Philippines AIDS crisis looms

While HIV infection rates have dropped globally over the last decade, recent predictions warn that the Philippines will see a five-fold increase in infections before President Benigno Aquino finishes his current term.  But last week’s UN High Level Meeting on AIDS offers the administration a chance to reset policy and commit to reversing recent trends.

On June 8-10, thirty years after the world’s first reported case of HIV, the UN General Assembly met to set new goals for combating the spread of the virus. As the meeting concluded, the General Assembly adopted a wide-ranging agenda for curtailing the global HIV/AIDS epidemic, though it will be up to individual nations to implement their own prevention and treatment strategies.

To date, the Philippines has escaped the worst of the AIDS crisis. Although low condom use, an active sex industry, and widespread lack of knowledge about HIV have long presaged a dangerous outbreak, official figures put the number of infected persons under 15,000 in a country of over 90 million. While the official numbers almost certainly reflect under-reporting, the situation in the Philippines hasn’t yet reached the dangerous levels seen a decade ago in Thailand or Cambodia or, more recently, in Indonesia.

Sadly, long-standing predictions of higher HIV/AIDS infection rates seem to have started coming true. Official numbers from the Philippine National AIDS Council (PNAC) for the first four months of 2011 show marked increase in infections from the previous year; since 2009, infection rates have more than doubled. Cases among youth between 15 and 24 years of age have spiked 1,000 percent in the last three years. Given the general lack of knowledge and stigmatization of HIV, the official figures probably belie a far more serious situation.

In May, extrapolating from these data, Department of Health (DOH) Undersecretary Enrique Tayag warned that the Philippines would see five times the number of HIV cases by 2015.

Tayag was part of the delegation that attended last week’s meeting, and he was joined by DOH Secretary Enrique T. Ona and Undersecretary David Lozada.  Now back in Manila, these officials have the chance to play an important role in convincing the Aquino administration to take a more proactive approach to combating HIV in line with the goals outlined by the General Assembly’s Political Declaration (pdf).

Legally, Philippine HIV/AIDS policy is guided by a 1998 law, Republic Act No. 8504 (RA 8504). Although dated by over a decade, RA 8504 provides an excellent framework for containing outbreaks and reducing future risk, including provisions for HIV/AIDS education in public schools, guidelines for blood donations, and expanded HIV testing throughout the country. Recently, national politicians, including former first lady Imelda Marcos, who was elected to Congress last year, have called for the strengthening of the law.

But while congressional calls for more PNAC funding are welcome, the proposed reforms focus primarily on more monitoring.  At present, PNAC does an admirable job of collecting and rapidly reporting data. Also, though some reforms are needed, in its original form RA 8504 lays out a robust, comprehensive policy for the country. The problem, though, has been implementation. Few high schools and colleges offer any education on HIV, while public officials often suffer from the same lack of knowledge as the wider population.

The official attitude toward condom use is especially worrying. Outright hostility toward condom use is currently the Philippines’ de facto, and sometimes de jure, official policy. In a sweeping 2004 report, Humans Rights Watch documented numerous abuses, including police confiscation of condoms from sex workers and public crackdowns on condom distribution and promotion.  Furthermore, the politically powerful Catholic Church strongly lobbies against condoms. Boxer and Congressman Manny Pacquiao speaks for many when he calls condom use ‘sinful.’

National leadership can change the course of events. Thailand and Cambodia, after implementing national public health campaigns, saw infection rates fall steadily year after year. A similar effort in mass education, national condom promotion, and readily available testing and treatment promises comparable results for the Philippines. As DOH officials report back from their time at the United Nations, Aquino has the opportunity to take these kinds of clear steps to protect the Philippines from a worsening epidemic.

Unfortunately, the statement delivered to the General Assembly by Undersecretary Lozada was far from promising. Posted on Facebook by gay rights activist Jonas Bagas, who was also part of the official Philippine delegation to the meeting, the tortured statement offered no policy specifics and little urgency. Bagas has been pessimistic since.  On Twitter, he wrote, ‘I don’t think I accomplished anything.’

With the conclusion of the meeting, the initiative to address the HIV/AIDS situation in the Philippines lies solely with the Aquino administration and local officials throughout the country.

RA 8504 offers a good starting place, especially paired with the goals outlined in the new UN declaration. No law or statement, though, will reverse the current alarming trends without political will. If he leads now, Aquino has the opportunity to keep his country safe from an epidemic the UN calls ‘one of the most formidable challenges to the development, progress, and stability of our respective societies and the world at large.’

John Schellhase is a Master’s candidate in Global Affairs at New York University and a former US Peace Corps Volunteer in the Philippines. –John Schellhase, http://the-diplomat.com/asean-beat/2011/06/15/philippines-aids-crisis-looms/