many employers are not aware of the Department Of Labor and Employment (DOLE) Department Advisory No. 05 (Series of 2010) or because of the lack of punitive action on violators.
  16. 16. Crossgovernment approach with industry support THE GREAT WALL Barrier •Carefully crafted messages based on what people wanted/needed to hear LACK OF PUBLIC AWARENESSS LACK OF RESOURCES LACK OF PROVIDER AWARENESS •Policy report galvanised political will