We decided to open the project in the capital region, Metro Manila, since it has the highest prevalence, and focused activities on the slum communities of Tondo. 

MSF had already worked in Tondo, so we were familiar with its particular health challenges: it is a densely populated, impoverished area, served by only a few health centres with limited staff. Tondo also had a very low case detection rate, and the community had limited access to diagnosis. Furthermore, since the onset of the COVID-19 pandemic in 2020, community outreach had been restricted, and many health centre staff had been reallocated to quarantine facilities and vaccination. 

In 2021, we began coordinating with the City of Manila Health Department, and started our first active case-finding activities in June. In addition, we provided TB preventive treatment and developed materials for patient education and counselling. 

In the southern part of the Philippines, we continued our work in Marawi, in the Bangsamoro Autonomous Region in Muslim Mindanao. We provided people displaced and affected by conflict with general and mental healthcare, as well as treatment for non-communicable diseases, in several facilities. 

The year closed with an exploration in Northern Mindanao, which was ravaged by Typhoon Rai (local name Odette). Our teams visited the hardest-hit areas of Surigao del Norte province, including the islands of Siargao and Dinagat, to assess the needs and prepare a response.

*World Health Organization Tuberculosis Fact Sheet, October 2021