Antimicrobial resistance (AMR) is a global public health threat that warrants urgent attention. Countries developed their national action plans (NAPs) following the launch of the Global Action Plan on AMR in 2015. The development and implementation of NAPs are often complicated due to the multifaceted nature of AMR, and studies analyzing these aspects are lacking. We analyzed the development and implementation of the Philippine NAP on AMR with guidance from an AMR governance framework. We conducted in-depth interviews with 37 participants across the One Health spectrum. The interviews were transcribed verbatim and were analyzed thematically, adopting an interpretative approach. The enabling factors for NAP implementation include (1) a high level of governmental support and involvement of relevant stakeholders, (2) the development of policies to support improved responses in infection prevention and control and antimicrobial stewardship, and (3) better engagement and advocacy by professional associations and civil society groups. The challenges include (1) a lack of resources and regulatory capacity, (2) insufficient impetus for AMR research and surveillance, and (3) limited One Health engagement. Although there has been considerable progress for human health, strengthening the involvement and representation of the animal health and environment sectors in the AMR scene must be undertaken. Developing well-defined roles within policies will be paramount to the strong implementation of AMR strategies.

Tuberculosis (TB) is a chronic infectious disease that remains to be a primary health concern globally. The Philippines is among the top TB-burdened countries. Workplace TB prevention and control programs are essential to ensure the health and safety of workers and economic security. There remains a knowledge gap regarding the Philippine workplace TB prevention and control program implementation. This qualitative study involving key informant interviews reviewed the implementation of the workplace TB program in selected companies in a high TB burden region in Eastern Philippines. Results were presented under four themes in accordance with the components of the workplace TB policy: preventive strategies, medical management, data recording and reporting, and social policy. Various good practices, opportunities, and challenges in the implementation of the workplace TB program were identified. There is a need to strengthen the enforcement of policy across different components. Compliance with guidelines on preventive strategies and recording and reporting schemes needs to be intensified. Coordination across different levels and agencies may also be enhanced to allow more efficient implementation. Increased awareness of corporate decision-makers may improve company ownership of the program leading to improved implementation while increased awareness of employees on their rights and entitlements may likewise enhance compliance.

Background. Pneumococcal vaccination has been widely used for the prevention of pneumococcal disease, with two types of vaccines available since 2009. With the World Health Organization (WHO) recommendation of incorporating pneumococcal conjugate vaccines (PCVs) in National Immunization Programs (NIPs) worldwide, a ten-valent PCV (PHiD-CV) was initially introduced in the Philippines in 2012. This, however, transitioned to the use of the 13-valent PCV (Prevnar) subsequent to the recommendation of the Formulary Executive Council in 2014. Objective. This review aimed to present evidence on pneumococcal disease and vaccine inclusion in the Philippine NIP from 2005 - 2021. Methods. This narrative review compiled articles on Pneumococcus from January 2005 to October 2021, sourcing literature from databases such as BIOSIS Preview, CAB Direct, Embase, Google Scholar, and others. Results. In the Philippines, there was a shift in prevalent serotypes of Streptococcus pneumoniae among children under five following the introduction of PCV13 in the National Immunization Program in 2014, with serotype 14 becoming the most common by 2018, and a significant reduction in isolates reported in 2020, where only serotypes 5, 19A, and 23F were identified among invasive strains. The immunogenicity results of a potential vaccine candidate should be factored into the overall evidence when conducting a reassessment of PCV. Conclusion. As part of the decision making about the inclusion of the PCVs in the NIP of the Philippines, various factors such as local epidemiology, vaccine supply, cost, and programmatic characteristics must be careful weighed. Enhancing laboratory and surveillance capacity are essential to provide evidencebased decision-making in terms of existing serotype distribution and antimicrobial resistance (AMR) profile in the country. With the introduction of a new affordable formulation of a 10-valent PCV offering a comparable serotype coverage, the reassessment of choice of PCV with the consideration of all three formulations, namely PCV13, PHiD-CV, and SIIPL-PCV, may be warranted.

The global public health threat of antimicrobial resistance (AMR) has been accelerated by many interrelated factors spanning across One Health—human health, animal health, and the environment. Singapore launched its own National Strategic Action Plan (NSAP) on AMR in November 2017 with the aim of tackling the growing threat of AMR in Singapore through coordinated approaches. However, little is known about the policy process and development of the NSAP in Singapore. In this study, we analysed these aspects using an AMR governance framework. In-depth interviews were conducted with 20 participants across the One Health spectrum. The interviews were transcribed verbatim and analysed thematically. Areas that were well executed included (1) good coordination across various agencies, (2) a dedicated office to coordinate the work on the NSAP, and (3) a high level of governmental support. Areas that were lacking included (1) a lack of participation from certain sectors, (2) insufficient awareness around the AMR issue, (3) constraints in information sharing, and (4) a lack of ideal indicators to track the progress in addressing AMR. Improvements in these areas will provide a more holistic One Health engagement in support of the effective planning and implementation of the NSAP.

Background: The COVID-19 pandemic prompted extensive vaccination efforts globally, yet in the Philippines, many families remained unvaccinated. Caregivers are key decision-makers for family vaccination, but evidence on factors influencing their own vaccine uptake is limited. Methods: A cross-sectional survey of primary caregivers was conducted in low COVID-19 vaccine uptake regions in the Philippines from July to October 2023 using a validated questionnaire. Multivariable logistic regression identified enablers and barriers to vaccine uptake. Results: Among 775 respondents, 72.3% completed primary vaccination, 3.3% had incomplete vaccination, and 24.4% were unvaccinated. Key factors for vaccination included self, family, and community protection, and the influence of government regulations. Distrust in vaccine safety was the main barrier. Positive associations with vaccine uptake were found for age [30–45 years (aOR = 2.23) and 46–59 years (aOR = 2.84)], education [secondary (aOR = 2.25) and tertiary (aOR = 4.93)], and employment (aOR = 1.99). Confidence in vaccine safety (aOR = 1.92), vaccine effectiveness (aOR = 2.23), and satisfaction with vaccination efforts (aOR = 2.39) were additional enablers. Disagreement with restrictions on the unvaccinated was a barrier (aOR = 0.31). Conclusions: This study identified multiple factors influencing COVID-19 vaccination among primary caregivers in low uptake areas of the Philippines. Interventions addressing perceptions about vaccine safety and effectiveness, particularly among younger and less educated caregivers, may improve public trust and satisfaction with vaccination efforts.

COVID-19 vaccines were recommended for the pediatric population in the Philippines in February 2022, after adults, due to both the direct and indirect effects of COVID-19. Despite ongoing vaccination efforts in the Philippines, pediatric COVID-19 vaccination uptake remains low. As such, this study aimed to determine the enablers and barriers of pediatric COVID-19 vaccination uptake amongst children 5–11 years in the Philippines. A cross-sectional survey among 546 caregivers of children aged 5–11 years was conducted onsite in three selected regions in the Philippines with low COVID-19 vaccine coverage between July and October 2023. Multivariable logistic regression was performed to identify factors associated with pediatric COVID-19 vaccination uptake. Of the respondents, 143 caregivers had at least one child vaccinated against COVID-19, while 395 had none. The most common reasons for vaccination were protection against COVID-19 (93.7%), influence of government-mandated regulations (48.3%), and recommendation of healthcare workers (19.6%). High vaccine confidence (79%), high perceived vaccine benefit (81.1%), and perceived need for vaccination (78.3%) were enablers of vaccination. Among those who did not vaccinate, the most common reasons were distrust in vaccine safety (58.5%), perception that the child was too young (25.3%), and the child not wanting to get vaccinated (18.2%). Caregivers who decided not to vaccinate also had concerns about side effects (35.7%), low perceived need for COVID-19 vaccination (21.5%), and disagreed at requiring vaccinations for schooling (26.3%). Caregiver age [aOR = 3.00; 95% CI 1.65–5.46 for adults 30–45 years vs. aOR = 2.65; 95% CI 1.17–5.5.99 for adults 46–59 years], and perceived need for vaccination (OR = 2.56; 95% CI 1.31–5.03) were associated with pediatric COVID-19 vaccination uptake in the multivariable analysis. These factors were compared to caregivers aged 18–29 and those who responded ‘neutral’ to the survey, respectively. Key factors associated with COVID-19 pediatric vaccination uptake in the Philippines were perceived protection against COVID-19 illness, government mandated regulations and healthcare worker recommendations, while non-vaccination was associated with safety concerns, and children’s age and preference to not be vaccinated. Understanding the social and behavioral drivers among caregivers may help policy decision-makers and implementers develop targeted interventions to enhance uptake of COVID-19 and routine childhood vaccines.