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VI. GOVERNMENT RESPONSE

Human Rights Watch interviewed a number of government officials in the Philippines about the adequacy of HIV/AIDS information for populations at risk of infection. Dr. Manuel Dayrit, the Secretary of Health and chair of the Philippines National AIDS Council (PNAC), told Human Rights Watch that his department’s policy was “to provide as much information as possible” about HIV/AIDS, but that “the preferred message for avoiding HIV infection for the general population would be to avoid risky sex and [practice] abstinence.” Dayrit expanded on this as follows:

The use of condoms would be more appropriate for people who are already engaging in high-risk behavior. . . . The message that would be given is that the best way to avoid HIV is to abstain from risky behavior, not to use injecting needles, and if you can’t help yourself, you have to consider using a condom.²⁰²

On the issue of the government’s supplying condoms to vulnerable populations, especially in places where local governments were not doing so, Dayrit said that as long as USAID and other donors were donating condoms, “given the tightness of the budget, . . . money won’t be used for that purpose.” Asked whether the government might pick up the slack when USAID ended its condom shipments, he replied, “Perhaps, I don’t know. Donations won’t end until three or four years.”²⁰³ In July 2002, newspaper columnist Rina Jimenez-David reported that President Gloria Macapagal-Arroyo had responded “No” to the same question.²⁰⁴

Human Rights Watch asked Secretary Dayrit about the alleged diversion of P50 million worth of national funds from contraceptive supplies to natural family planning. He replied that the government had adopted a “nuanced” approach whereby the national health department would finance natural family planning for those who wanted it, and local governments would finance artificial contraception. For its part, the national government had already awarded a P50 million (approximately U.S.$888,000) contract to an NGO, Couples for Christ, to teach natural family planning. By contrast, the entire HIV prevention budget of the ministry of health was, according to Dayrit, “in the neighborhood of P100 million [approximately U.S.$1,776,000].” Dayrit defended this expenditure on natural family planning in these terms:

People pay lip service to natural methods, but actually they don’t understand it. They think rhythm and withdrawal are the only natural methods, which they’re not. So the national government is saying, we’ll primarily promote natural, which has never been truly promoted before. So artificial methods can continue to be promoted, particularly for local governments who can distribute artificial contraception in their health centers any way. So it’s a very nuanced policy.

Asked whether a national policy on condoms was needed to leverage local resources, Dayrit said this was a “sweeping generalization,” and that many local governments had funded condoms on their own initiative. He acknowledged that Manila City had banned all artificial contraception, saying that Mayor Atienza “is given local government authority to decide on these issues,” and “we can only persuade them, but we cannot for example push them.” He later added that the passage of a national reproductive health law would mandate Manila City to provide reproductive health services, which is precisely why he thought the proposed bill was so controversial.

Human Rights Watch asked an official of the Department of Interior and Local Government (DILG), Assistant Secretary Austere Panadero, about the effectiveness of delegating condom promotion efforts to the local level without a clear national policy. “It’s a political issue,” he said, adding:

The president said it has to be a local action. There will not be a national policy on 100 percent condom use. The church is very influential here. The condom issue is not seen as an HIV issue—it’s associated with artificial birth control.²⁰⁵

Panadero said that as of January 2004, AIDS ordinances had been enacted in eighteen LGUs, and that DILG’s ultimate target was forty cities.

Human Rights Watch interviewed the officer in charge of the Philippines National AIDS Council, Dr. Rhoderick Poblete, about various obstacles to implementation of the national AIDS Act. Poblete said that the impact of the church on HIV prevention efforts was “very evident” at the national level, and he cited provisions of the AIDS Act requiring abstinence messages on condom packaging (a measure he said had not been enforced) and restricting condom information in schools.²⁰⁶ The church is “that silent and invisible hand” when it comes to AIDS policy, he said. In the area of school-based HIV/AIDS education, Poblete said that a curriculum developed by the Department of Education in 1996 had “not yet been fully implemented,” and that this was being done “slowly, in collaboration with some parent-teacher associations.” One obstacle to school-based HIV/AIDS education was that school administrators would generally not implement it without “a big national memo” directing them to do so.

On the issue of HIV prevention among sex workers, Poblete said that “we have two contrary policies” in the Philippines, one of which requires STD testing as a prerequisite for employment in entertainment venues, and the other of which forbids mandatory HIV testing. Asked whether safeguards existed to ensure informed consent for HIV testing, Poblete said that the government relied on NGOs to inform sex workers of their right to refuse testing. “They are already informed of their rights before they go to the [social hygiene] clinic,” he said. “The check and balance comes from the interface with NGOs.” Poblete said that outside of government-supervised sentinel surveillance sites, “you will hear horror stories from NGOs and vulnerable populations that some of them were required to be tested for HIV.”

Interviews with local health officials in the Philippines shed further light on the government’s perspective on HIV prevention. The chair of the Baguio AIDS Watch Council, Dr. Charles L. Cheng, told Human Rights Watch that his area had “a long way to go in terms of addressing gaps in knowledge” of HIV, and that their information and education campaigns had reached “maybe 10 percent of the population.”²⁰⁷ Among the neglected populations, he said, were freelance sex workers, whom the city lacked “the manpower, logistics, and vehicles” to reach, as well as clients of sex workers. Jane Perez, program coordinator for the Angeles City AIDS Council, expressed the same challenge of reaching freelance sex workers with HIV testing and preventing services. “Some sex workers don’t even want services, because they don’t want people to know they are sex workers,” she said. “They are a population in hiding.”²⁰⁸