Public Health
Chapter 1
PUBLIC HEALTH: BY C.E.A. WINSLOW;
(CHARLES EDWARD AMORY WINSLOW)
– a seminal figure in Public health; president of
American Public Health Association, consultant to
the WHO.
The science and art of preventing disease, prolonging
life, and promoting health and efficiency through
organized community efforts for the sanitation of the
environment, the control of community infections,
the education of the individual in personal health,
the organization of medical and nursing services for
the early diagnosis and preventive treatment of
disease, and the development of the social machinery
which will ensure to every individual in the
community a standard of living adequate for the
maintenance or improvement of health.
PUBLIC HEALTH: DEFINED BY WHO
Refers to all organized measures (whether public or
private) to prevent disease, promote health, and
prolong life among the population as a whole. Its
activities aim to provide conditions in which people
can be healthy and focus on entire populations, not
on individual patients or diseases.
Similarities
1. Community - group of people with common
characteristics or interests living together
within a territory or geographical (physical
boundary).
2. It deals with preventive rather than curative
aspects of health.
3. It is concern with population-level rather
than individual-level health issues.
PUBLIC HEALTH:
AN INTERDISCIPLINARY APPROACH OF
EPIDEMIOLOGY, BIOSTATISTICS, AND
HEALTH SERVICES.
The three main public health functions are:
1. The assessment and monitoring of the health
of communities and population at risk to
identify health problems and priorities.
2. The formulation of public policies designed to
solve identified local and national health
problems and priorities.
3. To assure that all the populations have access
to appropriate and cost effective care,
including health promotion and disease
prevention services.
PUBLIC HEALTH: PRE-HISTORIC ERA
– disease from a supernatural perspective
➔ NO concept of public health since people
were neither organized nor settled in one
geographical area (nomads)
➔ Pre-historic peoples adopted “health-related
practices” for religious purposes ( for health
or disease is a divine act)
➔ That a person is sick because he/she has been
cursed or punished by a deity or a
supernatural being
➔ Disease is a supernatural event
➔ Only those “gifted” in explaining the
inexplicable phenomenon can address the
situation (Ex. babaylan-Amaya)
➔ People settle in a communal living (ex.
Tribes)
SHAMANS
– medicine men, natural healers of the tribes
Shamans were skilled:
1. Used medicinal herbs, usually gathered by most
women in the tribe
2. used amulets, charms or spells that would
supposedly ward off evil spirits that would cause
illness
3. conducted ceremonies that would appease the
gods or supernatural beings and eventually revert the
curse that caused the illness
4. gave advice on how to maintain an illness-free
life
Shamans would invoke the good spirits in order to
ensure that the tribe or its particular members would
be free from harm or illness
GEOPHAGY
– ingestion of clay or earth as a mode of treatment
➔ Used clay to cover wounds or cuts
➔ Trepanning was practiced (pre-historic
health practice)– drilling a hole into a human
 skull, believing that the hole would release
the evil spirit dwelling in the person causing
illness; continued until medieval period
➔ Tribes grew, human beings started
developing skills more intricate than hunting
and farming
➔ Living together became more difficult in
accessing food and clean water, disposal of
human waste and getting rid of the dead
➔ To address the emerging issues, civilizations
started building infrastructures to live
comfortably
Excavation and anthropological studies of ancient
Egyptians revealed the establishments of
rudimentary baths and toilets in dwelling places;
high regards for personal cleanliness but the
rationale was more religious than medical.
ANCIENT EGYPTIANS
– developed form of writing in keeping records on
how certain illnesses should be cured or treated that
served as references of their civilization.
Shamans evolved NOT just “summoners” of spirits
and conduits of the gods’ messages and medical
advice but also “surgical” skills even inventing
devices that appeared to be the prototypes of modern
day surgical instruments.
Mummification – a form of taking care of the dead
(Egyptians)
GREEKS CIVILIZATION
(MEDITERRANEAN)
– developed form of writing and recording through
which precepts (rules) and norms were codified and
documented
Greek philosophers started to re-think the way
Egyptians looked at health and illness and slowly
digressed (tuned aside) from the perspective of the
supernatural as the cause of illness and disease to a
“rational” or “logical” paradigm
➔ Aristotle, Socrates and Pythagoras
HIPPOCRATES
– father of Western medicine; contributed largely to
the “professionalization” of medicine separating it
from religious rituals and the supernatural
➔ Nutrition Coined the term epidemic
● Epis (“on” or “akin to”)
● Demos (“people”)
➔ Causal relationships Disease and climate,
water, lifestyle, and nutrition
De Aere, Aquis Et Locis or Of Air, Water and
Land – written by Hippocrates
➔ Proposed that diseases develop due to our
environment and NOT because of some form
of divine act
➔ That food, occupation and climate cause
diseases
➔ Established Hippocratic School of Medicine;
first to use terms: acute, chronic, endemic,
epidemic, paroxysms and exacerbation
➔ Paroxysm- a sudden recurrence or attack of
a disease; a sudden worsening of symptoms.
➔ Exacerbation- the process of making a
problem, bad situation, or negative feeling
worse; "a lack of stress reduction skills
His book may be considered the first rational guide
to the establishment of science-based public health
Greeks, concepts 0f 4 Humors:
1. phlegm 3. yellow bile
2. blood 4. black bile
ROMANS
– imperialists; warriors
➔ Romans spent more wealth and efforts in
developing infrastructures that would
develop their conquered states
➔ Romans built sewers and aqueducts
➔ Roman doctors learned much about health &
medicine through wounded warriors or
gladiators
➔ Battlefield and arenas – Roman doctors’
learning halls
➔ Preferred studying on living persons rather
than dissecting corpses
➔ Thus resulted to dissecting animals
● Roman Aqueducts Le Pont du Gard, in
southern France
● The coliseum (stadium)
GALEN
– Greek physician, migrated Rome, dissected
monkeys; his works became:
a. foundation of Human Anatomy
b. scientific dogma
Through the Medieval Period. Romans believed that
establishment of community sanitation contribute to
the maintenance of health and the prevention of
spread of diseases:
a. Public baths – built to promote
community hygiene monitored strictly by Roman
authorities
b. hospitals – (built originally for the
injured soldiers or recuperating veterans of war) for
the sick and injured for treatment and study
MIDDLE AGES (DARK AGES)
– fall of Roman civilizations
➔ Emergence of Christianity
➔ Western Society – European, Shift away
from Greek and Roman values
➔ Landlords or serfs replaced monarchs and
villagers conglomerated to form feudal
system
➔ Landlords protected the villages and built
forts w/c evolved into castles to provide
defense from invaders or plunderers
➔ Early Christian monks and philosophers
preserved Roman and Greek ideologies
within monasteries
➔ Monasteries became hospices to cater the
pilgrims who got sick along the way
➔ Influence of Christianity, esp. Roman
Catholic Church was strong esp. about health
and illness
MIDDLE AGES (476-1450 AD) SHIFT
AWAY FROM GREEK AND ROMAN
VALUES
➔ Physical body less important than spiritual
self
➔ Decline of hygiene and sanitation
➔ Beginnings of PH tools
➔ Quarantine of ships and travelers for 40 days,
Isolation of diseased individuals could help
prevent the spread of disease
➔ Persons denied entry to infected ships
➔ Faith and prayer were the accepted treatment
for illness
Concept of sin, a consequence of illness
To restore health – be free from sin, amend with
God (forgiveness);
A regression into a prehistoric perspective about
health that somehow disregarded the importance of
public health issues – the environmental sanitation,
a strategy for preventing diseases- - - outbreaks of
diseases, epidemic , Black plague
➔ B. plague – decimated one third of Europe’s
population for 5 years
➔ Bubonic (Black) Plague – Yersinia pestis
transmitted through flea bites; swollen lymph
glands at the axilla, groin and upper femoral
areas, gangrene of the extremities, high fever
and hematemesis, aching limbs
➔ Hematemesis – vomiting blood
➔ Hemoptysis - spitting of blood that
originated in the lungs or bronchial tubes;
coughing of blood 
➔ The Oriental rat flea (Xenopsylla
cheopis) is the primary vector for Yersinia
pestis (plague).
➔ Humans with close contact with birds may
also be fed upon by the sticktight flea
(Echidnophaga gallinacea).
➔ The Oriental rat flea, also known as the
tropical rat flea, is a parasite of rodents,
primarily of the genus Rattus, and is a
primary vector for bubonic plague and
murine typhus.
➔ This occurs when a flea that has fed on an
infected rodent bites a human, although this
flea can live on any warm blooded mammal.
Bubonic (Black) Plague
Medieval people called it "the blue sickness," La
pest ("the Pestilence"), and "the Great
Mortality."
➔ The name bubonic comes from the medieval
Latin word bubo via Italian
bilbo--meaning a pustule, growth, or
swelling.
Fleabite transmits common plague bacteria.
Normally, the fleas that bite humans (Pullex
irritans) are a separate species from the fleas that
live on rats (Xenopsylla cheopis),
IS A PARASITE, and the bubonic bacteria can
survive indefinitely in its normal host, the European
black rat (Rattus rattus). Occasionally, however, a
desperate flea would mistakenly bite a human host,
and then the human contracts the disease. Once a
human is infected, the plague bacterium can spread
for a few weeks by human fleas hopping from person
to person and biting them.

 Yersinia pestis (plague).
Once the bacteria have built up in the human body,
there is a small but documented chance of it evolving
into an airborne version (the "pneumatic strain")
that infiltrates the blood vessels in the lungs. This
version not only can be spread by fleabite, but it can
be transmitted by airborne water particles from
coughs and sneezes. This pneumatic strain is the one
that's truly lethal. In Florence, archeologists
exhuming 15th-century mass graves found a mutant
version of the bubonic plague.  traditions
Bacillus anthracis and Yersinia pestis are two
Tier-1 biothreat agents that pose a great risk to
public health due to their exceptionally high
virulence (1–4). B. anthracis, a Gram-positive
bacterium, is the causative agent of anthrax, and Y.
pestis, a Gram-negative bacterium, is the etiological
agent of plague.Jun 26, 2017
➔ The bacterium is transmitted by fleas or
aerosols, causing different forms of plague:
bubonic, septicemic or pneumonic  Medicine”, major reference book for med school
Black plague outbreak – started in China brought
to Europe via trade routes
Genoese ( Genoa, Italy) trading ships – sailed
through the Black Sea docked at the port of Sicily in
Messina carrying the bodies of sea farers others
gravely ill
➔ Bodies covered with black boils (called Black
Death) ,
➔ So contagious “the merely touching of the
clothes appeared to itself to communicate the
malady to the toucher” acc. to Giovanni
Boccaccio, Italian poet
➔ Due to pandemic, scientists and religious
leaders established interventions to curb the
spread of the disease
PUBLIC HEALTH HISTORY
More hospices were built in response to plague
- Some hospices became specialized as
leprosaria or leper houses to isolate the
healthy – the forerunners of the method of
“quarantine” – one of the public health
interventions today
● Medieval – 700 AD to1500
● Early part of Medieval period – med
school began, Europe and Middle East Asia
Schola Medicana Salernitana (Salerno
Medical School) – world’s first medical school
- Teachers used Greco-Roman medical
tradition complementing w/ Arab and Jewish
perspectives
- Regimen sanitatis Salernitanum –
poem written by the school, emphasized
personal hygiene, diet, exercise, and
temperance as methods to maintain health
and well-being; the first health guide for
the masses
Islamic medicine – influence of Greek and Roman
Al-Razi (Muhammad ibn Zakariya Razi) –
Father of Pediatrics, pharmacist
- Arabic scholar and physician
- Wrote the book, “The Diseases of Children”
- A trailblazer (leader) in opthalmology
- Wrote about medicinal plants & other modes
of therapy
Avicenna ( Abu Ali al-Husayn ibn Abd Allah
ibn Sina) – Persian; wrote “The Canon of
world-wide until mid of 16th century
Islam’s major contribution – proliferation of
female doctors since medieval Muslims only want
female doctors to examine female patients
RENAISSANCE PERIOD
– scholar Girolamo Fracastoro,
- Broadened public’s understanding of how
epidemics or infections spread;
- Introduced concept of fomite, a vehicle
carrying pathogens (cause diseases)
● Andreas Versalius – wrote “On the
Structure of the Human Body”
● William Harvey- did an intensive of human
circulatory system and properties if blood
● Anton Van Leeuwenhoek – bacteria &
other microorganisms, how they caused
diseases
➔ During 15th century - Italian boards of
health institutionalized a system that record
and registered deaths esp. if due to infectious
diseases
➔ Bills of mortality – form of death
registration
➔ John Graunt – pioneered analysis of the
bills of mortality entitled “ Natural and
Political Observations Made Upon the Bills of
Mortality” (1662);
 - Basis for evidence-based planning and
evaluation of public health interventions
- early 1500’s - parishes in England required
family of the deceased a documentation prior
to the burial;
- modern-day death certificates
COLONIAL PERIOD
– European countries conquered other lands by sea
to find rich trade centers in Asia:
➔ Discovered new lands and cultures
➔ Exchange of diseases; colonizer & the
colonized
➔ Ex. Spanish explorers brought smallpox
virus to the Americans - - decimated
thousands of the natives of the New World
➔ Explorers who came back from New World
brought with them syphilis; people thought
of water was the carrier thus public baths
were banned
➔ New World – introduced new remedies to
diseases in European countries
Quinine – discovered from a South American
Quina-quina tree; medicines against malaria
Carl Linnaeus (botanist) – called the tree
(Quina-quina) “Cinchona” in honor of Spanish
Countess of Chinchon who brought bark from the
tree when she returned to Europe from Peru
Other historians attributed discovery of quinine to
the Jesuit Missionaries – who discovered the use of
the tree to cure fever from native Indians
Chinese (as early as 2nd century) - used Qinghao
plant (Artemisia annua) to cure fever and malaria
- Chemical Artemisinin was isolated and still
being used with other drugs to combat
malaria
1800 – disease (bad air);
● Charles Louis Laveran – French surgeon,
discovered parasites in the blood from
patients with malaria; comprehended the
etiology of malaria
● Ronald Ross – discovered that malarial
parasites could be transmitted by mosquitoes
; people got infected through mosquito bites
- Public Health focused on Infectious Diseases
Immunization (Vaccination) – biggest
innovation, pioneered by Dr. Edward Jenner
(Father of Immunology) – smallpox; many
were succeptible but milkmaids were “resistant” due
to exposure to cowpox
- Jenner tested by injecting cowpox pustule
into a boy(James Philips, 8 years old); doubts
occurred; went on till people were convinced,
called vaccine (vacca or cow)
Industrialization – sanitation, overcrowding - - -
epidemics and outbreak occurred
➔ Edwin Chadwick, Secretary of the
England’s Poor Law Commission, “ Report
on the Inquiry into Sanitary Conditions of the
Laboring Population of Great Britain” - -
prevalence and cause of diseases
Cholera outbreak – 1831 killed more than Black
Plague
● Dr. John Snow – elucidated transmission
of Cholera source, water pump; Father of
Epidemiology
● Florence Nightingale - professionalization
of nurses
● Lilian ward – introduced concept of public
health nursing, working with the poor in US
Robert Koch – developed field of bacteriology
Koch’s disease – Mycobacterium tuberculosis
Koch’s Postulates –
1. “The microorgansm must be found in
abundance in all organisms suffering from
disease, but should NOT be found in healthy
organisms;
2. The microorganism must be isolated from a
diseased organism and grown in pure culture;
3. The cultured microorganism should cause
disease when introduced into a healthy
organism; and
4. The microorganism must be re-isolated from
the inoculated, diseased experimental host
and identified as being identical to the
original specific causative agent.”
Louis Pasteur – challenged the predominant
concept of spontaneous regeneration ; his work
ranged from fermentation, inoculation of vaccine
against rabies; & killing of bacteria in milk
(pasteurization)
20th century – rise of developments in Public
Health mostly associated with social reforms
Early part(1900) – infectious diseases : polio
and Yellow Fever (Aedes aegypti}
- Councils and boards for health established in
various countries – to combat diseases
regulating quarantine activities and
occupation-related issues that impact on the
people’s health
IN THE PHIL. (HISTORY OF PUB.
HEALTH)
A - PRE- SPANISH ERA -  building more hospitals and implementing
Ancient Filipinos regarded health as a harmonious
relationship with the environment, both natural and
supernatural.
- Belief in the power of both the animate and
inanimate world was central to their way of
life.
- Diseases, their causes and treatment were
associated with mysticism and superstitions.
(evil spirits or an enemy)
THE SPANISH ERA
Establishment of first health institutions - by
Spanish friars.
1st hospital, a dispensary organized by Franciscan
priest, Fr. Juan Clemente, later became San Juan
de Dios Hospital
- (Many were closed, destroyed. Some are still
withstanding like San Juan De Dios and San
Lazaro Hospital.)
Hospital Real de Españoles - the very first
hospital in the Philippines, was initially built in Cebu
in 1565 but was transferred to Manila. It was
destroyed by an earthquake in 1863.
The San Lazaro Church and Hospital -
represents early medical healthcare in the Spanish
era. By 1557 clinic-1558 hospital for leprosy patients
and other diseases. First name was Hospital de
Naturales/ Hospital de los Indios Naturales. Built by
Friar Juan Clemente
An important development in public health
administration during the Spanish regime was the
introduction of water supply in 1690.
➔ Founding of the country’s first medical school
(University of Santo Tomas-1871) 1611-built,
1871-college of medicine
➔ Around 1574, smallpox also called bolotong,
became the first recorded epidemic in the
history of the country. It spread to provinces
as far as Cagayan, Samar and Leyte and killed
over 30, 000 Filipinos by the 1760s.
➔ Spaniards organized Medicos Titulares
equivalent to health workers
HEALTHCARE UNDER THE AMERICANS
➔ After defeating the Emilio Aguinaldo-led
revolution, established Board for Health
for the Phil. Islands (thru Phil.
Commission;
➔ Americans provided better healthcare by
measures to prevent the spread of diseases.
➔ Later replaced by Board for Health - to
supervise all matters pertaining to public
health. During this time, a myriad of health
problems need to be confronted like the
abysmal state of public sanitation and the
uncontrolled spread of diseases. The Bubonic
plague ravaged Manila and several adjacent
towns, smallpox was still prevalent in the
provinces, and lepers lived in the streets
without medical assistance.
➔ Formal medical education and more medical
benefits given to Filipinos.
➔ Established garbage crematory (1899)
➔ First Sanitary ordinance and Rat Control
(1901)
➔ The cholera epidemic of 1902-1905 claimed
200,222 lives including 66,000 children.
Three percent of the population was
decimated in the worst epidemic in the
Philippine History.
HISTORY, AMERICAN REGIME
➔ In 1907, the Leper Law (Act No. 1711)
provided for the compulsory apprehension
detention and aggregation of lepers at the
Culion Leper Colony. (Culion – an island in
the province of Palawan)
➔ Hansen’s disease – Mycobacterium leprae
➔ Was known as the “Land of the Living
Dead” no definitive cure until the 1980s.
--was called the Island of No Return - that
during that time when a leprous member of
the family was collected for segregation,
families knew that it would be the last time
they would see him or her. Jun 27, 2012
➔ Tala Leprosarium, Dr. Jose N. Rodriguez
Memorial Hospital (DJNRMH), was
established in 1940 (Jul 17, 2012, in Caloocan
City)
HISTORY PH
Opening of the University of the Philippines College
of Medicine. (1907)
➔ 1905 started building
➔ 1910 changed name from Philippine
Medical School to UP College of
Medicine
*Medical education – one of the concerns of the
Board of Health not only because of the intimate
relationship of medicine to sanitation but because of
the scarcity of native physicians. The only existing
medical school was UST
- Board for Health was renamed Dept. of P
H and Welfare; Dr. Jose Fabella – 1st
secretary
- became DOH
PHIL. HISTORY OF PUBLIC HEALTH
Philippine Assembly-Commonwealth Period
*Start of Filipinization, the transfer of power from
Americans to Filipinos
➔ Opening of Philippine General Hospital
(1910)
➔ First initiated use of anti-typhoid vaccine
(1912)
➔ First time hypochlorite of lime was used for
treating water supply (1912)
➔ First used of dry vaccine against smallpox
(1913)
➔ Manufacture and free distribution of
“tiki-tiki” for treatment of beri-beri (1914)
➔ Anti-dysentery vaccine was first tried locally
(1922)
➔ Construction of regional leprosaria in Cebu,
Luzon, and Culion.
➔ Bureau of Health was reorganized into the
Department of Health and Public Welfare
(1940)
JAPANESE REGIME
➔ Japanese occupation - practically
paralyzed the activities on the whole country.
➔ Public health and sanitation - set back a
quarter of a century.
➔ Hunger, disease and epidemic stalked the
land and health and other social services were
in a large measure a shambles.
➔ The Bureau of Health continued to function
but the activities were directed towards the
handling of emergencies; the prevention of
the occurrence of epidemics especially
malaria, which was ravaging the Japanese
military; regulations for slaughtering of
cattle, hogs and carabaos and the creation of
the Board of Nutritional Research in 1943.
➔ After World War II,WHO, 1948
➔ 1950 – CDC, Centers for Disease Control and
Prevention in Atlanta, USA
➔ Penicillin – Alexander Fleming
➔ Polio vaccine – Jonas Salk & Albert Sabin
(Sabin’s vaccine – oral polio vaccine)
➔ Immunization – most popular public heath
intervention against CD
POST WORLD WAR II TO PRE-MARTIAL
LAW
After the Japanese occupation, incidence of
tuberculosis, malaria, and severe malnutrition
increased among the lower classes. Over 5,000
previously segregated lepers escaped in search of
food.
*Several milestones in public health marked
this post war period:
➔ Enactment on 19 June 1954 of Republic Act
1082 entitled: An Act Strengthening Health
and Dental Services in Rural Areas. *RHU
program
➔ Reorganization of the DOH (1958) - a partial
decentralization of power and created eight
Regional Health Offices, organized under
which were the provincial and municipal
health offices.
PRE MARTIAL LAW
The same period saw the creation of several offices -
➔ The Dental Health Services (1963)
➔ The Malaria Education Services (1966)
➔ The Disease Intelligence Center (1961),
➔ The Division of Nutrition (1960)
➔ Food and Drug Administration (1963)
➔ National Schistosomiasis Control
Commission
➔ National Nutrition Program (1968).
➔ Development of the Family Planning
movement
Launching of health programs like
➔ Project Helping Hand
➔ Operation Tribal Minority
➔ The Maria Way (Medical Assistance to Rural
Indigent Areas)
➔ Philippine Rural Reconstruction Movement
(PRRM)
Which aims to attract doctors to doctorless areas.
THE MARTIAL LAW
➔ At the height of all these development in
public health came the declaration of the
Martial law on Sept. 21, 1972.
➔ Nation was transformed from a Presidential
to a Parliamentary form of government.
Declared a new society, Presidential decrees (
ex. #1081)were issued one after the other.
➔ First decree created the National
Economic Development Authority for
economic planning.
➔ Dept. of Health - changed to Ministry of
Health continued to function in accordance
with public health structure previously laid.
➔ Implementation of the Restructured Health
Care Delivery system where the three levels of
care was evolved – the primary, the
secondary and the tertiary.
➔ The problem of access was addressed by the
establishment of Barangay Health Stations
manned by midwives. Tertiary Hospitals were
constructed – the Philippine Heart Center,
the Philippine Children’s Hospital.
➔ Operation Timbang and Mothercraft, a
nationwide nutrition program providing
supplementary food for infants and
pre-school and school children. (NUTRIBUN
– bread w/ vitamins)
➔ Rural Health Practice Program of the Dept. of
Health requiring graduates of Medicine and
Nursing to render service in rural areas.
➔ Creation of the Nutrition Council of the
Philippines (1974).
➔ Research Institute for Tropical Medicine
(RITM) was inaugurated on 23 April 1981 as
the research arm of the Department of Health
in infectious and tropical diseases.
THE AQUINO (CORY) ADMINISTRATION
➔ Ministry Health was renamed again as
Dept. of Health
➔ Proclamation No.6, 1986 - committed the
government to the goal of universal child and
mother immunization by 1990.
➔ In 1987 - the International Safe Motherhood
Initiative was launched to reduce maternal
deaths.
➔ Started the national Epidemic Surveillance
System in 1988 under the Field Epidemiology
Training Program in 18 sentinel states in
different regions of the country to track down
the occurrence of 14 diseases that have the
potentials of causing outbreaks including,
HIV/AIDS surveillance.
➔ The National Drug Policy together with the
Generics Act of 1988 RA 6675 to ensure the
availability of safe, effective, and affordable
quality drug identified by their generic name
and give the patient the first decision in the
choice of their drug.
➔ RA 7170 – Organ Donation Act of 1991 –
legalizing the donation of all or parts of the
body after death for specified purposes.
THE RAMOS ADMINISTRATION
➔ Dr. Juan Flavier - Secretary of the DOH,
continued to adopt Primary Health care as its
strategy but emphasis shifted from curative to
preventive and promotive care
➔ National Immunization Day
➔ While the expanded immunization program
has already been launched in the Aquino
administration, there were still some who
have not been reach because of peace and
order conditions or were in inaccessible
areas.
➔ “Ceasefire for Children” – nationwide
call so people would devote one day for the
immunization of their children against TB,
Diphtheria, Tetanus, Pertussis, Polio and
Measles.
➔ Response to the call – tremendous;
Non-government and government sectors,
religious organizations, civic groups, local
officials, media, private corporations,
international organizations and volunteers
gave their support.
➔ BCG (Bacille Calmette-Guerin) – a live
strain of Mycobacterium bovis developed by
Calmette and Guerin, an attenuated (reduced
strength) vaccine to prevent tuberculosis and
other mycobacterial infections.
➔ DPT (diphtheria, pertussis/whooping cough,
and tetanus)
➔ OPV (Oral Polio Vaccine)
➔ MMR (Measles, Mumps, Rubella/German
Measles)
➔ Promotion of Traditional Medicine
(herbal medicine)
➔ “Yosi Kadiri” (anti-smoking campaign)
➔ “Araw Sangkap Pinoy” to prevent Vitamin
A, iron and iodine deficiencies Status and
Recommendation on Flour Fortification with
Vitamin A and Iron.
➔ Creating the Philippine National AIDS
Council as a national policy and advisory
body in the prevention and control of HIV/
AIDS.

Undersecretary of Health, Dr. Jaime
Galvez-Tan
➔ RA 7719 “National Blood Services Act
of 1994” – to promote voluntary blood
donation.
➔ RA 8172 “An Act of Salt Iodization
Nationwide (ASIN).” An act providing for
salt iodization nationwide was approved 1996
named FIDEL.,( Fortified for Iodine
Deficiency Elimination)
➔ RA 7875 “National Health Insurance
Act of 1995” – The Philippine Health
Insurance Corporation (PhilHealth) was
established to oversee its implementation.
BENIGNO AQUINO, JR. ADMINISTRATION
➔ Tobacco and Alcohol Excise Tax Reform Act
of 2012
➔ Reproductive Health Act of 2012
INTERNATIONAL AGENCIES OF PUBLIC
HEALTH
● WHO – World Health Organization
● UNICEF – United Nation International
Children Emergency Fund
● CARE – Co-operative for Assistance and
Relief Everywhere
● UNDP – United Nations Development
Programme
● USAID – United States Agency for
International Development
● SIDA – Swedish International Development
Agency
● GAVI – The Global Alliance for Vaccines and
Immunization
PHIL. HEALTH AGENCIES
● Bureau of Food and Drugs (BFAD)
● Bureau of Health Devices and Technology
(BHDT)
● Bureau of International Health Cooperation
(BIHC)
● Bureau of Quarantine and International
Health Surveillance (BQIHS)
● Cleancities.net
● Commission on Population (POPCOM)
● Dangerous Drugs Board (DDB)
● Department of Health (DOH)
● Department of Health Treatment and
Rehabilitation Center- Bicutan
● Health Human Resource Development
Bureau (HHRDB)
● Integrated Day Services for Senior Citizens
and Children
● Lung Center of the Philippines
● National Kidney and Transplant Institute
(NKTI)
● National Adverse Drug Reaction Advisory
Committee (NADRAC)
● National Center for Disease Prevention and
Control (NCDPC)
● National Center for Health Promotion
(NCHP)
● National Center for Mental Health (NCMH)
● National Epidemiology Center (NEC)
● National Nutrition Council (NNC)
● Occupational Safety and Health Center
(OSHC)
● Philippine College of Physicians (PCP)
● Philippine Council for Health Research and
Development (PCHRD)
● Philippine Health Insurance Corporation
(PhilHealth)
● Philippine Heart Center (PHC)
● Philippine Institute of Traditional ad
Alternative Health Care (PITAHC)
● Philippine National AIDS Council (PNAC)
● Research Institute for Tropical Medicine
(RITM)
● The INCLEN Trust
● Visayas Primary Health Care Services, Inc.
● 1977 – small pox, eradicated
● 1978 – Declaration of Alma-Ata on Primary
Health Care(from Kazakhstan), Health is a
human right
● 2000- “Health for All” but many commented
impossible to achieve
● Selective Primary Health Care-
conference in Italy
● 1982 – UNICEF (United Nations Int’l
Children’s Emergency Fund came up w/
GOBI strategy
● Growth Monitoring, Oral Rehydration
Therapy, Breastfeeding and Immunization
● Later GOBI-FFF – Family Planning, Food
Supplementation & Female Literacy
● Emerging Diseases –AIDS (20th
century-)
● Early part of 21st century)
● AIDS – caused by HIV transmitted :
 unprotected sex, contaminated blood
transfusion, hypodermic needles and mother
to child during pregnancy (Vertical
transmission), delivery or breast feeding
● NO cure for AIDS but anti-retroviral
treatment – reduce risk of death and
complications
● 2003 – SARS (severe acute respiratory
syndrome), Hongkong and southern part of
China – spread to 37 countries + Phil ( 14
cases in Phil, 2 died)
● Swine flu , 1998 – US, H1N1 flu virus (Int’l)
● 1918 flu pandemic was due to Swine flu
● 1997-2002 – new strains,H5N1(Avian),
H3N2 & H1N1
● Hemagglutinin, Neuraminidase
surface antigens
● 1976 – microbiologist, Peter Piot, discovered
Ebola Virus while investigating mysterious
illness in Zaire (Congo);
● 2014 , parts of West Africa – Ebola
outbreak; NO cure
● Public Health continues to evolve as it
responds to dynamic changes in society,
locally & globally
● Middle East respiratory syndrome
coronavirus (MERS-CoV) Mar 11,
2019 — MERS-CoV is a zoonotic virus,
which means it is a virus that is transmitted
between animals (dromedary camels) and
people. 
● 2019 Wuhan corona virus
(SARS-CoV-2) - CoVid-19 disease
● Variants – alpha, β,γ,delta , Omicron
PRES. RODRIGO R. DUTERTE
Officially signed the Universal Health Care (UHC)
Act into law, which guarantees equitable access to
quality and affordable healthcare services for all
Filipinos; will automatically enroll Filipino citizens
into the National Health Insurance Program and
expand PhilHealth coverage to include free medical
consultations and laboratory tests.
Aside from the automatic enrollment of all Filipinos
to PhilHealth, other significant reforms that will be
implemented over time include: designating
PhilHealth as the national purchaser for health
goods and services for individuals, such as medicines
RA. 11525 by Pres. RRD
– - Begun and held in Metro Manila, on Monday, the
twenty-seventh day of July, two thousand twenty.
AN ACT ESTABLISHING THE CORONAVIRUS
DISEASE 2019 (COVID-19) VACCINATION
PROGRAM EXPEDITING THE VACCINE
PROCUREMENT AND ADMINISTRATION
PROCESS, PROVIDING FUNDS THEREFORE, AND
FOR OTHER PURPOSES
- Sec 12 vaccine card NOT mandatory
requirements for educational, gov’t
transactions

FUTURE OF PUBLIC HEALTH

Wide range of issues:
➔ Infectious diseases – ex. HIV/AIDS
➔ Chronic diseases
➔ Violence
➔ Injury prevention
➔ Birth defects
➔ Bioterrorism

Public health practitioners – doctors, nurses,

engineers, nutritionists
Professionals in the behavioral & social
sciences – demographers, communication
specialists: & specialists in evaluation science and
decision science