Call out the Department of Health (DOH), you should.
In March, the DOH reported that the HIV cases in the Philippines continue to balloon; we now have 54 new HIV cases per day, up from 13 in 2013, 31 in 2018, and 41 in 2022.
The number – by itself – should shock us. Some may say that we have high numbers now because more people are getting tested (which is good); but at the same time, that the number is that high (in itself) should be a cause to worry. Particularly since among the newly diagnosed cases, 71% were 15-34 years old (with 31% from the 15-24 age group), meaning that most of the newly-infected are young and belong to productive age range.
With numbers, though, we tend to get lost in the – yes – numbers alone.
- From 13 in 2013 to 54 in 2023: Shocking!
- 31% from 15-24 age group: Shocking!
- 97% were infected through sex: Shocking!
- 57 died from deaths due to any cause among people with HIV in March: Shocking!
But these numbers only tell parts of the story.
This time, let’s call out the never-ending problem plaguing supplies of antiretroviral medicines (ARV) needed to be used by Filipinos living with HIV.
Specifically: The inconsistent supplies of ARVs made available to people living with HIV (PLHIV).
Also specifically: The slow rollout of newer – and less harmful – medicines particularly to PLHIV in far-flung areas.
And also specifically: The just-as-slow not-for-sale rollout of pre-exposure prophylaxis (PrEP, the drug that cuts the risk for HIV infection by 99%) outside of metropolitan areas.
These issues are actually connected.
- As of 10ish this morning, I spoke with a PLHIV about to get his quarterly refill. He was informed that he will only be given one bottle (instead of the usual three bottles) this time, and the “excuse” given was because of DOH’s non-delivery of stocks.
This already happened before, with the DOH disliking the word “stockout”, even if the impact remained the same – i.e. PLHIV not getting ARV. And apparently, this is still an issue now.
Aside from keeping PLHIV alive, ARV actually curb the spread of HIV; when a PLHIV religiously takes ARV, the viral load is lowered so that transmission is prevented (the whole premise of undetectable = unstransmittable). Meaning, PLHIV who religiously take their ARV can not infect their sexual partners. Remove ARV in the equation, and you don’t only kill the PLHIV, you’re actually causing the very increase you complain about in the (delayed) monthly reporting of new HIV cases in the country.
- Over the weekend, I spoke with one who still uses ARV with Efavirenz… that ingredient that causes hallucinations (among others). When told that newer 3-in-1 ARV is now available via the Tenofovir-Lamivudine-Dolutegravir combo, he just said this wasn’t even mentioned to him. And yeah… it’s because the rollout hasn’t been as comprehensive (yet) as desired (and should be).
- I interviewed a transgender woman who does sex work in Cebu City in January, and she actually already used PrEP… while doing sex work in Thailand. Yes, she thinks she knows where to get information and supplies in Cebu City. But seemingly belying this claim is… no, she hasn’t actually accessed any such facility for information on, or supplies of PrEP. As part of one of the key populations supposed to benefit from PrEP, she – like the others like her I also interviewed in Cebu Province – are not targeted.
Note that the DOH actually approved the inclusion of PrEP among the country’s responses to HIV. That was in 2022. And a year later… nada.
Here’s the thing with the 54 new HIV cases per day as reported by DOH: If DOH itself is still plagued by issues related to ARV supplies that could save the lives of PLHIVs while cutting the risk of HIV infection at the same time, then we’re blinding ourselves into thinking the number of cases will go low anytime soon. Expect it to worsen.
The pro tip here for those observing the country’s response to HIV: Don’t dwell on just those numbers. If you want to know how well the country is dealing with HIV, check the ARV supplies. Because that exemplifies how much attention is really given to what those numbers represent. And with the issue re supplies… questions ought to be raised, it seems.
