Scaling Up the Fight Against Thyroid Disease: ABCGH and Merck Expand Community Screening Nationwide
- Dr. Arthur Gallo
- 2 days ago
- 7 min read
When we first rolled out our community based thyroid screening program, my hope was simple. Prove that we could catch thyroid disease early in the communities we serve. Build the real world evidence to convince partners that it was worth doing at scale. That earlier pilot did exactly that. It gave us the data to show what many of us in Asia Pacific medicine have long suspected. Our region carries a high burden of thyroid disorders, and too many cases go undiagnosed until they have already caused complications.
If you have not read that first piece, start there. It is the foundation for everything below. You can find it here: Free Thyroid Screening Program Launched by Merck and ABC's for Global Health.
I am glad to share that, on the strength of that evidence, ABC's for Global Health and Merck have partnered once again. This time, we are taking the program well beyond Pampanga.
Why thyroid disease is a quieter problem than it should be
Most people think of thyroid disease as rare, or as something that only shows up on a lab report by accident. In my years of practice, first in surgery and now running community health programs, I have seen the opposite. Thyroid disorders are common, and they hide well. A patient with an underactive thyroid might just feel tired, gain some weight, or feel cold more often than usual. A patient with an overactive thyroid might feel anxious, lose weight without trying, or notice a racing heartbeat. None of these symptoms scream thyroid disease on their own. They get blamed on stress, age, or a busy season of life.
That is exactly why screening programs like this one matter. We are not waiting for patients to walk in complaining of a swollen neck or an obvious symptom. We are going out and testing broadly, in communities where a lab test for thyroid function would otherwise be out of reach because of cost or distance.
How TSH and FT4 screening actually works
I get asked this fairly often, so let me explain it simply. TSH stands for thyroid stimulating hormone. It is produced by the pituitary gland, and it tells your thyroid how much hormone to make. When TSH comes back abnormal, high or low, it is usually the first sign that something is off with thyroid function. FT4, or free thyroxine, measures the actual thyroid hormone circulating in your blood. Together, a TSH and FT4 result give our clinicians a much clearer picture than either test alone.
A single TSH kit and a single FT4 kit are simple, affordable tools. What is expensive, historically, has been getting them into the hands of people who never see an endocrinologist. That is the gap this expansion is closing.
Bringing screening to Benguet and Iloilo
We distributed 3,000 TSH test kits and 300 FT4 kits to two provincial governments that share our belief. Prevention has to happen where people already are, not only inside hospital walls. In Benguet, under Governor Melchor Daguines, the partnership launched in February 2026. In Iloilo, under Governor Arthur R. Defensor, Jr., it followed in April 2026.
Both provinces bring their own challenges. Benguet has mountainous terrain, with communities spread across elevations that make regular transportation difficult. Iloilo has a wide island geography, where reaching a barangay can mean a boat trip in addition to a long drive. In both cases, local government leadership made the difference between a good idea on paper and kits that actually reached patients. Our team worked directly with each province's health office to plan routes, train local health workers on proper sample handling, and set realistic targets for each rollout phase.
A national push during International Thyroid Awareness Week
In the last week of May 2026, we joined the Philippine College of Endocrinology, Diabetes and Metabolism, known as PCEDM, for a nationwide screening drive. This was part of International Thyroid Awareness Week 2026. Through the work of PCEDM's regional and local component societies, we screened 800 individuals across the country in that single week.
What struck me most about that week was not just the number, though 800 screenings in seven days is meaningful. It was watching endocrinologists, general practitioners, and community health workers from different regions all pulling toward the same goal at the same time. I am a surgeon who has treated advanced thyroid disease that could have been caught years earlier. Weeks like this one are exactly why I do this work.
Meeting people where they already go
Screening only works if it is accessible. So we also brought the program into everyday spaces. Watsons and Mercury Drug partnered with us to raise awareness across their branches in Metro Manila. We screened 300 patients on site and put up patient facing infographics, so that even someone just picking up a prescription could learn their risk.
This is the model I keep coming back to. Do not wait for patients to find specialty care. Bring basic screening into the pharmacy, the barangay hall, and the mobile clinic. It is the same philosophy behind our broader approach to chronic disease, which I have written about in more detail in our overview of the
most prevalent chronic diseases in the Philippines. Thyroid disease sits alongside diabetes and hypertension as a condition that responds well to early detection and much worse to being ignored.
What happens after a positive screening result
A screening test is only useful if there is a clear next step, so I want to walk through what happens when a patient's TSH or FT4 result comes back abnormal. Our clinical team reviews the result and speaks with the patient directly, in plain language, about what it means. For many patients, this leads to a referral for confirmatory testing and, where needed, a connection to an endocrinologist or a partner hospital. For patients managing a chronic thyroid condition long term, we talk about treatment options and how to keep taking prescribed medication consistently, which matters just as much for thyroid disease as it does for the maintenance medicines I have written about before.
We do not consider a screening complete once the test is run. It is complete once the patient understands their result and knows what to do next. That follow through is, honestly, the harder and more important half of the work.
Why this matters
Thyroid disease sits squarely in the non communicable disease category that our health system, and health systems across the Asia Pacific, are still catching up on. Diagnosis remains out of reach for many Filipino families simply because of cost. Undiagnosed thyroid disorders do not just sit quietly. They can mask or worsen other conditions, from cardiovascular strain to complications in pregnancy. Every kit we distribute is, in a very real sense, an attempt to close that gap before it becomes a hospitalization.
There is also a broader research value here. Every result we collect, with patient consent, adds to a growing body of real world evidence about thyroid disease prevalence in the Philippines. That evidence is what convinced Merck to expand this partnership in the first place, and it is what will make the case for the next expansion after this one.
What we look for in a partner province
Not every province is ready for a rollout like this on day one, and I want to be transparent about what we actually look for before committing kits and staff time. We need a provincial or city health office willing to co-own the logistics with us, since we cannot cover every barangay alone. We need at least one accessible cold chain or storage point for kits, even simple ones, to keep test materials usable.
And we need a way to close the loop after screening, whether that is an endocrinology referral network, a partner hospital, or a public health office equipped to follow up on abnormal results. Benguet and Iloilo had all three, which is part of why those partnerships came together as quickly as they did.
Training the people who run the screenings
A kit is only as good as the person using it. Before any of these rollouts began, our team spent time training local health workers and volunteers in each province on proper sample collection, kit handling, and how to explain the process to a nervous patient in a way that actually puts them at ease. Small details matter here. A rushed explanation makes people distrustful of a test they do not understand. A calm, clear one gets more people to say yes, and more accurate samples once they do.
This training investment is part of why I am confident these numbers will hold up as real, usable data rather than a one time count. The people running the screenings in Benguet and Iloilo today will still be running them next year, and the year after that, using the same standards we set from day one.
Putting the Asia Pacific burden in context
It is worth explaining why I keep returning to the phrase Asia Pacific when I talk about thyroid disease, rather than just talking about the Philippines on its own. Iodine related thyroid conditions, autoimmune thyroid disease, and nodular thyroid disease all show patterns across our region that differ from what gets published in research coming out of North America or Europe. A screening protocol built entirely on data from elsewhere can miss what is actually happening here.
That is part of why the real world evidence from our original pilot mattered so much to Merck, and why I believe it will matter to the next partner we bring into this work. We are not just running a generic screening program in the Philippines. We are building a Philippine specific, and more broadly an Asia Pacific specific, picture of how common these conditions really are, and at what age they tend to show up.
What's next
Data collection and analysis across all these sites is still ongoing. We are working toward a target of 10,000 patients screened before we publish our full results. I look forward to sharing what we learn, both the clinical findings and the lessons on what it takes to run a program like this across such different regions of the country.
If your community, pharmacy, or local government wants to be part of this effort, we would welcome the conversation. Reach out through our contact page, or read more about the communities we already serve on our story and projects page.
Comments