Bridging the gap: A call for transforming nephrology, healthcare in Phl

Just last week at American Society of Nephrology (ASN) Kidney Week 2024 in San Diego, we were surrounded by the latest advancements in nephrology. From breakthroughs in chronic kidney disease (CKD) management to innovations in dialysis and transplantation, each development promises a better future for patients. Yet, for those of us connected to the Philippines, the experience brings to light a stark reality: many of these advancements feel out of reach for Filipino patients.

Kidney disease is a significant health issue in the Philippines. With CKD rates steadily rising and dialysis dependency increasing, kidney care should be a national priority. However, the challenges facing Filipino patients with kidney disease echo the broader issues within our healthcare system. The disparity between the resources available at a global conference like ASN and the needs of Filipino patients back home is a powerful reminder of the systemic changes required to transform healthcare in our country.

Challenge of misdirected resources

In the Philippines, nephrology — and healthcare in general — often operateS in a system where resources are misallocated. While high-cost interventions are sometimes used for those who don’t benefit most, essential care remains inaccessible to many. Kidney patients, who often face lifelong treatment, are especially vulnerable to these gaps. Chronic dialysis, for instance, is a necessity for end-stage kidney disease, yet many Filipinos struggle to access even the most basic level of care.

If our healthcare system is better aligned with its resources with patient needs, we could redirect funds from costly procedures toward accessible treatments that benefit the majority. Basic, proven interventions — such as structured CKD management programs, dialysis for those who need it, and affordable medications — could have a transformative impact. In this way, nephrology can serve as an example of how aligning resources with patient needs can improve care for all Filipinos, not just those with kidney disease.

Learning from our neighbors’ progress

Looking across Southeast Asia, several countries that once faced similar healthcare challenges have transformed their systems in just a single generation. Take Thailand, for instance. Through the introduction of its Universal Coverage Scheme, Thailand managed to make healthcare accessible to 99.5 percent of its population, significantly improving public health outcomes and reducing poverty due to medical expenses. By focusing on universal access and preventive care, Thailand has become a model for how resource-limited countries can still offer comprehensive healthcare.

Vietnam, another close neighbor, has also made significant strides. Over the past two decades, Vietnam has expanded its healthcare infrastructure, focusing on primary care and preventive services. With targeted investments and effective health policies, Vietnam has reduced its infant mortality rate by more than 70 percent and nearly doubled life expectancy since the 1990s. Today, it stands as an example of how focused reforms can create impactful, long-term change in public health.

These success stories offer the Philippines valuable lessons. Through government-led reforms that prioritize access, quality, and cost-effectiveness, countries like Thailand and Vietnam have shown that it’s possible to build healthcare systems that serve all citizens equitably. For the Philippines, these examples illustrate that the goal isn’t just about acquiring high-end technologies; it’s about creating a framework that meets our population’s health needs.

Vision for nephrology and healthcare in the Philippines

What could a renewed vision for kidney care and healthcare in the Philippines look like? It must focus on creating a healthcare system that is effective, accessible, and tailored to the realities of Filipino society. For nephrology, this means prioritizing services that address the most pressing needs — such as early diagnosis, community-based management of CKD, and a robust dialysis network.

This vision should also extend beyond nephrology, ensuring that healthcare is a universal right rather than a privilege. By prioritizing treatments that are proven, cost-effective, and accessible, the Philippines can avoid the trap of investing in high-cost interventions that serve only a few and instead work toward a system that provides for all.

In this vision, nephrology can play a leading role in demonstrating how a balanced, practical approach to healthcare can make the greatest impact. If the system’s resources are directed toward what genuinely improves patient outcomes, nephrology — and all of healthcare — will be more sustainable and effective for all Filipinos.

Role of the next generation of physicians

Key part of this vision lies in empowering the next generation of Filipino healthcare providers. They represent a wealth of potential, with many having trained internationally and bringing a deep commitment to improving local healthcare. Witnessing Filipino trainees and practitioners at global conferences like ASN Kidney Week is a testament to this dedication. With the right support, mentorship and focus on local needs, these young doctors can be the catalysts for positive change within the country.

Our goal is not to replicate another country’s healthcare system but to develop a uniquely Filipino approach that addresses our population’s health needs and aspirations. The next generation of healthcare providers has the potential to drive this shift, moving the country’s healthcare system closer to one that is practical, sustainable and inclusive.

The path forward

The road ahead for Philippine healthcare reform is challenging but not insurmountable. With a generation of skilled and dedicated professionals and successful models to draw inspiration from, there is every reason to believe that the Philippines can create a healthcare system that is not only advanced but equitable. We owe it to the Filipino people to push for this change to refuse to settle for a system that leaves too many behind and, instead, build one that provides quality care for everyone.

In this way, we can reimagine the Philippines as not only the “Pearl of the Orient” in name but as a nation whose healthcare system reflects the resilience, strength and dignity of its people.