Slide 2 of 5
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Under the Reform Agenda, TB was targeted for elimination together with four (4) other diseases to drastically reduce the burden of the disease. To achieve the goals of disease elimination, DOH proposed a multi-year budget so that the five (5) priority public health programs will be insulated from the uncertainties of the annual budgetary process. The scheme was supposed to allow for wider latitude in the implementation of public health programs with access to funds based on performance benchmarks and level of utilization. This scheme was not possible with the usual yearly government appropriations. However, legislative action was required to enact this scheme.
Because of strong advocacy to the Department of Budget and Management (DBM), it agreed to “earmark” cost of TB drugs and supplies in lieu of the multi-year budget. It realized that indeed the TB program was a priority as propounded by DOH.
What is the dynamics involved? Under the Health Sector Reform Agenda, a line item in the budget called Health Operations, including TB Control Operations, Disease Prevention and Control , Health Promotion and other Health Operations was proposed and approved by DBM starting 2000. The DOH then proposed a baseline budget for TB Control. DBM earmarks the budget for TB meaning it agrees to approve the budget proposed for TB (if it cannot raise it further) and endorses it to Congress for appropriation. Earmarking guaranteed that the budget proposed and approved for cost of TB drugs was not affected by any budgetary cuts before and after approval of the budget.