I was recently standing in a corridor of a hospital ward, fully expecting to see rows of patients battling dengue or tuberculosis — illnesses I often saw during medical school. Instead, bed after bed was filled with people recovering from strokes, nursing kidney problems, or fighting complications from diabetes. These non-communicable diseases (NCDs) have quietly overtaken infectious diseases as the biggest killers in the Philippines. They might not spread the way viruses do, but they’re everywhere. And let’s be honest: we’re not doing nearly enough to stop them.

A crisis we can no longer ignore

The statistics tell a sobering story: seven out of 10 Filipino deaths now come from NCDs. Each year, countless Filipinos suffer heart attacks, strokes, or kidney failure that could have been prevented. Our country even has one of the highest rates of kidney disease in Southeast Asia, driven largely by uncontrolled diabetes and hypertension. If these trends hold, experts warn that NCDs could double by 2040 — an alarming prospect for millions of families.

But this crisis doesn’t stop at our hospitals; it also wreaks havoc on our economy. NCDs cost the Philippines around ₱756.5 billion every year, draining household savings and overwhelming healthcare services. Roughly 30 percent of health expenses go toward managing chronic conditions, and a large portion of that comes directly out of patients’ pockets. Too often, families must choose between buying medicine or putting food on the table. In a country where job instability and poverty are already pressing concerns, the added burden of an NCD can push entire households to the brink.

The policies that worked — and where we’re falling short

It’s not that our government has been asleep at the wheel. The Sin Tax Law, which raised taxes on cigarettes and alcohol, was a genuine game-changer. Smoking rates dropped, and the revenue helped fund public health programs. In 2018, an additional tax on sugary beverages aimed to curb rising obesity and diabetes. Both were based on solid evidence and, when enforced properly, showed real results.

However, good policies lose steam when they’re not enforced aggressively or expanded intelligently. Even with higher tobacco taxes, one in five Filipino adults still smokes -- and an alarming number of teenagers are picking up the habit. While soda has gotten pricier, junk food remains cheap, heavily processed, and aggressively marketed. Young children, especially in urban areas, are bombarded with ads for salty snacks and instant meals, driving our collective salt intake to twice the recommended limit and fueling a hypertension crisis.

Healthcare access is another stumbling block. The Universal Health Care (UHC) Law was supposed to guarantee preventive services for everyone, but many Filipinos still don’t have a regular doctor or can’t afford their medications. All too often, people show up at the hospital only after their kidneys have failed or a stroke has robbed them of the ability to work. Although PhilHealth pays for some medical expenses, out-of-pocket costs for NCDs remain crippling, causing many families to drain their life savings just to stay afloat.

What needs to change?

If we’re serious about reversing these trends, we can’t keep focusing on symptoms. We have to target root causes — both in our public policy and our everyday environments. That means:

1. Strengthening primary care

Barangay health workers must be the front line in screening for hypertension and diabetes. These dedicated community workers are doing their best in many areas, but they’re often short on manpower, proper training, and basic equipment. Giving them the support and funding they need could significantly reduce the number of severe cases that end up in our hospitals.

2. Making healthier choices more accessible

Right now, it’s cheaper and easier to buy instant noodles than to put fresh vegetables on the table. Public spaces for safe exercise — parks, sidewalks and bike lanes — are limited, especially in crowded cities. Yet places like Marikina have shown that urban areas can be redesigned to encourage physical activity, build clean public markets, and promote a healthier lifestyle. We need a “health-in-all-policies” approach nationwide, ensuring decisions about zoning, agriculture, and taxation are made with public health in mind.

3. Expanding telemedicine

The pandemic demonstrated how effective telehealth can be. If a patient with diabetes in a remote barangay could speak to an endocrinologist online every few months, they might avoid dangerous complications. By covering teleconsultations through PhilHealth, we could catch NCDs earlier and manage them better, especially in underserved areas.

4. Introducing stronger food policies

We’ve shown that taxes can help reduce consumption of harmful products like cigarettes and sugary drinks. Why not junk food packed with salt, trans fats, and other harmful ingredients? Many countries have banned trans fats outright and required clear, front-of-pack labeling to help consumers make quick, informed decisions. A similar move here could steer people toward healthier choices — and potentially save thousands of lives.

A silent epidemic that demands action

Unlike a pandemic that sparks immediate alarms, NCDs tend to slip under the radar. They creep in slowly, exacting a deadly toll over months and years. Yet the reality is that we are smack in the middle of a preventable crisis. The question is whether we’ll continue to let it grow or finally address it head-on with real urgency.

We know stronger primary care can catch illnesses early, preventing expensive, life-threatening complications down the road. Implementing these measures broadly — and ensuring they stick — could save over 350,000 Filipino lives in the next 15 years. That figure represents countless families spared from heartbreak and economic ruin, and a healthcare system focused on preventive measures rather than last-ditch efforts to save lives.

NCDs may not dominate the headlines the way Covid-19 once did, but they’re just as lethal, if not more so. Will we wait for more families to lose everything to chronic illness? Or will we finally put non-communicable diseases at the top of our agenda? We have no time for half-measures. Whether it’s pushing for stronger food regulations, providing better funding for UHC, or boosting frontline screenings, the time to act is now.