The recent government issuances involving the Coronavirus Disease 2019 (Covid-19) cite Republic Act No. 11332, also known as the “Mandatory Reporting of Notifiable Diseases and Health Events of Public Health Concern Act” (approved on 26 April 2019). Here is a primer on R.A. 11332.

What are the powers granted to public health authorities under this law?

(1) Mandatory reporting of reportable diseases and health events of public health concern;

(2) Epidemic/outbreaks and/or epidemiologic investigation, case investigations, patient interviews, review of medical records, contact tracing, specimen collection and testing, risk assessments, laboratory investigation, population surveys, and environmental investigation;

(3) Quarantine and isolation; and

(4) Rapid containment and implementation of measures for disease prevention and control.

What is a “public health authority”?

“Public health authority” refers to the Department of Health (DOH) (specifically the Epidemiology Bureau, Disease Prevention and Control Bureau, Bureau of Quarantine and International Health Surveillance, Health Emergency Management Bureau, Food and Drug Administration, government hospitals. Research Institute of Tropical Medicine and other National Reference Laboratories, and DOH Regional Offices), the local health office (provincial, city or municipality), or any person directly authorized to act on behalf of the DOH or the local health office.

What is a “notifiable disease”?

A notifiable disease refers to a disease that, by legal requirements, must be reported to the public health authorities. 

Who has the duty to prepare a list of nationally notifiable diseases and health events of public health concern?

The Epidemiology Bureau under the DOH shall regularly update and issue a list of nationally notifiable diseases and health events of public health concern with their corresponding case definitions.The selection and the deletion of diseases and health events of public health concern shall be based on criteria established by the DOH.

What is a “health event of public health concern”?

Health event of public health concern refers to either a public health emergency or a public health threat due to biological, chemical, radio-nuclear and environmental agents.

What is a “public health emergency”?

A public health emergency refers to an occurrence or imminent threat of an illness or health condition that:

(1) Is caused by any of the following:

• (i) Bio terrorism;

• (ii) Appearance of a novel or previously controlled or eradicated infectious agent or biological toxin;

• (iii) A natural disaster;

• (iv) A chemical attack or accidental release;

• (v) A nuclear attack or accident; or

• (vi) An attack or accidental release of radioactive materials; and

(2) Poses a high probability of any of the following:

• (i) A large number of deaths in the affected population;

• (ii) A large number of serious injuries or long-term disabilities in the affected population;

• (iii) Widespread exposure to an infectious or toxic agent that poses a significant risk of substantial harm to a large number of people in the affected population;

• (iv) International exposure to an infectious or toxic agent that poses a significant risk to the health of citizens of other countries; or

• (v) Trade and travel restrictions.

What is an “infectious disease”?

Infectious disease refers to a clinically manifested disease of humans or animals resulting from an infection.

What is an “emerging or re-emerging infectious diseases”?

Emerging or re-emerging infectious diseases refer to diseases that: (1) have not occurred in humans before; (2) have occurred previously but affected only small numbers of people in isolated areas; (3) have occurred throughout human history but have only recently been recognized as a distant disease due to an infectious agent; (4) are caused by previously undetected or unknown infectious agents; (5) are due to mutant or resistant strains of a causative organism; and (6) once were major health problems in the country, and then declined dramatically, but are again becoming health problems for a significant proportion of the population.

What is a “public health threat”?

A public health threat refers to any situation or factor that may represent a danger to the health of the people.

What is an “epidemic” or “outbreak”?

An epidemic/outbreak refers to an occurrence of more cases of disease than normally expected within a specific place or group of people over a given period of time.

Who has the power to declare the existence of an epidemic or public health emergency?

The Secretary of Health shall have the authority to declare epidemics of national and/or international concerns except when the same threatens national security. In which case, the President of the Republic of the Philippines shall declare a State of Public Health Emergency and mobilize governmental and nongovernmental agencies to respond to the threat.

Provincial, city or municipal health offices may only declare a disease outbreak within their respective localities provided the declaration, is supported by, sufficient scientific evidence based on disease surveillance/data, epidemiologic investigation, environmental investigation, and laboratory investigation.

What is “mandatory reporting”?

Mandatory reporting refers to the obligatory reporting of a condition to local or state health authorities, as required for notifiable diseases, epidemics or public health events of public health concern.

The DOH, through the Epidemiology Bureau, shall issue the official list of institutionalized public health information system, disease surveillance and response systems for mandatory reporting of notifiable diseases and health events of public concern.

The DOH and its local counterparts are mandated to implement the mandatory reporting of notifiable diseases and health events of public health concern.

All public and private physicians, allied medical personnel, professional societies, hospitals, clinics, health facilities, laboratories, institutions, workplaces, schools, prisons, ports, airports, establishments, communities, other government agencies, and NGOs are required to accurately and immediately report notifiable diseases and health events of public health concern as issued by the DOH.

What is “disease surveillance”?

Disease surveillance refers to the ongoing systematic collection, analysis, interpretation, and dissemination of outcome-specific data for use in the planning, implementation, and evaluation of public health practice. A disease surveillance system includes the functional capacity for data analysis as well as the timely dissemination of these data to persons who can undertake effective prevention and control activities.

The DOH and its local counterparts shall establish and maintain functional disease surveillance and response systems, which include coordination mechanisms, implementation protocols for reporting and response, measures for data security and confidentiality, and procedures and provision to ensure safety of personnel conducting disease surveillance and response activities.

Data collection, analysis, and the dissemination of information from official disease surveillance and response systems can only be done by authorized personnel from the DOH and its local counterparts and may only be used for public health concern purposes only; thus, should be exempted in the provision of Data Privacy Act on accessibility of data.

The DOH and its local counterparts shall ensure that all surveillance and response officers have adequate capacity for mandatory reporting of notifiable diseases, risk assessment, epidemiology, disease surveillance, and response to epidemics and health events of public health concern. It shall also ensure that the safety and protection of all personnel directly involved in surveillance and response activities are upheld.

All personnel of the DOH and its local counterparts, and all other individuals or entities involved in conducting disease surveillance and response activities shall respect, to the fullest extent possible, the rights of people to liberty, bodily integrity, and privacy while maintaining and preserving public health and security.

What is “epidemiologic investigation”?

Epidemiologic investigation refers to an inquiry to the incidence, prevalence, extent, source, mode of transmission, causation of, and other information pertinent to a disease occurrence.

How to establish the Epidemiology and Surveillance Units (ESUs)?

The DOH, in coordination with the LGUs, shall ensure that the Epidemiology and Surveillance Units (ESUs) are established and functional in all levels of the DOH and its local counterparts, and in public and private health facilities and laboratories, as well as ports and airports in ah provinces, cities and municipalities throughout the country. The ESU shall capture and verify all reported notifiable diseases and health events of public health concern; provide timely, accurate, and reliable epidemiologic information to appropriate agencies; conduct disease surveillance and response activities; coordinate needed response; and facilitate capacity building in the field of epidemiology, disease surveillance and response at the Epidemiology Bureau.

All ESUs shall have trained required human resource complement and provision of adequate resources, including equipment, logistics, communication, transportation, laboratory supplies and reagents, personal protective equipment and health insurance, to effectively perform their disease surveillance and response functions.

What acts are prohibited under this law?

The following are prohibited under R.A. 11332:

• (a) Unauthorized disclosure of private and confidential information pertaining to a patient’s medical condition or treatment.

• (b) Tampering of records or intentionally providing misinformation.

• (c) Non-operation of the disease surveillance and response systems.

• (d) Non-cooperation of persons and entities that should report and/or respond to notifiable diseases or health events of public concern.

• (e) Non-cooperation of the person or entities identified as having the notifiable disease, or affected by the health event of public concern.

Disclosure of confidential information will not be considered violation of this Act under this section if the disclosure was made to comply with a legal order issued by a court of law with competent jurisdiction.

[See Arresting Patients who Lie about material Travel History, or those who Refuse to Comply with the Quarantine]

What are the penalties for violations?

Commission of the prohibited acts shall be penalized with a fine of not less than P20,000 but not more than P50,000, or imprisonment of not less than one (1) month but not more than six (6) months, or both such fine and imprisonment, at the discretion of the proper court.

The Professional Regulation Commission shall have the authority to suspend or revoke the license to practice of any medical professional for any violation.

The Civil Service Commission shall have the authority to suspend or revoke the civil service eligibility of a public servant who is in violation.

If the offense is committed by a public or private health facility, institution, agency, corporation, school, or other juridical entity duly organized in accordance with law, the chief executive officer, president, general manager, or such other officer in charge shall be held liable. In addition, the business permit and license to operate of the concerned facility, institution, agency, corporation, school, or legal entity shall be cancelled.