On September 4-5, 2024, an onsite visit was conducted in Batangas City, Region 4A, as part of the “Pilot Study to Evaluate the Effectiveness and Safety of the Bedaquiline-Pretomanid-Linezolid (BPaL) Treatment Regimen in the Philippines.” The visit involved key participants, including Mr. Niño Magpusao and Mr. Edilberto Casil from TBpeople Philippines, alongside Dr. Maria Imelda Quelapio, Dr. Irene Flores, Ms. Charlotte Cabalitan (representatives from TB Alliance, KNCV TB Foundation, Tropical Disease Foundation, Philippine Business for Social Progress, Inc., and Jose B. Lingad Memorial General Hospital.) The primary objectives were to evaluate the effectiveness and safety of the BPaL/M treatment regimen, assess the capacity of iDOTS (integrated Directly Observed Therapy Short-course) facilities in managing the regimen, and foster collaboration with local health offices and treatment centers.

During the visit, the team performed patient management assessments, including a review of a patient undergoing the BPaL regimen at Bauan TB DOTS Center RHU 1, who reported positive health improvements and a better quality of life. However, a significant challenge was noted: some TB patients, despite being on the BPaL/M regimen, were non-compliant with their treatment. This issue highlighted the urgent need for effective patient support interventions. The visit highlighted the important role of a Patient Support Group, consisting of TB survivors, in motivating and encouraging patients to adhere to their treatment regimens until completion.

Courtesy calls were made to local health officials, including Dr. Winston E. Ilagan of the Bauan Municipal Health Office and Dra. Elizabeth Versoza-Saria at PDOHO Batangas Health Office, where discussions centered on the BPaL regimen’s benefits for local TB management. The officials strongly supported the initiative and showed enthusiasm for establishing a Patient Support Group within their city and municipality. Additionally, a visit to Batangas Medical Center (BatMC) highlighted staff satisfaction with the regimen’s integration, and site surveys at the Batangas City Provincial Health Office and Mataasnakahoy RHU provided further insights. Laboratory visits to BatMC’s Xpert and Chem labs affirmed the efficiency of diagnostic tools used with the regimen.

Key findings revealed high patient satisfaction with service delivery and significant health improvements. The successful integration of the BPaL/M regimen into local TB care practices was noted, along with the importance of collaborative efforts between health offices and research organizations. The visit also reinforced the need for patient support systems to address adherence challenges. Although iDOTS facilities showed capacity for managing the regimen, further enhancement of infrastructure and support systems was recommended. Overall, the visit offered valuable insights into the BPaL regimen’s impact and set the stage for future initiatives to strengthen TB treatment and outcomes in Batangas City.