247956 How to create an epidemic: Antibiotic access and drug resistance in the Philippines

Wednesday, November 2, 2011: 8:50 AM

Paul Kadetz, PhD, MSN, MPH , Department of International Development, University of Oxford, Oxford, United Kingdom
Devolution of health care to the local community level since 1991 has resulted in markedly increased health disparity in the Philippines. The decentralization of administrative duties without the parallel decentralization of medical resources is believed to have contributed to this disparity. In particular, access to pharmaceuticals has been severely compromised at the local level.

In order to determine the effect of the reduction of access to pharmaceuticals on local level health care and community health, qualitative semi-structured interviews (n=100) recruited from convenience and snowball sampling in three different Philippine municipalities were conducted at the local level of both rural and municipal health units. Quantitative epidemiologic analysis of the incidence and prevalence of antibiotic resistance from municipal health units and provincial hospital records were compared.

Findings include the increased cost and decreased physical availability of pharmaceuticals has resulted in a lack of essential drugs and antibiotics and a rationing of antibiotics with markedly reduced sample dosing from municipal and local health units of one to two days; with an infeasible expectation that patients would purchase pharmaceuticals after the initial 1-2 day samples were exhausted. Quantitative data analysis reveals that the current policy of sample dosing in some municipal health units is increasing vulnerability to population drug resistance. A critical analysis of current public health policies contributing to these issues are reviewed.

Learning Areas:
Clinical medicine applied in public health
Protection of the public in relation to communicable diseases including prevention or control
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy

Learning Objectives:
1. Describe how decentralisation of health care in the Philippines has contributed to health care disparity. 2. Identify the factors that have compromised access to pharmaceuticals. 3. Explain how the various factors that have compromised access to essential medicines and antibiotics, with erratic dosing, is resulting in antibiotic resistence in the Philippines.

Keywords: Access and Services, Community-Based Public Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted and authored this research
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.