Philippines behind on commitment to combat HIV/AIDs

A UNAIDS official noted Friday that the Philippines is lagging in its commitment to combat HIV/AIDs — one of seven nations in the world, and only of two in the Asia-Pacific region, where the incidence rate of HIV infections increased by over 25%. However, the political will to implement a comprehensive, cooperative and inclusive health program could reduce incidence rates down to zero in five years and improve the country’s chances at achieving its Millennium Development Goals (MDGs).

“In all of Asia and [the] Pacific, more than 60 countries, the only two countries where [incidence] rates have increased by 25% are Bangladesh and the Philippines,” said Steven J. Kraus, director of the regional support team in Asia and the Pacific for the Joint United Nations Programme on HIV/AIDS (UNAIDS), citing findings from the UNAIDS Global Report on the epidemic released last November.

Mr. Kraus said the Philippines is going against the global trend of a 20% decline in HIV infections, and is at risk on several MDG targets, namely universal education (MDG1), maternal health (MDG5), gender equality (MDG3), the environment (MDG7), and of course HIV/AIDS (MDG6).

“The Philippines won’t meet the other MDGs if they also don’t meet their MDG 6. The reverse is also true… They are all interrelated. Progress on one actually does result in progress on others,” Mr. Kraus said.

The Philippine government, he said, could take its cue from other governments that have reviewed the MDGs, redoubled their efforts and changed their policies to meet their targets.

Malaysia, having identified in 2007 that drug use was driving the HIV/AIDS epidemic in the country, changed its punitive laws and legislations on drug use. It now offers medical services to drug dependents who wish to reduce their dependency via methadone maintenance treatment (MMT), and expanded a program on distributing needle syringes so drug dependents are allowed to inject drugs safely.

Similarly, drug use is a primary mode of transmission in Bangladesh, the only other Asian country with an over 25% increase in incidence. The Muslim nation has followed Malaysia in expanding its needle syringe exchanges, and offering MMT or opiate substitution therapy (OST). They’ve also scaled up programs with sex workers to include condom-distribution.

China, which has five provinces that account for 50-60% of infections in the region, has the world’s largest expansion of OST — from eight centers in 2004 to over 600 centers in 2010. Condoms are available in sex work. And given that 30% of all infections in China are men having sex with men (MSM), they’ve provided grants to MSM communities to implement projects in their own community. This includes drop-in centers for peer support, outreach to where men gather to have sex, condom promotion, treatment for sexually transmitted infections (STIs) and programs to improve self-esteem.

“They’re very practical… Let’s acknowledge that this behavior exists, and let’s work with that. So there’s examples in the region — and that’s one of the reasons why we see success in Asia,” said Mr. Kraus.

The Philippines faces the same issues, Mr Kraus noted, the same vulnerable populations being drug users and sex workers, and predominantly MSM (82%), who usually stay under the radar because of the stigma (even if the Philippines has not criminalized MSM as have 20 other Asian countries).

“Keeping human behavior underground and making human behavior illegal is not a good approach… If you criminalize adult behavior, you are going in the direction that puts the health of populations at risk, and you create an environment where those who need services the most don’t get them,” said Mr. Kraus.
Countries such as Switzerland and Germany have de-criminalized “adult behavior” such as prostitution. New Zealand, through a public dialogue, went so far as to actually legalize it.

While these are radical approaches that may not be easily accepted in a predominantly Catholic country such as the Philippines, there are other proven methods that can be adopted. The Church, he said, is actually a valuable partner in the efforts of the Philippines to find its own combination of prevention methods to craft a comprehensive, acceptable program.

“I’m absolutely convinced that the Philippines, if they put their mind to it, the government, civil society and the Church, you’ll bring down your 25%, you’ll have a 25% reduction in the next five years.”  –Businessworld