Resource Type: Report
Authors: Matthew Kukla & Chris Lovelace
Despite substantial funding for tuberculosis (TB) prevention and treatment over the last ten years, both by donors and governments, the worldwide incidence of TB remains troubling. Across lower- and middle-income countries, access to TB services is limited, and the quality of TB services is often substandard. Many countries face questions over the long-term financial sustainability of their efforts to prevent and treat the disease.
In the Philippines, there are roughly 290,000 new TB cases per year (WHO, 2016). Meanwhile, donor funding for TB has declined, health care costs are rising, and out-of-pocket spending accounts for roughly two-thirds of national TB expenditures. The Philippines needs to identify mechanisms to improve the efficiency of TB spending (i.e., mechanisms for spending money wisely). In the short term, this may mean finding ways to improve outputs—such as access, use of services, and quality—for a given level of spending on TB. In the long term, the Philippines and countries facing similar challenges may be interested in finding ways to achieve better outputs with fewer resources.
The Philippines was the subject of one of several country case studies linking strategic TB purchasing with improved efficiency and better outcomes. In April 2016, HFG conducted a brief but in-depth assessment of health purchasing/provider payment and PFM systems in the Philippines, to identify rigidities and barriers. The assessment had a twofold purpose:
- HFG would observe and learn from key stakeholders in the Philippines, with the aim of synthesizing information on PFM barriers and provider payment bottlenecks.
- Where these issues were not already being addressed, HFG would make recommendations for removing barriers and bottlenecks.