Strengthening the Philippine HIV/AIDS Policy
This paper will focus on the presentation of Dr. Neil Tan Gana[1] on the issue of HIV and AIDS as a critical part of human security. A huge portion of the presentation was devoted on the national legislative agenda to amend the current law[2] on HIV and AIDS prevention through the proposed Senate Bill No. 1390 of 2017.
According to the Philippine AIDS Registry of the National Epidemiological Center, Department of Health, in May 2017 alone, there were 1,098 new HIV antibody sero-positive individuals reported to the HIV/ AIDS & ART Registry of the Philippines (HARP). This was 48% higher as compared with the same reporting period last year (741) and also the highest recorded cases ever since 1984. Eighty- seven percent of those were asymptomatic at the time of reporting. Most (95%) were male. The median age was 28 years old (age range: 2 year-67 years). More than half were from the 25-34 year age group while 30% were youth aged 15-24 years. The regions with the most number of reported cases were: National Capital Region (NCR) with 404 (37%) cases, Region 4A with 155 (14%) cases, Region 3 with 108 (10%) cases, Region 7 with 98 (9%) cases and Region 11 with 60 (5%) cases. An additional 273 cases (25%) came from the rest of the country. Reported modes of transmission were unprotected sexual contact (1,068), needle sharing among injecting drug users (27) and mother to child transmission (3). A staggering 68% were accounted for males who have sec with males.
The above data is alarming especially so that the Philippines is the only country from Southeast Asia which made it to the list of only 7 countries where the trend is increasing by more than 25% while the rest of our neighbors are going down or at least at a mitigated level.
In the most recent Young Adult Fertility Survey of the UP Population Institute (2013), the data showed that, many of the young people still hold the notion that HIV can be transmitted through mosquito bites, through hugging and kissing, or through sneezing or coughing. These data showed that our young people still hold in them a lot of misconceptions which often leads to risky health behavior and practices. Education becomes imperative therefore at this point.
These misconceptions also lead to a lot of unfounded discrimination and up to some extent, violation of people’s fundamental human rights. There were those who were terminated from jobs when the management learned of their HIV status. Some were stripped off of scholarships and were prevented from pursuing an apprenticeship program on the pretext that they are unfit for training. Some of those with HIV were not provided dental services by dentists for fear that they might be infected with HIV. This shows that miseducation leads to discrimination and discrimination heightens the stigma against HIV.
It is for this reason why the Philippines enacted RA 8504 or the Philippine AIDS Prevention and Control Act of 1998. The law requires all academic institutions to regularly hold an information campaign to prevent HIV. It challenges the role of social institutions in getting to zero – zero new infections, zero hive-related discrimination and zero AIDS-related deaths. It also provides the rights of people living and affected with HIV and AIDS. Among these rights are: the right to privacy, the right to confidentiality, freedom from discrimination and freedom from compulsory testing. Today, HIV testing remains to be voluntary in the country. Therefore, no one should be compelled to submit to testing as a requirement for admission or employment.
But the Philippine HIV and AIDS prevention law needs to be revisited for its failure to adapt to the fast changing landscape of HIV and AIDS in the Philippines. Some observations and propositions are as follows:
Lack of cultural sensitivity in the policy framework. While the policy framework carries gender and human rights frameworks, it must also add a cultural sensitivity principle due to the multi-cultural landscape of the Philippines and there are already noted cases affecting the indigenous peoples communities.
Too much focus on education-prevention; inadequate provisions on treatment, care and support. Since the focus of the law was on education, important provisions on treatment, care and support services for PLHIV were missing. Key to addressing HIV is early diagnosis and treatment.
Absence of legal support for HIV-related cases. There are already anecdotal reports of HIV-related discrimination in the country and some cases of breach of confidentiality. One barrier is the lack of legal support for PLHIV who want to pursue a legal action for redress of their grievances. There is also a dearth of legal practitioners who are conversant with the laws related to HIV and AIDS.
Lack of online and clan-based support services. While the trend shows that, among MSMs, the social media is identified as the primary means of facilitating meet ups and casual sex, no program or project has been implemented to penetrate the social media as venue for intervention. A pool of online and clan- based peer educators must be developed and capacitated to provide accessible education and accurate intervention.
Weak provision on making condoms readily available to the public. Data would show that the primary means of transmission is through unprotected sexual contact, specifically homosexual and bisexual contact. No policy yet has been promulgated to make protective devises like condoms readily available. To this end, there should be a provision for a mandatory condom dispenser in or near access points like bars, internet cafes and even schools.
Limited age of consent. The current law requires that those who are minors must secure parental consent before they can submit themselves for HIV testing and counseling. Given the fact that the key affected population is getting younger and younger, the age of consent must be reduced to at least 16 years old because early detection leads to early treatment where survival rates can be higher. If the age of consent cannot be reduced, the other option is to empower social workers to issue proxy consent under the principle of parens patriae, where the state act as the parent of the child in cases where the welfare of the child must be ensured.
The challenge to eradicate HIV and AIDS is really daunting. But together, we can slowly manage it. We know what works: we know that prevention and treatment pay dividends; and we know that a rights-based approach must spearhead our efforts towards the ultimate goal of "zero new HIV infections, zero discrimination and zero AIDS related deaths". Strengthening the rights of stigmatised population groups must remain in the political spotlight.
[1] The Impacts of HIV and AIDS Research: The Philippines in Spotlight. Department of Biology, Ateneo de Manila University. Forum on Global Development and Human Security: Perspectives from Education, Health and Labor Studies, October 14, 2017, Animo Lab, 12/F, HSSH, De La Salle University.
[2] Republic Act 8504, Philippine HIV and AIDS Prevention Act of 1998.
