One health in the Philippines: A review and situational analysis.

The Philippines faces a complex and interconnected web of human, animal, and environmental health issues, including zoonotic and reverse zoonotic diseases, antimicrobial resistance, food insecurity and contamination, and threats from environmental degradation. This paper examines these issues, existing interventions, and their implementation challenges. The overall framework used to analyze the level of operationalization of the One Health approach is the Multi-sectoral One Health Coordination Framework developed by the World Health Organization, Food and Agriculture Organization, and the World Organization for Animal Health. A two-step process was conducted: literature review, followed by consultations with government and non-government stakeholders across national, subnational, and local levels. There has been significant progress in laying the foundation for collaboration between the human, animal, and environmental sectors. These are demonstrated by the presence of structures and systems, including inter-agency task forces, emergency response plans and mechanisms, and a network for health human resources. However, these are eclipsed by challenges, including the limited governance mechanisms within inter-agency committees, fragmented risk assessment and surveillance, untapped opportunities for joint investigation and response, insufficient resources for capacity-building, and absence of comprehensive risk communication and community engagement initiatives. These challenges highlight the importance of promoting multi-sectoral governance and ensuring resource allocation and sharing. Joint activities across risk assessment, surveillance, investigation, and response are critical in ensuring a proactive and holistic approach to addressing threats. A well-capacitated interdisciplinary workforce, not only capable of managing these hazards but also empowering communities to protect themselves, is necessary in ensuring innovation and collaboration on health risks at the human-animal-environment interface. In light of the multifaceted challenges faced by the Philippines, the One Health approach emerges as a vital strategy. By addressing governance issues, enhancing coordination, and bolstering resource allocation, the country can better protect the health and well-being of its people, animals, and ecosystems.

Socio-economic factors and its influence on the association between temperature and dengue incidence in 61 Provinces of the Philippines, 2010-2019.

BACKGROUND: Temperature has a significant impact on dengue incidence, however, changes on the temperature-dengue relationship across axes of socio-economic vulnerability is not well described. This study sought to determine the association between dengue and temperature in multiple locations in the Philippines and explore the effect modification by socio-economic factors. METHOD: Nationwide dengue cases per province from 2010 to 2019 and data on temperature were obtained from the Philippines' Department of Health-Epidemiological Bureau and ERA5-land, respectively. A generalized additive mixed model (GAMM) with a distributed lag non-linear model was utilized to examine the association between temperature and dengue incidence. We further implemented an interaction analysis in determining how socio-economic factors modify the association. All analyses were implemented using R programming. RESULTS: Nationwide temperature-dengue risk function was noted to depict an inverted U-shaped pattern. Dengue risk increased linearly alongside increasing mean temperature from 15.8 degrees Celsius and peaking at 27.5 degrees Celsius before declining. However, province-specific analyses revealed significant heterogeneity. Socio-economic factors had varying impact on the temperature-dengue association. Provinces with high population density, less people in urban areas with larger household size, high poverty incidence, higher health spending per capita, and in lower latitudes were noted to exhibit statistically higher dengue risk compared to their counterparts at the upper temperature range. CONCLUSIONS: This observational study found that temperature was associated with dengue incidence, and that this association is more apparent in locations with high population density, less people in urban areas with larger household size, high poverty incidence, higher health spending per capita, and in lower latitudes. Differences with socio-economic conditions is linked with dengue risk. This highlights the need to develop interventions tailor-fit to local conditions.

How comprehensive and effective are waste management policies during the COVID-19 pandemic? Perspectives from the Philippines.

This study presents a comprehensive analysis on policies governing the management of COVID-19 waste in the Philippines, highlighting gaps in pre-existing policies and opportunities for further policy development and adaptation in the context of present and future public health emergencies. A hybrid search strategy and consultative process identified fifty (50) policy documents directly impacting the management of wastes (general domestic, healthcare, and household healthcare waste) released prior to and during the pandemic. Content analysis revealed comprehensive policy coverage on managing general domestic waste and healthcare waste. However, there remains a dearth in policies for managing household healthcare waste, an emerging category for waste generated by patients isolating at home or in isolation facilities. Applicable, pre-existing policies were neither adequate nor specific to this category, and may therefore be subjected to variable interpretation and mismanagement when applied to this novel waste category. Assessment using the modified Cradle-to-End-Of-Life (CTEOL) framework revealed adequate policy coverage across the waste lifecycle stages. However, policies on reducing waste generation were relatively minimal and outdated, and policy gaps in waste segregation led to downstream inefficiencies and introduction of environmental health risks in waste collection, treatment, and disposal. The internal validity of policies was also evaluated against eleven (11) criteria adapted from Rütten et al. and Cheung et al. The criteria analysis revealed strong fulfillment of ensuring policy accessibility, goal clarity, provision of human resources, and strength of policy background, but weak fulfillment of criteria on providing adequate financing, organizational capacity building, monitoring and evaluation, and encouragement of opportunities for public participation. We conclude that existing waste management policies in the Philippines leave much room for improvement to ensure effective management of COVID-19 waste from various settings and circumstances. Hence, these policies are expected to adapt and evolve over time, utilizing the best available technology and environmental practices. Integrated, region-wide waste management systems, involving both government and society, and strengthened by equitable provisional support are needed for effective waste management that is both inclusive and resilient in the face of present and future pandemics.