Declaration of Policy
- Aims to reduce malaria morbidity by 70% and mortality by 50% in 26 category A provinces by 2015.
- Seeks to increase malaria-free provinces and prevent recurrence in malaria-free areas.
- Policy revises first-line treatment from CQ+SP to AL based on local and global efficacy studies.
Guiding Principles
- Effective Diagnosis and Treatment: Continuous review and evaluation of drug efficacy and approaches.
- Primary Health Care Approach: Community participation, involvement of barangay health workers, adapting strategies to local conditions.
- Universal Access: Diagnostic and treatment services must be accessible to vulnerable groups.
- Integrated Service Delivery: Malaria services integrated with other health programs for efficiency.
- Health System Support: Adequate training, drug availability, quality assurance, and information campaigns.
- Multi-Sectoral Collaboration: Engagement of government agencies, LGUs, private sector, NGOs, donors, and others.
Objectives
- Ensure early and accurate diagnosis and effective treatment nationwide.
- Guide health workers in implementing updated guidelines.
- Promote compliance among DOH offices, LGUs, and private sector.
- Generate stakeholder support across localities.
Scope of Application
- Applies to all government offices (national to local), public/private health facilities, NGOs, development partners, and all malaria-control stakeholders.
Definitions
- Combination Therapy: Two schizontocidal drugs with independent action.
- ACT: Artemisinin derivatives combined with another schizontocidal drug.
- Confirmed Malaria: Diagnosed via microscopy (gold standard) or Rapid Diagnostic Tests (RDTs).
- Direct Observed Therapy (DOT): Supervised intake of anti-malarial drugs.
- Health Workers: Physicians, nurses, midwives, barangay health workers, malaria microscopists.
- Malaria Treatment Failure: Recurrence of symptoms/parasitemia within 28 days after correct treatment.
- Severe Malaria: Organ dysfunction due to high parasite load with specific clinical syndromes.
- Uncomplicated Malaria: Febrile condition with parasites but no severe signs.
General Guidelines
- Diagnosis primarily by microscopy with quality assurance; RDTs used where microscopy unavailable or in emergencies.
- Treatment First line: AL combination for confirmed uncomplicated and severe P. falciparum malaria.
- Second line: Quinine combo (quinine + doxycycline/tetracycline/clindamycin) for AL unavailability or treatment failure.
- Artesunate suppository for unconscious severe cases pending transfer.
- ACT can be used for all Plasmodium species.
- Only WHO pre-qualified or GMP-certified drugs used.
- DOT mandatory for first three days of AL treatment.
- Immediate referral and pre-referral anti-malarials for severe cases, pregnant women, and children under 5.
- Only competent health workers to perform diagnosis and treatment.
- Adequate drug supply and logistics essential; remaining SP stocks to be used before full shift to AL.
- Malaria case reporting through PhilMIS or FHSIS, integrated under PIDSR.
- Regular monitoring for compliance.
Roles and Responsibilities
- DOH-NCDPC: Lead policy execution, dissemination, training, quality assurance, drug procurement, sentinel site selection, advocacy, monitoring.
- Procurement Division: Timely procurement, storage, distribution.
- National Epidemiology Center: Data provision and integration of surveillance systems.
- PhilHealth: Review benefits for malaria diagnosis and treatment.
- Centers for Health Development (CHD): Train staff, assure quality, manage drug distribution, report surveillance, resource mobilization, advocacy.
- Local Government Units (LGUs): Train workers, advocate adoption, fund training and supplies, manage stocks, assure quality and reporting, investigate adverse reactions, monitor implementation.
- Rural Health Units: Implement guidelines, confirm diagnosis, provide follow-up smears, conduct training and IEC campaigns, manage drug stocks.
- Barangay Health Workers and Volunteers: Case finding, supervise treatment intake, mobilize communities, report adverse reactions, conduct follow-up.
- Hospitals: Provide services and anti-malarials per protocols.
- NGOs and PhilMAM: Support service delivery, training, community engagement, social marketing, resource mobilization.
Repealing Clause
- AO 19, s. 1996, AO 129, s. 2002, and other inconsistent issuances are rescinded.
Effectivity
- The order takes effect immediately upon signing on January 13, 2009.