AS if the flood control corruption scandal and the apparently improper use of confidential funds by high officials weren’t sufficiently disgusting, here comes the indefinite freeze on procurement of tuberculosis (TB) drugs. Some very concerned health advocates who have chosen to remain anonymous have alleged that resigned acting health secretary Jose Pujalte’s order to suspend the scheduled P3 billion procurement of TB drugs was made to ensure that a favored party would bag the contract.
The concerned citizens filed a complaint with the Office of the Ombudsman against Pujalte. A few days later, the latter resigned. In their complaint, the Concerned Health Advocates for the Prevention and Control of Tuberculosis pointed out that the budget and timetable for the procurement of TB drugs and related supplies are “fixed by law to eliminate corrupt administrative discretion” (GMA News, Aug. 5, 2026). The act of Pujalte to halt the process was nothing less than an act of sabotage, according to the complainants.
While Pujalte, who served as acting health secretary for less than a month, may deserve the benefit of the doubt, the timing of his order could not have been worse: There’s already a shortage of TB drugs due to several failed biddings since 2023. Prospective suppliers reportedly backed out over concerns about foreign exchange rate fluctuations, increased freight costs, among others.
Without an adequate supply of TB drugs, how can we beat the disease? The Philippines ranks third in the world — after India and Indonesia — in terms of TB incident cases per 100,000 population. The disease kills an average of 98 Filipinos every day. Respiratory TB was the eighth leading cause of death in the country in 2025. TB, unlike the diseases that top the list of causes of death, is infectious. According to the World Health Organization, TB is the “world’s leading cause of death from a single infectious agent,” the “leading killer of people with HIV” and “a major cause of deaths related to antimicrobial resistance” (WHO, March 24, 2026).
Yet, TB is preventable and curable. The programs, the technologies, the expertise, the drugs, and even the money exist to make eradication of TB happen. Unfortunately, we just seem incapable of getting it right. Why is TB such a “wicked problem”? This was the term used by UP Manila’s Dr. TJ Robinson Moncatar at a panel discussion on TB organized by Ateneo de Manila on the occasion of World TB Day last March. TB is a wicked problem, Dr. Moncatar explained, because “efforts to eliminate [it] are hindered by persistent gaps in governance and decentralization, economic and financial barriers, human resource constraints, weaknesses in service delivery networks, and fragmented public-private engagement” (Ateneo de Manila, March 27, 2026).
TB being an infectious disease means that it isn’t simply the problem of the infected person. An infection becomes the wicked problem of the entire family, household, community and whoever the infected person has close and frequent contact with. One undiagnosed, active case can soon become many.
Untreated TB can affect other parts of the body, including the bones and the brain. This was explained by Dr. Dahlia Yu, a pediatric pulmonologist of Chong Hua Hospital, Cebu City. In the Aug. 11 edition of the Openline News Forum of MyTV Cebu, Dr. Yu also explained that infants have the highest risk of getting infected if they live with a person with TB. The risk for this age group is a staggering 30–40 percent. The risk decreases as the child gets older but the point is that no child should be at risk of contracting TB. Two children have died from TB-related causes in Cebu City this year. Last year, TB also claimed the lives of two children, according to Dr. Yu. The four fatalities came from four different barangay (villages) of the city.
That’s four children too many. Failure to prevent and control TB means failure to curb its spread. Such failure puts everyone at risk, especially vulnerable population groups such as children, the elderly and the sick.
Early detection of TB “leads to higher cure rates, prevents silent transmission within families and communities, and reduces severe illness and TB-related deaths,” to quote Dr. Nikki Catalan of the Cebu provincial government. But in the end, ramped-up screening and early detection will amount to nothing if the government cannot provide, for free, the life-saving TB drugs for the entire duration of the treatment period. In fact, if we doubt that the drugs will be available throughout the six-month treatment regimen, would we still want to be screened? What’s the use? If treatment is interrupted, it could lead to multi-drug resistance — something that the WHO calls a “public health crisis and a health security threat.”
“Every day that life-saving TB drug is withheld is a step toward multi-drug resistance, spread and death,” the Concerned Health Advocates for the Protection and Control of Tuberculosis warned in their complaint against Pujalte. A wicked problem indeed. Now with a new secretary, the DOH must act swiftly to address the TB drug shortage.
