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Donor cuts could threaten global progress on HIV, new researches warn

A report issued by the Kaiser Family Foundation and UNAIDS found that eight of 14 donor governments reduced their spending on global HIV efforts in 2017. Overall, donor government funding for HIV increased from 2016 to 2017, following two years of declines. Also, mismanagement of funds is a big problem, such as in the Philippines.

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Photo by Freddie Collins from Unsplash.com

If donor government funding for HIV continues to fall, nearly two decades of progress against the disease will be in jeopardy, according to new researches.

Using newly available data, a study from researchers at the Institute for Health Metrics and Evaluation and the Harvard T.H. Chan School of Public Health showed that cuts to development assistance for HIV could do serious harm in hard-hit countries, which continue to rely greatly on this aid.

“If donors falter in their support for HIV, the consequences could be devastating,” said Linda-Gail Bekker, president of the International AIDS Society and International Chair of AIDS 2018. “Smart investments are curbing the spread of HIV and saving both money and lives. Now is not the time to stall or pull back.”

A report issued by the Kaiser Family Foundation and UNAIDS found that eight of 14 donor governments reduced their spending on global HIV efforts in 2017. Overall, donor government funding for HIV increased from 2016 to 2017, following two years of declines. However, this increase was largely due to a shift in timing of US support, and is not expected to last.

To date, there has been limited data on whether the downward trend in development assistance for HIV threatens global progress against the disease.

To address this and other research questions, a study presented by Annie Haakenstad of the Harvard T.H. Chan School of Public Health estimated HIV expenditures by source and function in 188 countries from 2000 to 2015. The results showed that of the $48 billion spent on HIV in 2015, about 62% came from domestic spending by governments and about 30% came from development assistance. In countries with high HIV prevalence, however, nearly 80% of spending came from development assistance.

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The study concluded that development assistance remains a major portion of spending on critical HIV prevention and treatment program, especially in the hardest-hit countries. The study team urged high-prevalence countries that rely on international aid to plan strategically to ensure that declines in external financing do not threaten progress towards an AIDS-free generation.

A study presented by Deepak Mattur of UNAIDS provided new insight on trends in domestic HIV spending, based on an analysis of data from 112 low- and middle-income countries.

The study found that, overall, domestic public spending on HIV in these countries increased by 60% from 2006 to 2016. In low-income countries, it increased from $121 million to $256 million; in lower-middle income countries, from $231 million to $980 million; and in upper-middle income countries, from $2.4 billion to about $6.9 billion.

Almost all regions increased their domestic HIV resources. For example, in the Asia Pacific region, resources increased by 132%, and in Eastern and Southern Africa, resources increased by 57%. The lowest increase, 33%, was in Eastern Europe and Central Asia. The study also found that domestic public spending on HIV has a significant positive relationship with the GDP per capita of a country, coverage of antiretroviral therapy, and HIV prevalence.

The study concluded that sustained increases in domestic public spending will be critical for ending AIDS as a global public health threat by 2030.

A study presented by John Stover of Avenir Health in Glastonbury, US, investigated how well the current allocation of resources for HIV is optimized for cost effectiveness in 55 low- and middle-income countries that account for about 90% of all new infections.

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The study found that cost effectiveness varies widely across countries and interventions. Antiretroviral treatment dominates cost per death and disability adjusted life years averted, and also ranks high in cost effectiveness for infections averted.

The most cost-effective prevention interventions were generally voluntary medical male circumcision, prevention of mother-to-child HIV transmission, outreach to sex workers and condom promotion. These programmes currently receive about 14% of direct intervention funding, which is about two-thirds of the need. The most cost-effective programmes are in East and Southern Africa, where HIV incidence is high and costs are generally low.

The authors concluded that resources for HIV prevention and treatment are generally targeted appropriately, but more focused allocation of resources could improve cost effectiveness by about a quarter. Resource allocations should be continually assessed because cost  effectiveness can change significantly as HIV incidence patterns change.

This is perhaps worth stressing since with the budget cuts, mismanagement of funds is also a big problem, such as in the Philippines.

7 B.S. (or at least half-truths) you hear about HIV in the Philippines

POZ

159 reported HIV-related deaths in August as number of new infections remain high

There were 1,047 new HIV positive Filipinos reported to the HIV/AIDS & ART Registry of the Philippines in August 2018, higher than the 859 HIV cases reported in July.

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There were 1,047 new HIV positive Filipinos reported to the HIV/AIDS & ART Registry of the Philippines (HARP) in August 2018, bringing the January-August 2018 figure to 7,579; and the total HIV cases overall (from January 1984 to August 2018) to 58,181. The August figure is higher than the 859 HIV cases reported in July.

Worryingly, the DOH reported that for August, there were 159 HIV-related deaths; in July, there were only 30. The figure may even be higher because of under- or non-reporting.

Majority of those newly diagnosed to have HIV in the Philippines are still male – e.g.998 (95%) of the newly diagnosed in August were male. The median age was 28 years old (age range: 15 – 61 years old). More than half of the cases (51%, 537) were 25-34 years old and 30% (309) were 15-24 years old at the time of testing.

Sexual contact remains the main mode of transmission (98%, 1,022). Among this, 87% were males who have sex with males (MSM). Other modes of transmission were needle sharing among injecting drug users (2%, 17). There were eight cases that had no data on mode of transmission.

Only 30,667 PLHIVs are on ART as of August 2018. Most (97%) were males.

Incidentally, the Department of Health (DOH) continues to receive flak for its inaction and misaction when dealing with HIV in the Philippines. In September, for instance, and even if DOH laments proposed budget cuts, it allocated supposedly scarce funds to hold a beauty pageant. To appease critics, it eventually held a rushed Metro Manila-centric “dialogue” with select people living with HIV (PLHIV), although what transpired in the gathering was not publicly shared.

On beauty pageants and messed up priorities in dealing with HIV in Phl…

DOH-accredited treatment hubs also continue to lack HIV-related services (e.g. CD4 count, viral load test), and yet continue to fully benefit from the PhilHealth payment of the PLHIVs.

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POZ

Some gay and bi men see PrEP as a ‘social problem’

Some see PrEP as a “social problem” since its users were seen as promiscuous, irresponsible, immoral and naïve. They also believe that uptake of PrEP is undermining use of condoms and that PrEP users are responsible for ongoing epidemics of STIs among gay and bi men.

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Everyone isn’t on the same page on PrEP.

Gay and bisexual men hold different attitudes towards men who use pre-exposure prophylaxis (PrEP), according to It’s just an excuse to slut around’: gay and bisexual mens’ construction of HIV pre-exposure prophylaxis (PrEP) as a social problem, a research done by M. Pawson, et al. and published in Sociology of Health & Illness.

The use of emtricitabine/tenofovir (Truvada) as PrEP was approved in the US in 2012; eventually also rolled out in other countries (including extremely limited and elitist distribution in the Philippines). Studies have shown that, with good adherence, PrEP can reduce the risk of HIV infection by almost 100%.

However, PrEP uptake has faced significant barriers, including knowledge, access and affordability.

Also, the integration of PrEP within existing HIV prevention efforts based on behavior change – especially consistent condom use – has encountered challenges, particularly when linked with the stigma associated with sexual promiscuity and “bareback” sex (unprotected anal intercourse with non-primary partners).

For this research, a series of focus group discussions were conducted in New York City. Thirty-two gay and bi men (with an average age of 35 years) were invited to share their views about PrEP, in late 2015 and early 2016. Most (n = 28) self-identified as gay and 11 were HIV positive.

Overall, the men had a good awareness of PrEP, with many reported seeing advertisements, discussion of PrEP on social media or said they had heard of PrEP from friends.

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But not all the participants discussed PrEP accurately, with various misconceptions existing – e.g. that it’s a lifetime commitment, and that if one stopped taking PrEP and subsequently became infected with HIV the virus would be resistant to antiretrovirals because of previous exposure to medication.

Some of the men also see PrEP as a “social problem” since its users were seen as promiscuous, irresponsible, immoral and naïve. These same individuals believed that uptake of PrEP was undermining use of condoms and that PrEP users were responsible for ongoing epidemics of STIs among gay and bi men.

The researchers noted that “by framing PrEP use as enabling gay and bisexual men to violate subcultural norms of sexual etiquette espoused in previous HIV prevention efforts, claims makers were able to present PrEP users as social problem villains,. Countering claims makers’ framing PrEP as a social problem, some men constructed PrEP as a helpful prevention tool in the fight against the HIV epidemic within gay and bisexual communities. Much of their discourse was couched within a harm reduction model in which PrEP medication is framed as significantly reducing the harm associated with engaging in risky sexual behavior.”

Those who participated also had notions of “deserving” and “undeserving” PrEP users – e.g. men in relationships with an HIV-positive partner fell into the “deserving” category.

“By studying the construction of PrEP as a social problem, we were able to highlight how gay and bi men define what they consider appropriate ways to prevent the spread of HIV. Public health organizations that design and disseminate HIV prevention messaging should strive to construct more inclusive definitions of sexual health practices in ways that seek to combat the stigma currently associated with those who make use of other preventions methods besides condoms,” the researchers ended.

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Op-Ed

Death by inaction and misaction

If the people supposed to serve us are failing to do so, even if they know they can do something if they really, really want to, then I can’t help but be sad… and angry… and speak out.

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Photo by Cristian Newman from Unsplash.com

By Stephen Christian Quilacio

In March 2015 – just over three years ago – playwright, author and longtime gay rights and AIDS activist Larry Kramer gave a blistering speech. Dubbed “Cure!”, he likened HIV to a “genocide inflicted upon gay people.”

To wit, and I quote part of his speech:

“Thirty-four years. HIV/AIDS has been our plague for 34 years. We should have known more about this plague by now. 34 years is a very long time to let people die.
I think more and more about evil. I believe in evil. I believe evil is an act, intentional or not, of inflicting undeserved harm on others. Genocide is such an act. I believe genocide is being inflicted upon gay people.
Genocide is the deliberate and systematic extermination of a national, racial, political, or ethnic group. Such as gay people. Such as people of color. To date, around the world, an estimated 78 million people have become infected, 39 million of whom have died. When we first became acquainted with HIV there were 41 cases.”

Then – to stress his point – he (aptly) added:

“I no longer have any doubt that… government is content, via sins of omission or commission, to allow the extermination of my homosexual population to continue unabated.”

I am bringing this up now, though this time to highlight what it’s like to be HIV-positive in the Philippines.

See… I am a Filipino living with HIV. I’ve been HIV-positive since 2013. And though hailing from Northern Mindanao, I have since moved to Metro Manila; and I am now based in Taguig City.

My life as a Filipino with HIV – from the start until now – continues to be extremely challenging. And in many instances, this is due to the inaction and misaction of service providers, including (if not particularly) the government.

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Take for instance the continuous running out of supply of antiretroviral (ARV) meds in the country.

This has been an ongoing issue, first loudly raised in 2013 and then “denied” by the Department of Health (DOH) in 2014.

At that time, Dr. Rossana Ditangco, research chief at the Research Institute for Tropical Medicine-AIDS Research Group (RITM-ARG), one of the treatment hubs in the country, said that the limited ARV supply was “because of the delay in the delivery of (ARVs) to the Department of Health (DOH).”

This was belied by Dr. Jose Gerard Belimac, head of DOH’s National AIDS/STI Prevention and Control Program, who claimed then that there is no delay in the procurement of ARVs, just as there is no “official pronouncement from the DOH to the treatment hubs to control (the distribution of ARVs) because of a delay in the procurement (of ARVs),” he said in an exclusive interview by Outrage Magazine. Belimac stressed then that “for now, all the ARVs that we promised to provide to the patients are available.”

The ‘missing’ ARVs of the Philippines

The denial makes one angry though, because – while still in Cagayan de Oro City at that time – we who were accessing meds were not getting our steady ARV supply. We had to “borrow” meds from other PLHIVs just so none of us would skip our dosage; though ending missing meds all together when the supplies didn’t arrive.

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It was as if we were being told we were lying (by claiming there’s a shortage) by the very body that is covering up its erroneous system/s.

And then just a few weeks ago, I was informed by my doctor (this time in Metro Manila) that my meds may have to be changed because there is no supply of Nevirapine (what I have been taking). Apparently, I ain’t the first (and perhaps not the last) whose meds may be changed NOT because it’s necessary but because… the DOH’s supply system is problematic.

“I write this piece not because I want to, but because I need to. Because people continue to suffer and even die, and your efforts continue to be wanting.”
Photo by Elijah O’Donnell from Unsplash.com

Looking back, I also remember not even knowing of viral load (VL) for years while in Mindanao. The hub I used to go to only offered CD4 count (not VL); and – come to think of it – this wasn’t even regularly done because the CD4 machine may not have been working or there was no reagent or… other such reasons were given to us.

To date, many PLHIVs from outside Metro Manila (and even those here) do not know their VL or CD4 count.

And this is even if the amount we paid PhilHealth was the same as everybody else; and the services we were supposed to be getting (based in the OHAT package) was supposed to include this.

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I am not sure if there is reconsideration of DOH accreditation being done… but non-offering of paid-for services is, for many of us, an “accepted norm.” We actually pay for services that we don’t use.

Last July, 30 people died from AIDS-related complications in the country. And since January 1984 (when the first case was documented in the Philippines) to July 2018, a total of 2,735 deaths were already reported in the country. Ninety percent (2,462) were male.

Since we already have 57,134 reported cases (as of July 2018), the number of deaths seem… small. But – of course – this is ONLY those that were reported; I am certain that many more were unreported.

But note that even now, approximately only half of the number of Filipinos with HIV have access to life-saving meds. And – as repeatedly stressed – access isn’t even regular because of problems with the supply.

There comes a point when we have to say enough’s enough.

I write this piece not because I want to, but because I need to.

Because people continue to suffer and even die, and your efforts continue to be wanting.

Part of Kramer’s closure for his lament reads:

“Allowing people to die is evil and genocidal. Yes, I believe in evil. 78 million people have become infected, 39 million have died…”

I may sound melodramatic, so call me “drama queen” if you want.

But if the people supposed to serve us are failing to do so, even if they know they can do something if they really, really want to, then I can’t help but be sad… and angry… and speak out.

Because at this point, I see where Kramer is coming from.

And to his point, let me add: I know what he’s talking about.

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Op-Ed

How to organize a ‘community dialogue’ when you don’t want the community to go…

After the Department of Health (DOH) was criticized for holding a beauty pageant even though it supposedly has limited budget, a rushed “community dialogue” is scheduled, which won’t be surprising if the target community does not participate.

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Photo by Mathew Schwartz from Unsplash.com

Yesterday, I was speaking to a close HIV-positive friend whose Nevirapene supply is already running out. “Giatay (I’ll be damned),” he said, adding that he was told that like a friend of his who is taking the same meds as him, he may have to be shifted to LTE already because THERE IS NO SUPPLY OF NEVIRAPENE.

This is yet another issue that the Department of Health (DOH) should be focusing on, instead of its recently-concluded beauty pageant.

So it should have come as a “pleasant” development that a “community dialogue” is being held with the DOH.

To be honest, I almost feel sad for the Department of Health (DOH). ALMOST.

First, it was criticized for holding that beauty pageant even as it laments that its budget is getting cut. Walang pera, supposedly; but may pang-pageant (There isn’t any money, supposedly; but there’s funding for a beauty pageant)…

On beauty pageants and messed up priorities in dealing with HIV in Phl…

And then now, to respond to the criticisms hurled its way, this “open dialogue” is supposed to happen so that “PLHIVs and other advocates (can) gain better understanding of the plans and programs of the government relating to the HIV situation in the country”.

If you are interested – or, perhaps even more importantly, if you are in the area – this “dialogue” is happening at the 3rd floor of DOH Bldg. 14 in Tayuman in the City of Manila on October 3 (Wednesday) from 3.ooPM to 4.ooPM.

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But while this seems like a “good” effort to appease the critics, let’s be extremely blunt here: This seems like a thanks-but-no-thanks “effort”.

Why so?

Info about this “dialogue” was only posted online 15 hours ago (by 10.10AM of the very day of the gathering).

The info was (solely) shared on Facebook; and so – if you don’t know anyone who saw this post – you won’t even become aware of this gathering.

Even if you forget the rushed organization of this “dialogue”, the people behind this are forgetting that:

  1. Not all PLHIVs or HIV advocates who may want to attend are near the area – e.g. there are those in the Visayas and Mindanao;
  2. Many of those who are adversely affected by existing policies/practices re HIV are NOT even from Metro Manila – e.g. no CD4 count and VL machines in many DOH-accredited hubs in Visayas and Mindanao; and
  3. Even Metro Manila-based PLHIVs have work (or other things to do), and they can’t just drop everything in such short notice.

This really is a no-win situation for the DOH for now. And by extension, a no-win situation for the HIV community in the Philippines.

If the intent is true, it may be best to (among others):

  1. Release a financial statement on the pageant that just happened;
  2. Release DOH’s plan/s re HIV in the Philippines, particularly concerning numerous issues I am sure they already know/repeatedly hear about;
  3. and THEN call for a REAL (and non-rushed) dialogue.
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The life-or-death issues – as already repeatedly stated – are numerous.

ARV shortage/stockout.

DOH-accredited hubs that collect the PhilHealth money even if they do not render the services required of them anyway.

Access to pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP).

Absence of Filipino Sign Language interpreters who can assist Deaf Filipinos to get tested for HIV; and – if they test HIV-positive – access treatment, care and support.

Exclusion of life-saving meds in the OHAT package (e.g. Cytomegalovirus retinitis/CMV retinitis).

And – as already stated over and over and over again – I can go on and on and on…

That close friend who is, himself, experiencing the running out of ARV is NOT in Metro Manila right now, and he laments this fact. And for him, “kneejerk reactions are fucking up HIV-related responses.”

Earl Monroe once said: “Don’t rush. Be quick, but don’t hurry.”

Now this sure isn’t that…

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Op-Ed

5 Ways women empowerment in churches can prevent HIV & AIDS

The fact is, gender imbalances worsen the impact of HIV and disproportionately subject women to unequal power relations, violence, discrimination and poverty.

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The HIV epidemic is recognized to be gendered. In most countries half of the number of all people living with HIV (PLHIV) are women. However, in the Philippines, the gender breakdown of PLHIV has changed over time. In 1984–1990, 62% were female. From 1991 to the present, only 6% are female, although the absolute number of cases among females has been increasing. This situation is largely driven by gender inequality.

Perhaps not surprisingly, a 2015 National Council of Churches of the Philippines (NCCP) study found that mainline Protestant churches strongly support women’s empowerment, with almost all key informants supporting the equality and non-discrimination of women as safer practice for HIV and AIDS prevention.

The same study provide five ways churches can help prevent HIV and AIDS.

1. Understanding why Filipinas become vulnerable

Darlene Marquez-Caramanzana, former program secretary on Ecumenical Education and Nurture of the NCCP, added that gender imbalances worsen the impact of HIV and disproportionately subject women to unequal power relations, violence, discrimination and poverty.

“For Filipino women, negotiating condom use with their partners remain a challenge. Women also fear and experience violence and rejection from their partners or husbands, making them reluctant to get tested for HIV. Women as care providers of families also carry the burden of deaths from AIDS. We at NCCP commit to providing a space for both males and females to challenge harmful gender norms to reverse the negative impact on women and girls,” said Marquez-Caramanzana.

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2. Historical push for gender equality

“We are an open-minded church that gives women equal footing with men – may lady bishop na kami (we have a lady bishop). We have more female leaders than male leaders,” said a clergy from a NCCP member church in Luzon.

The ordination of women in mainline Protestant churches in the Philippines is seen as a milestone for gender equality.  At the 20th anniversary of women ordination of Iglesia Filipina Independiente, Rosalina Rabaria, the first woman ordained a priest in 1997, said the acceptance of women as part of the clergy is a “historical victory in the struggle against biblical patriarchy [and] church hierarchical and cultural biases.”

This milestone has been a key event in improving women’s key role in their faith communities.

The ordination of women in mainline Protestant churches in the Philippines is seen as a milestone for gender equality. This affects decision-making including in dealing with HIV.

3. Mainstreaming women’s empowerment

The NCCP study has shown that churches already have women-centric efforts, including hiring women as leaders, gender sensitivity trainings/workshops, and formation of women’s organizations within the churches. One key informant even said that to promote women’s rights within the FBO, they include discussions of Republic Act 9262 (The Anti-violence Against Women and Their Children Act of 2004) in existing programs, teaching female churchgoers that “puwede ka mubalibad sa imong asawa (you can refuse your partner’s advances).”

4. Building alliances outside the church

With this inclusion of women empowerment in existing efforts, the study showed that are at least some resources allocated by most churches on this, including all KI from Metro Manila and 63% in national offices.

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To implement existing efforts, or if there is need for efforts to be developed/implemented, all key informants also said that they already formed alliances to promote women’s equality, or are willing to ally to show their support for the promotion of women’s equality as a safer practice for HIV and AIDS prevention. Some of these allies include inter-faith organizations, local government units, and women’s organizations (e.g. Gabriela and Babae Plus).

5. Providing and advocating for better care and support

The Board of Women’s Work of the United Methodist Church (BWW-UMC), an NCCP member church, already started a partnership in assisting women living with HIV with their PhilHealth insurance enrollment and other medical expenses.

For Phoebelyn Carreon, former HIV program coordinator of the BWW-UMC, there are women-specific needs that existing programs fail to respond to.

“Women living with HIV tell us that finding obstetric and gynecological services in their treatment hubs is a challenge. While antiretroviral medication is provided for free by Global Fund, health services for women are not all the time free or affordable. While we educate our church on HIV and AIDS prevention, we do what we can to raise funds for the needs of women living with HIV, who mostly are unemployed,” Carreon ended.

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From the Editor

On beauty pageants and messed up priorities in dealing with HIV in Phl…

After encountering a young PLHIV who has to prostitute himself just to access ARVs, Michael David Tan finds it infuriating that the Department of Health saw it fit to allocate lots of money to HOLD A BEAUTY PAGEANT. For him, from the get-go, this approach needs to be closely looked at.

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Photo by Valentin Salja from Unsplash.com

I am chatting with a person whose HIV rapid test only recently showed he’s reactive. He was told by this satellite clinic in Mandaluyong City that he can actually proceed to get the meds; though only if:

  1. He pays his PhilHealth; and
  2. He pays for all his lab tests.

The problem is, this young person – who did not even finish schooling – is unemployed.

So he is chatting with me now to “manghiram ng P100 (borrow a hundred pesos) so I can go to a client who will give me P1,000; which I can then use to pay for my lab tests.”

Yes, he is resorting to selling himself. To access life-saving medicine that is supposedly – and ERRONEOUSLY claimed to be – “free”.

It is cases like this young person’s that make it infuriating that the Department of Health (DOH) saw it fit to allocate lots of money to… HOLD A BEAUTY PAGEANT.

In a pageant-obsessed country like the Philippines, at least superficially, this seems like an “intelligent” move.

But from the get-go, this approach needs to be closely looked at and reconsidered.

  1. The pageant is supposed to create “HIV advocates”. BUT only those who fit specific qualifications can enter – e.g. age limit, height limit, vital stats requirement of participants (with the candidates even told to ‘model’ in swimwear as part of the screening process). So now – with this ‘move’ – what is being insinuated is that you need to be young, beautiful/handsome and be willing to strut in your bikini first before you can be considered an HIV ‘advocate’…
  2. We are supposed to dismantle this lookist society; to recognize people’s worth NOT based solely on how they look. Pageants – by their very nature – promote the status quo (of lookism) by giving “positions of power” only to those who “fit” socially-constructed standards of beauty and attractiveness.
  3. The country has a lot of REAL advocates who do for free what should be DOH’s job – e.g. community-based HIV screeners who go from barangay to barangay without any payment. There are those doing community-based HIV screening (CBS) who are RUNNING OUT OF RAPID TEST KITS, so they are now unable to serve; unable to be advocates. Seriously now, if there’s money for a beauty pageant, surely there’s money that can be given to those already working on the ground, or even to buy life-saving paraphernalia used in battling HIV in the Philippines.
  4. One of the supporters of this beauty pageant told me that Pia Wurtzbach’s effort to bring the spotlight to HIV is a good example of the “relevance” of a beauty pageant like this, as it could “create another Pia”. In a marketing standpoint, this is not a well-thought response; mainly because if you wanted to “create” someone to be like Pia to promote HIV awareness in the Philippines, then… JUST HIRE PIA HERSELF!
    Besides, as a friend aptly said: You can’t just “create” a Pia. She “works” because she’s unique.
  5. If you need a crown, a title and the prize money before you start advocating for HIV-related issues in the Philippines, then you’re not really an “advocate” and what you’re doing is not “advocacy”.

PLASTIC CROWNS
There remain many life-threatening and urgent issues concerning HIV in the Philippines. And if you try bringing these issues up (e.g. to government people, or NGOs), you’d more likely be told “there’s no money”. But apparently there is. Just not for the urgent ones…
Photo by Pro Church Media from Unsplash.com

The fact is, numerous HIV-related issues continue to plague the country.

READ:  Insurance companies may now provide insurance coverage to PLHIVs

We get 31 new cases every day now.

A growing number of those getting infected are getting younger and younger (e.g. in July, 28% were from the 15-24 age bracket).

The ARVs in treatment hubs are OLD – e.g. many have expired, and the Philippines still uses meds already discontinued in Western countries. Don’t get me started with the shortage that the DOH continues to deny is happening.

We still don’t have widely-distributed pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP).

Newly-diagnosed PLHIVs – like that young person at the start of this article – are still unable to pay for their baseline tests; and so they can’t proceed to the next steps (including starting their ARV therapy). And even if they can get the lab tests done, their ARV supply is compromised because they can’t pay their PhilHealth.

There are treatment hubs that do not have viral load machines, so that PLHIVs do not know their VL years and years after they tested HIV-positive. And this is even if they have been paying the same PhilHealth amount that should give them that VL test. DOH accredited these hubs; they need to monitor if the hubs comply with policies related to their accreditation.

There are accredited hubs that do not even offer CD4 test. This is accepted as “normal”, and again, this is even if the PLHIVs in these hubs still pay the same PhilHealth amount that should grant them the CD4 test. Similar to the above: DOH accredited these hubs; they need to monitor if the hubs comply with policies related to their accreditation.

READ:  I threw up my ARVs. Should I take more meds?

There remains lack of updated knowledge even among existing service providers – e.g. try asking them about U=U, and you’re more likely to encounter internalized stigma and discrimination, largely because… this is not even openly discussed in the Philippines, including by DOH.

There are no Filipino Sign Language interpreters who can assist Deaf Filipinos to get tested for HIV; and – if they test HIV-positive – access treatment, care and support.

I can go on and on and on…

But just try bringing these issues up (e.g. to government people or NGOs) and you’d more likely be told “there’s no money”.

Well… apparently there is money; just not for these…

DOH is complaining about the pending budget cut, but – the way I see it – it shouldn’t/can’t/ought not to complain about any budget cuts when it can spend money ON A BEAUTY PAGEANT. This may sound harsh, but words that immediately come at least to my mind include misuse, squandering (with a friend going as far as using the word “misappropriation”) or words similar to that…

As it is – and yes, I recognize this – I’ve already been repeatedly told that I’m too… negative.

I’m not sure I’m being “negative”; instead, I am being more “realistic”.

And the thing is, as long there are PLHIVs like that young person who has to prostitute himself just so he can access life-saving meds and services even as a big amount of money is spent on a beauty pageant, I say we all should be…

READ:  On skipping taking ARVs

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