“Sinimulan ni Etta (Rosales), tatapusin ni Risa (Hontiveros).”
This was a statement delivered during a “non-partisan” rally that called for the (immediate) passage of the anti-discrimination bill (ADB) that has been languishing in Congress for 19 years now. It highlighted how the same ADB was first filed in the 11th Congress by Akbayan partylist Representative Etta Rosales. That version of the bill was approved on third and final reading in the 12th Congress, but failed to gain traction in the Senate. And now – after Liberal Party’s Sen. Bam Aquino “helmed” it (and let’s admit this, just sat on it) in the last Congress – it was re-filed in the 17th Congress on December 7, 2016 as Senate Bill No. 1271 by Sen. Risa Hontiveros (herself aligned with Akbayan and LP).
The legislative status of the ADB is still listed as “Pending Second Reading, Special Order (12/14/2016)” in the official website of the Philippine Senate. And as per the office of Hontiveros, SB 1271 is still only up for interpellation in the Senate.
And so now, what Etta started, Risa is supposed to finish.
BUT – forgive me here because I know not everyone is going to like this or even want to hear this – the very first thought that came to my mind when this message was shouted was: Etta started it (and we thank her for that), and Risa may be continuing what Etta started (thanks to her, too), BUT this fight is OURS, not hers (or theirs). Tayo ang tatapos nito (It is us who will end this), not her (or them). Because if the message is just the former, then… why do WE still need to hold a “non-partisan” rally?
This led to a somewhat lengthy discussion (among some admittedly older LGBTQI community leaders, right at the People Power monument) on the road that the ADB has taken, and why we are still unable to pass this 19 years later.
And first among the points raised was/is the exclusionary approach in the development of the ADB.
I have mentioned this already in the past: When the version of the ADB that was being pushed was more comprehensive, and it specifically mentioned “persons with disability” as among those who should be protected from discrimination, I remembered asking for a version of the ADB in Filipino Sign Language (FSL) so Deaf LGBTQI people will also understand it. To date, nganga (figuratively: we are still waiting with open mouths).
Related to this, when I spoke with senior LGBTQI leaders from the Home for the Golden Gays (HGG), the current head Ramon Busa noted how they were “never once invited in any discussions related to the ADB.” So much for inclusion…
Ask the LGBTQI leaders (particularly those developing the ADB), too, where to get a copy of the proposed law, and you’d probably just be told to “get it from the Internet” in such-or-such Website. As if every LGBTQI Filipino has access to the Internet [e.g. I have spoken with LGBTQI Filipinos from Mindanao who told me: “Wala nga kaming kuryente, Internet pa kaya (We don’t even have electricity, much more Internet access)!”]…
Secondly, there’s this seeming credit hogging that shifted the focus on the intent of the bill (i.e. OUR protection) to “who gave you the ADB?”. The latter part changes the discussion by highlighting who we “owe” for our rights; who we should “support”; who we should hold our allegiance to. In Filipino: Kanino ang utang na loob.
Thirdly, there’s this seeming reluctance to admit that our approach/es to ADB may already need to be overhauled.
Get this: 19 years after the first ADB was filed, a major issue that those opposing it continue to raise is “because ADB means LGBTQI people will be granted marriage equality”. That people continue to erroneously believe the ADB=marriage equality narrative highlights a failure in the way/s of getting the message/s across of the ADB handlers. And, yes, that this has been happening for 19 years now means… these same handlers already need to reconsider their approaches already (!).
It can be said that many people (including many in the LGBTQI community) dislike Rep. Geraldine Roman (with her shifting political parties, and her support for the death penalty, among others). But – heck! – she helped (in a big way) to get the ADB passed in the Lower House in just over a year. Let’s emphasize that: Just over a year. This hasn’t happened for over a decade under our “usual” approach(es). You don’t have to kowtow to her or to even love her; but let’s all at least start reaching across aisles so that, maybe, we can learn from each other; on what works and what doesn’t, and then apply what’s effective so we get the result that we all want (in this case, passage of the ADB).
It’s still questionable if Albert Einstein really said this, but the thought remains the same: “The definition of insanity is doing the same thing over and over again, but expecting different results”. Nineteen years is far too long; if we think our approach is working and shouldn’t be changed, we may have to wait for 19 more years…
And lastly, rounding up everything, the LGBTQI community needs to be made to understand that this is OUR cause. This is why the “Sinimulan ni Etta (Rosales), tatapusin ni Risa (Hontiveros)” statement is specious for me.
As the LGBTQI community in the Philippines pushes for the passage of the anti-discrimination bill, alliance building is key, thus the need to break partisan lines. Otherwise, the internal divisions will be our fall.
We need to, first, fix our ranks if we want to fix this world.
The March 17 rally, for me, shouldn’t have been just a rally; it should have been the Pride MARCH. After all, if the march is our political move for our Pride, then this WAS the moment to best show this (instead of the once-a-year parade that is led by sponsors that are able to give moolah, easily displacing LGBTQI organizations).
This would have been the best time to unite the community irrespective of its members’ political colors, age, physical ability, social class, SOGIE and so on. Instead, as was mentioned to me by some pro-Duterte LGBTQI leaders, “It could just turn out to be an anti-Duterte rally”, so that they opted NOT to participate in a struggle that also includes them. No one reached out to them; they were just ignored, classified as “others”, even if we all belong under the same rainbow banner (thus highlighting again the “exclusionary” tactic mentioned above).
This should have been the best time to teach LGBTQI Filipinos to be more political (in pushing for our human rights), instead of ending up highlighting that yes, we are demanding for our rights, but not everyone is willing to brave the fight for these rights.
So yes, we say thank you to those who started the fight for us and are continuing this fight for us. But we need to own this fight. Only then will this succeed.
5 Things businesses can do to (truly) impact the LGBTQIA community
Already, numerous companies have been releasing Pride-related merchandise, out to get the pink currency by blinding members of the LGBTQIA community with glitters. But profiting from members of the LGBTQIA community may earn you some cash in the short term; but pinkwashing isn’t gonna help you in the long run.
Western-dictated LGBTQIA “Pride” is about to happen anytime now, with June fast approaching. This is supposed to be the one month in a year when everything LGBTQIA is to be “celebrated”, to be “showcased”. Why? Because – historically – it’s the same month when the Stonewall Inn riots happened in New York in the US, when members of the LGBTQIA community raged against the police because of abuses committed against them.
And so, not surprisingly, already, numerous companies have been releasing Pride-related merchandise, out to get the pink currency by blinding members of the LGBTQIA community with glitters. If you can afford to, head to the US in June, and walk in any – as in ANY – shopping area to understand this point. From Converse to Dr. Martens to Adidas to Starbucks to phone carriers to… just about everything, there’s something rainbow-colored being sold, supposedly in support of Pride.
Now, now, don’t get me wrong: The “presence” is noteworthy because everything LGBTQIA is (finally) going mainstream. I’m all for that.
But this mainstreaming is also problematic because it actually highlights so many of what’s wrong in society as a whole, and the LGBTQIA community in particular – e.g. how businesses are profiting from the LGBTQIA community without helping its members; and how many LGBTQIA people choose to look the other way just to… get their hands on those new pair of shoes with rainbow stripes, or those shirts with rainbow printing, or that P200 cup coffee in a plastic cup with rainbow design…
The “selling” of LGBTQIA “Pride” has been noted before, and the trend continues even now – e.g. Converse, which has “rainbow sneakers”, won’t even donate any proceeds to actual LGBTQIA causes; and locally, Bench has joined the bandwagon even if (back when the rainbow wasn’t so hip) it did not even support Ang Ladlad, and it can even be argued that it even created a fake “controversy” by using the LGBTQIA community to get media mileage.
In a gist: Many brand’s supposedly pro-LGBTQIA move is performative in the name of making a profit.
Talking to those under the rainbow (for instance, Pride organizers that spend half a million pesos for a half-day parade; but won’t even give a few hundred or thousand pesos to help feed LGBTQIA workers who are holding rallies after they were removed from work by multinational companies) is for another day; though for now, here are five things that businesses can do to (truly) impact the LGBTQIA community…
Put your wallet where your mouth is.
You say you support the rights of LGBTQIA workers who were kicked out of their jobs because of who they are? Then help fund them when they hold rallies against those who fired them.
You say you’re an HIV “advocate”? Sponsor one or two or three persons living with HIV by paying their PhilHealth (amounting to P2,400 per person per year).
You say you’re concerned about your LGBTQIA workers? Give them the same benefits being given to heterosexual people (e.g. those who can legally marry).
You say you’re concerned about senior LGBTQIA people? Help fund the establishment of an actual – physical – home for them.
You say you worry about the mental health of LGBTQIA people (including those working for you) because they continue to experience discrimination? Spend on mental health care.
You say you worry about LGBTQIA youth not being able to access education because of who they are/who they love? Offer a scholarship program to them.
And if you have supposedly LGBTQIA-related for-profit event, DONATE even a portion of your profit to LGBTQIA-related causes.
The harsh truth is: Talk is cheap; but your donation can save lives.
2. Choose where your money goes.
Related to #1, CHOOSE WELL.
There are too many “glittery” LGBTQIA or related organizations; but peel that glitter away, they’re nothing there but empty shells. There are way too many LGBTQIA or related organizations that we often hear of/about, but are actually infamous (in the LGBTQIA community itself) because they’re in the “advocacy” just to profit from it.
Know the opportunists.
Now, how to do this?
They disappear after Pride. LGBTQIA organizations that surface ONLY once a year are just as bad as the private companies that only surface at the same time; they’re really just there to make money.
They’re almost always JUST online or in mainstream media, boasting about this or that, all talk but you never see them do actual LGBTQIA-related work. They co-opt other people’s struggles (e.g. they’d say they represent minorities in the LGBTQIA community), and then they won’t let members of these minority sectors speak for themselves (for instance, LGBTQIA people who are also persons with disability/PWD, seniors, members of the Lumad communities, Muslims, informal working sector, informal settlers and those living with HIV). These people will claim to represent all, so “give us money”, but they do not know shit about these people they claim to represent. So please, STOP funding these people.
You only see them in parties/social gatherings; never where the action happens (e.g. picket lines of workers, including members of the LGBTQIA community, removed by multinational corporations; rallies for the anti-discrimination bill; visits in HIV treatment hubs; et cetera).
Their bosses “beg” you to “sponsor” their international trips. By itself this is “common practice” by NGOs and CBOs with non-existent funds; but when this is all they do, then you need to reconsider the support given to them.
Do your research. Not everyone “popular”, even members of the LGBTQIA community, have the community’s concern in their minds. Stop yourself from getting used and abused to profit off the misery of others.
3. We understand profit; but don’t stop there. Develop pro-LGBTQIA policies.
According to Stonewall in the UK, 19% of LGBT workers experienced verbal bullying from their colleagues, customers or service users because of their sexual orientation. Unfortunately, 13% say that they would not feel confident in reporting homophobic bullying in their workplace.
This no-so-welcoming environment is not good for LGBTQIA employees; and – to over-simplify – if your employees aren’t happy while working for you, their performance is bound to suffer, and this means a loss for your company.
So start creating those LGBTQIA-affirming policies.
Give diversity and inclusion trainings to all your employees (including those holding high positions) for them to understand sexual orientation, gender identity and expression (SOGIE).
Include people’s SOGIEs in the existing employee’s manual/handbook – e.g. allow trans women to use women’s CR/loo/toilet; punish those who discriminate; et cetera.
Offer the same benefits to the partners of LGBTQIA people (even if they are not legally married because the country still does not allow this).
Allow LGBTQIA employees to organize.
By making pro-LGBTQIA part of running your business, your impact will be there longer.
4. Hire LGBTQIA people, including in leadership positions.
In 2017, fastfood giant Jollibee Foods Corporation (JFC) apologized to genderqueer Bunny Cadag who alleged experiencing discrimination, following the PR tempest their story made since it was first shared online.
Cadag was interviewed for a job as a transcriber by people from the Human Capitol Development (HCD) at JFC’s main office in Ortigas. That first day of evaluation passed without incident. However, when Cadag returned another day to continue the training session, a certain Louie Angsico, said to be one of the contact persons of HCD, spoke with Cadag over the phone to tell them that JFC is not yet “welcoming to the idea” of having a transgender person working for the company. Angsioco allegedly added that JFC is a Roman Catholic company.
While JFC eventually apologized, the perception (particularly for members of the LGBTQIA community) continues to exist that Jollibee… discriminates.
Beyond the “image” angle, though, get this: Research from UCLA found that nearly all (92%) of companies with anti-discrimination policies credit the policies with having a positive impact on annual sales. Executives also said that these policies lead to better recruitment and retention of top talent.
The Center for Talent Innovation’s report, “Out in the World: Securing LGBT Rights in the Global Marketplace”, also found that 71% of LGBTQIA respondents and 82% of allies are more likely to purchase from a company that supports LGBTQIA equality.
So yes, having more LGBTQIA employees can positively impact the bottom line.
5. Don’t just show up once a year.
Companies that are ONLY seen once a year, attending corporate Pride parade, are actually seen as opportunists, using the LGBTQIA community only to get media mileage. And when NOT backed by the aforementioned points (e.g. creating LGBTQIA welcoming workplaces), this is actually what it really is.
So while joining the party is fun (and let me say this, those who can should do this), LGBTQIA-related efforts should NOT stop there.
In the end, profiting from members of the LGBTQIA community may earn you some cash in the short term; but pinkwashing isn’t gonna help you in the long run. Look at how Israel’s pro-LGBTQIA efforts are now seen as nothing but part of a “nation-branding program” to use the LGBTQIA community as cover for its abuses against Palestine. Or how Mar Roxas will always be marked by his flip-flopping on LGBTQIA issues. Or how there will now always be people who will see Bench as an opportunist by “selling” the rainbow, when it failed to support the LGBTQIA community when it mattered (i.e. while an LGBTQIA political party eyed a seat in Congress).
So do something good. Expect a return if you must; but ACTUALLY do something. It’s actually easy, and the benefits for any brand longer-lasting…
5 Things funders/donor agencies can do to ACTUALLY help the LGBTQIA community
When their LGBTQIA-related projects are funded, it is okay for organizations to (also) please the funders. But… shouldn’t the beneficiaries be the main focus since these efforts were made to benefit the people more?
In December 2018, while trying to persuade the “mother” of an organization for senior LGBTQIA people in Pasay City to apply for funding for their project/s, I was asked: “Where do they send the money if we don’t even have a bank account?”
In January 2019, while trying to encourage a Deaf trans community leader of an LGBTQIA group in Davao City to get grants to finance their efforts, I was asked: “Will they give us money if we’re not even registered with SEC (Securities and Exchange Commission)?”
And in February 2019, while reprimanding a Deaf friend, who also heads a pioneering Deaf LGBTQIA organization (based in Mandaluyong City) in the Philippines for getting used by Hearing organizations that avail of her services (without payment), thereby using her affiliation, I was bluntly told: “This is arguably the only way for us to ‘participate’ in ongoing efforts; we tried applying for funds before, but were told we’re too small, we don’t have the skills, we can’t even do accounting, and so on…”
These are – of course – only some of the more recent somewhat-similar assertions I continue to come across when chatting with grassroots LGBTQIA leaders in the Philippines. This inability to get funds NOT because they can’t do the job (or are not doing the work already), but because they’re not paper-pushers, they don’t know the “right people” (and so don’t know whose asses to kiss), they haven’t been provided training, and so on…
And in all these instances, the analogy that ALWAYS comes to my mind is that issue encountered by fresh graduates when they apply for a job – i.e. companies want people with experience, so they won’t hire fresh graduates, though – if they don’t get hired, how can the fresh graduates then get this so-called experience? The fault isn’t with the applicant but the employer.
An in the case of NGOs and CBOs, the fault – and let’s be blunt here – is on the funder/donor agency because of existing notions and practices that really should be overhauled.
Now how to overhaul these notions? Here are practical tips…
1. Stop funding ONLY big NGOs (and often only those with personal connections to people working for you).
The REAL work is NOT DONE by many of these; instead, they’re merely middlemen that profit from the actual work of grassroots organizations that these bigger organizations “fund” to do the hard work for them.
Fund the actual workers, not just the paper-pushers.
2. Related to #1, fund the smaller organizations.
For instance, note how – in support of LGBTQIA efforts in, say, Africa or Asia – many American-based NGOs get the money, instead of the ACTUAL African and Asian NGOs. They bring “attention” to the LGBTQIA-related issues in these areas, sure; but too much money is wasted on PR, instead of the actual efforts to help those affected by anti-LGBTQIA efforts in these areas.
I have heard numerous excuses about the non-preference for smaller NGOs, e.g.:
But the smaller organizations aren’t familiar with accounting system/s, you say. I said: Then train them. Or just provide the funding so they can get the training themselves.
But the smaller organizations aren’t legal entities yet, you add. Then fund them so they can afford to legally register.
In a gist: Not funding smaller organizations end up promoting an erroneous “for profit” approach of so many bigger NGOs that, as mentioned, reap the benefits from the work of those at the grassroots.
3. Go beyond the reports.
Yes, yes, yes – reports are great and all. But if this is the ONLY (or even MAJOR) indicator of success, then there really is a need to reconsider why we’re in advocacy at all.
In New York in 2014, I once spoke with a worker in a funding agency who boasted to me that “we fund a faith-based effort in the Philippines”. When the name of the church that was given money was mentioned (along with its now-former-leader), I told this person that the same was kicked out of the church because of allegations that involved – among others – financial matters. This is, I added, common knowledge; it’s all over the Internet.
“No, you ARE mistaken,” she said to me, succinctly. “We must not be referring to the same person.”
“No, I’m not mistaken.”
“But the reports we received are… good.”
“Have you ever visited the Philippines? Or spoke to other Filipinos aside from this one person, particularly the beneficiaries?”
She looked at me like I was crazy: “We do NOT do that,” she said. “We rely on the reports given to us; we trust these.”
“Your loss,” I said, “though a bigger loss for the community that’s supposed to benefit from the already-extremely-limited funds.”
I never heard from her EVER again.
4. Reach across (more) aisles.
Dealing with people we’re comfy with is great; but if funds are given to the same people over and over and over again, this creates a “hierarchy” in service provision. This is why there’s the so-called “Bangkok Mafia” in Thailand (a group of people said to know the ‘who’s who’ as far as donors are concerned, and so have somewhat-exclusive access to them). Now, whether this is true or not is up for debate; but that this perception exists at all ought to be a source of worry. Because more than anything, it gives that impression of an “in” crowd, the “chosen ones”, the “gatekeepers”, with the rest basically dependent on their mercy…
5. Revisit indicators (of success or failure).
Yes, popularizing a hashtag created for an event is good and well, but this form of (support to) “keyboard activism” should be limited.
Interviewing a Maranao transwoman (who originally came from Marawi) in Iligan City, I was once told: “We don’t even have electricity; yet you expect us to be active online.”
In the end, pleasing the funders is all good (this comes with the territory); but shouldn’t efforts be made to benefit the people more?
Worsening #ARVshortage in the Phl?
On Jan. 9, the Philippines gained a new HIV and AIDS law that is supposed to better the lives of Filipinos living with HIV. But many in the HIV community mark this day with distress, largely because of the worsening ARV shortage.
In September 2018, Xander (not his real name; anonymity requested), a Filipino living with HIV, claimed that he was told by the person working in the pharmacy of his hub to “consume already-expired medicines (the three-in-one tablet of Lamivudine/Tenofovir/Efavirenz)”, and that “it is “still good for three months after the expiration date.”
Since dealing with ARV-related issue is not new to him (it happened to him in the last quarter of 2013), he complained and was given newer meds. Noticeably, “those who didn’t complain – like I did – ended up using the expired meds,” he said.
Xander can only recall how he earlier lamented – again in 2013 – that the ARV shortage will happen again, particularly considering the continuing denial of the Department of Health (DOH) about this issue.
The 9th of January is supposed to be a happy day particularly for Filipinos living with HIV and their advocates. On that day, the newly-signed Republic Act 11166 or the Philippine HIV and AIDS Policy Act was released after it was signed into law by Pres. Rodrigo Roa Duterte. By replacing the 20-year-old Republic Act 8504 or the Philippine National AIDS and Control Act of 1998, this new law is supposed to boost the government’s response to HIV and AIDS by making health services for HIV and AIDS more accessible to Filipinos.
But many in the HIV community mark this day with distress, largely because of the worsening ARV shortage, which is not helped by the denial of the issue by various heads of offices – including government officials, as well as those helming treatment hubs/facilities and even select non-government organizations (NGOs).
In an unsigned statement (as if so that no one can be “chased” to be held accountable for the same statement), the DOH seemed to belittle the issue by outright claiming that there’s an ‘alleged’ shortage of ARVs; even as it also stated that they take the issue of HIV infection in the country seriously. Part of this is to take “great steps to ensure that access for HIV treatments are available for those who are diagnosed with HIV.”
The DOH statement added:
“As of October 2018, we have enrolled 32,224 persons living with HIV for treatment with ARV such as Nevirapine, Lamivudine/Tenofovir. The DOH has been providing free ARV to Filipinos living with HIV through our HIV treatment hubs.
“Based on our records, there are 3,200 registered PLHIV who are on Nevirapine and 1,791 PLHIV on Lamivudine/Tenofovir, as of December last year.
That just about half of the total PLHIVs in the Philippines use ARVs is worth noting, even if it’s another issue altogether.
But the mention of these two meds/cocktails is important because the complaints reaching – among others – Outrage Magazine, Bahaghari Center for SOGIE Research, Education and Advocacy, Inc. (Bahaghari Center) other and HIV-related community-based organizations/non-government organizations particularly currently mention these.
In Quezon City, for instance, at least eight PLHIVs alleged that they have been given incomplete medications – i.e. they were supplied with either Lamivudine/Tenofovir or Lamivudine/Zidovudine, but they have not been receiving Nevirapine because this is not available. These people are, therefore, taking incomplete meds.
Pinoy Plus’s hotline, PRC, has received similar allegations of non-delivery of Nevirapine.
In Cavite (Imus, Bacoor and Dasmariñas), at least three clients surfaced to allege about the same issue. PLHIVs are now “borrowing” each others’ Nevirapine supply just so they don’t miss their required dosage because their hub does not have supplies from the DOH.
There are similar allegations in Cagayan de Oro City, Davao City and Zamboanga City.
And in Alabang, the pharmacy of a treatment hub even posted on January 8, 2019 an announcement that “due to the shortage and delay of the deliveries at DOH, only one bottle will be dispensed of the following medicines: Nevirapine (200mg tablet); Lamivudine (150mg)/Zidovudine (300mg tablet); and Lamivudine (300mg)/Tenofovir (300mg tablet).” The same hub is telling its clients to “wait for further announcement on stock availability.”
Note that the RITM-AIDS Research Group’s pharmacy is putting the blame on the DOH.
The same DOH statement stressed that “the latest data, as of January 4, confirms that Nevirapine has already been delivered to the 16 treatment hubs to meet the requirements for February-April 2019. For Lamivudine/Tenofovir, a month’s supply has also been delivered to Regions X, VI and I. The rest of the regions will expect deliveries within this week.”
Noticeably, the DOH statement responds to issues only this January, even if this concern has been circulating in the PLHIV community since 2018, and only peaked now.
There are fewer ARV refills now. If, in the past, the usual practice is for hubs to give PLHIVs three bottles of ARV to last them for three months, a growing number are now complaining about the supply being cut to one month in numerous hubs – e.g. there’s that post in RITM’s pharmacy. Some allege that they are even supplied ARVs just for a week or even just for three days.
Due to the ARV shortage that the DOH is not outright confronting, expired medicines are allegedly being given to PLHIVs – as in the case of Xander.
Also due to the ARV shortage, the medication of a number of PLHIVs are allegedly being changed not because it’s medically sound, but because their usual medicines are not readily available. In Mandaluyong City, there are PLHIVs who claimed to have been told to use Lamivudine/Tenofovir/Efavirenz because it’s the only available ARV. If they refuse to do so, then they will have to stop taking their usual medications until such time when the delivery of supplies are normalized again.
To allow the DOH to respond to these claims, Outrage Magazine repeatedly reached out to the government body. Upon calling the media relations unit (at +63 2 651-7800 loc. 1126), we were turned over to the office of Dr. Gerard Belimac (+63 2 651-7800 locs. 2355, 2352, 2354). Five attempts were made to speak with Belimac or any other authority in his office, but he has been unavailable at those five times; and even after leaving requests for a statement from him on the ARV shortage, as of press time, the publication has not heard back.
As this is a continuing story, coordination will continue to – eventually hopefully – extensively hear from the DOH on this issue.
The DOH statement also stated that it is “working closely with our suppliers to ensure that there are no gaps in our supply chain. In fact, we are waiting for deliveries of an additional 12,375 bottles of Nevirapine good for another three months and 7,024 bottles of Lamivudine/Tenofovir good for another two months.”
The DOH also claimed that it is continuing to explore “for more partners in providing excellent support for Filipinos living with HIV-AIDS and in ending the deadly disease.”
As if wanting to pacify the complaining PLHIVs, the DOH statement transferred to responsibility to “HIV doctors to explore possible options”, or visit Facebook page (PLHIV Response Center) or email email@example.com. Note the use of a gmail account for a body with millions in budget.
No investigations on where the errors in the supply chain is happening so that these can be fixed is forthcoming. No one being held accountable here.
THE NEED TO GO BEYOND LIP SERVICE
Incidentally, Article V, Sec. 33 of the newly signed HIV law states: “The DOH shall establish a program that will provide free and accessible ART and medication for opportunistic infections to all PLHIVs who are enrolled in the program… A manual of procedures for management of PLHIV shall be developed by the DOH.”
The IRR is not even there yet, but this mandate to provide life-saving meds is now already cast in doubt.
Xander – who only had a refill of his ARVs – said that many like him who posted about this issue online were told to stop doing so “because we are supposedly creating panic among PLHIVs.”
He now says that people who cover up this issue are “as worse as those paid to work on this issue. Because if you go to the HIV community, we’ve long lived with worrying that our meds may not be given us at any moment. If some people think complaining about this is wrong, then they shouldn’t be in HIV advocacy, but work as PR people of those failing to do their jobs.”
In the end, “this needs to be resolved fast. Enough with discussing semantics on what we’re having is a shortage or a stockout; the fact remains that there are PLHIVs not getting their supplies. Lives are at stake. So supply the ARVs; now.”
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.
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:
- He pays his PhilHealth; and
- 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.
- 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’…
- 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.
- 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.
- 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.
- 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”.
The fact is, numerous HIV-related issues continue to plague the country.
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.
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…
3 Terms you need to know in HIV advocacy in the Philippines
HIV advocacy in the Philippines has evolved – and in many ways, devolved – to highlight erroneous practices. Here are at least three terms in use locally that highlight how BROKEN HIV advocacy is in the Philippines.
I was in Northern Mindanao when I first heard of a term used to refer to a service “provider” who – in a word (and there really is no going around this) – ALLEGEDLY “molested” masseurs who had to be tested for HIV as required by their line of work.
When interviewed, some of these masseurs alleged that a certain medical practitioner who – during testing – would “dulaan ang among itlog ug utin (fondle our testicles and our penises).” And then – as if to show them who’s the boss – “mu-ngisi pa jud siya, unya mu-schedule sa uban sa amo-a ug booking (this person would smirk at us, and would even schedule trysts with some of us).”
That was the first time I heard of a term that is apparently used to refer to people like this person: “advoKATI”, a play on “advocacy” and “makati (literally, itchy; and contextually, a slut)”, because they supposedly use advocacy as a cover for their itch/desire to pick up or sleep around.
Through the years, other terms being used related to HIV advocacy also came to my attention. And here are at least three of them; all of them highlighting how BROKEN HIV advocacy is in the Philippines.
n. Refers to a person who uses the advocacy as a front to get sexual partners.
The medical practitioner mentioned above is an example; though – by no means – is his case unique. Other examples include: giving (donated) vacc in exchange for sex with a PLHIV; providing after-testing services only to good-looking newly-diagnosed persons with HIV, while the not-so-good-looking are left to fend for themselves; and “counselors” using the confused state of mind of newly-diagnosed PLHIVs to sleep with them.
n. Profiting from HIV advocacy; or people who profit from the same.
Let’s get this straight: Profiting from HIV is not exactly new; nor is this exclusive to the Philippines.
Globally – and perhaps even more apparent – is the profiteering done by pharma companies that produce the life-saving ARVs for PLHIVs. There is also the issue with accessing “good” drugs by developed countries (e.g. PrEP) versus “dumping” of those not already used by the developed countries in the poorer countries (e.g. phase out of Nevirapine and Efavirenz).
Perhaps Peter Mugyenyi said it best when he tackled in “Genocide by Denial: How Profiteering from HIV/AIDS Killed Millions” the “incredible self-indulgence of the pharmaceutical companies and the cold-heartedness of the rich world that turned a blind eye until it was far too late, and then responded too slowly with too little.”
Now not just the big “bodies”, but even the other players in responding to HIV are mimicking this. And yes, this includes HIV “advocacy” in the Philippines, which is emulating this, too.
Here, we continue hearing that “there is no money in advocacy”, much more for those affected by HIV. This is supposedly why it’s difficult accessing existing treatment, care and support (TCS) – because, as always stressed – “there just isn’t enough money to go around”.
And then you hear about HIV “advocates” who can afford to buy numerous stuff (from a number of cars to a number of properties to luxury items to high-end gadgets to getting cosmetic surgery, and so on) from their “small” salary as NGO workers.
Or “advocates” who have drivers. WITH UNIFORM.
Or “advocates” who can tour the world using only their “meager” earnings from their “small” salary.
This is NOT to begrudge people their salaries.
BUT when you couple these with:
- Inability of newly-diagnosed PLHIVs to go to treatment hubs because they don’t have money to pay for their fare.
- Complaints from PLHIVs about inability to access to treatment because they can’t pay PhilHealth.
- Non-access to other meds for opportunistic infections (or the need to beg the likes of DSWD or PCSO to fund these meds).
I am starting to sound like a “sirang plaka (broken record)”, repeatedly writing about issues I’ve already written about.
BUT there’s this disconnect that is too painful to just ignore.
All because there are “advocates” who see HIV as a cash cow.
v. The use of HIV advocacy for social climbing. “Katkat” is a Bisayan word meaning “to climb”. This is often related to advoCASHy as it emphasizes only the glam in “helping” even sans the actual helping.
There are NGOs paying PR firms to promote HIV “advocacy”. Ask them how many people got tested because of the “campaigns”, and they’d tell you: Our indicator is the number of Facebook likes. “Likes” derived from the money paid to celebs, bars, photographers/videographers, alcohol consumed, et cetera. Partying in the guise of advocating.
There’s an “award” for people who “helped” HIV advocacy in the Philippines – even if grassroots HIV workers question the “winners” (e.g. who these people are, how they were chosen, what they’ve really done for the HIV community). What’s seemingly important is the hype created; particularly since celebs “joined” the “cause”. More photo ops mean more exposure means more (possible) funds.
There’s the funding of a photo campaign because the one disbursing the fund are “models” in the campaign, themselves.
There’s a well-funded beauty pageant even if we have (often denied) ARV shortage (not to mention hubs that still do not offer all tests included in the OHAT package, from CD4 count to viral load count).
As already noted in the past, there’s this focus on the glam/social climbing (e.g. get celebs to promote testing), perhaps forgetting that real advocacy goes beyond that.
And so here we are now, with 31 new HIV cases reported every month in the Philippines. Ten years ago, we only had one case EVERY DAY.
We are fucked. But we’re not only fucked because of lack of sex education, non-promotion of condom use, antiquated practices (e.g. we have yet to teach U=U in the country, or make PrEP and PEP widely accessible), and so on.
We’re also in deep shit because the people who should be serving us want us to be there so they can benefit from it.
This is the new(er) world of “advocacy”…
It’s called advoCASHy to promote advoKATI and advoKATKAT.
Back in Northern Mindanao, I asked those who alleged to have been victimized if they complained – officially.
I was told: “Na, kinsa ra ba mi (Yeah, right! Who do we think we are)? Kolboy kontra sa medical practitioner, paminawun ba mi (Sex workers versus a medical practitioner, who would listen to us)?”
Despite recognizing power structures and all that, I admit I still initially found the “excuse” inexcusable. Lodging a complaint against an abusive service “provider” seems like a good first step to remedy this situation. Letting things as they are only allows the erroneous system to continue.
And then – much later – the person they alleged did them harm formed a new NGO, and this NGO was funded by a bigger NGO based in Metro Manila. I mentioned the allegations to one of the heads of the Metro Manila-based NGO, hoping – perhaps – for them to closely look at the allegations since, and after all, they were “enabling” the person involved by funding this person.
Let me get this straight: These are all allegations, of course, and they need to be investigated to be validated/invalidated. Everyone involved ought to be heard – from those who accused, and the accused. But that they exist at all should already be cause for concern.
Alas, the allegations were ignored.
So this “provider” continues to be coddled – and enabled – so long as this person’s NGO churns out reports that the bigger NGO can use to get even more big bucks.
All too apparent, people choose to turn the blind eye so long as money keeps flowing in…
No wonder HIV advocacy is in the Philippines remains broken…
3 Reasons why TasP and U=U won’t happen soon in the Philippines…
Treatment is available for people with HIV. And if a PLHIV gets treatment, he does not need to die from AIDS-related complications, and he’ll reduce his viral load so he can’t transmit HIV to others. But in the Philippines, among the common reasons why TasP is NOT working is because of the failures of the service providers themselves.
Fact: Treatment is available for people living with HIV.
And if someone with HIV gets treatment, he/she does not need to die from AIDS-related complications.
And if someone also gets treatment, the antiretroviral treatment (ART) he/she uses reduces the HIV viral load in his/her blood, semen, vaginal fluid and rectal fluid to “undetectable level”. And get this: Evidence shows that individuals on effective antiretroviral treatment (ART) with an undetectable viral load cannot transmit HIV to others.
This is why treatment as prevention (TasP) is important.
So important, in fact, that the World Health Organization (WHO) guidelines call for “test and treat” strategies to “initiate all people diagnosed with HIV on ART as soon as possible after diagnosis as a way to decrease community viral load and reduce the rate of new HIV infections”.
But in the Philippines, among the common reasons why TasP is NOT working is because of the failures of the service providers themselves.
Testing is picking up, yes. But even now, not even half of PLHIVs access ART.
But so many of the after-test services continue to be lacking.
Here are three (of the many) reasons why I think TasP and U=U won’t happen soon in the Philippines:
1. After people get tested, no one really knows what to do next.
In the past three days, I have been speaking with three people whose HIV rapid test results were “reactive”. Soon after the tests, they were basically “dumped” by their “counselors”/service providers. These three were basically left on their own – and, as two of them said, “ni walang flyer na binigay para sana alam ko man lang ano na ang gagawin ko (no flyer was even given so I would at least be guided on what to do next).”
You’d expect more from the center where they got tested, too – both are satellite treatment hubs of one of the country’s major treatment hubs; and one is (in)famous for its extremely well-funded “efforts” to supposedly stop the spread of HIV in the Philippines.
The way I see it: Centers without after-testing support should NOT exist.
Because I said this before, and let me say this again: “You can’t just test people and then – after finding out they’re reactive/positive – ‘dump’ them to become somebody else’s problem. Because if/when you do, your concept of service provision is too limited, and as such, you’re actually part of the problem you claim to be dealing with…”
2. Baseline tests are NOT covered by PhilHealth.
In the Philippines, the treatment, care and support (TCS) received by most people living with HIV (PLHIVs) are covered by the Philippine Health Insurance Corporation’s (PhilHealth) Outpatient HIV/AIDS Treatment (OHAT) Package. Specifically, to those who are enrolled in PhilHealth, P30,000 is allocated per PLHIV per year, or P7,500 every quarter.
The 2010 circular that guided the implementation of the OHAT specifically stated that “covered items under this benefit are drugs and medicines, laboratory examinations including Cluster Difference 4 (CD4) level determination test and test for monitoring of anti-retroviral drugs (ARV) toxicity and professional fees of providers.”
The revised OHAT Package released last June 2015 stated that “covered items under this benefit are drugs and medications, laboratory examinations based on the specific treatment guideline including Cluster of Differentiation 4 (CD4) level determination test, viral load (if warranted), and test for monitoring anti-retroviral (ARV) drugs toxicity and professional fees of providers.”
Meaning: baseline tests are NOT covered by the OHAT package.
In 2015, Outrage Magazine interviewed Dr. Rosanna Ditangco, research chief at The Research Institute for Tropical-AIDS Research Group (RITM-ARG), a treatment hub located in Alabang. She lamented that management issues come to play in the delivery of treatment, care and support (TCS) services to PLHIVs.
For instance, “the OHAT Package does NOT cover baseline tests yet”, including such baseline laboratory tests as CBC, chest x-ray, PPD and blood chemistry (i.e. lipid profile, BUN, Creatinine, FBS), and CD4 count.
Let’s call this out already: This policy is – in a word – idiotic.
You need ARVs to treat HIV. You can ONLY get ARVs if you get your baseline tests done. If you have no money to pay for these baseline tests, then say goodbye to ARVs. Sans ARVs, you’re as good as dead.
3. Many medical practitioners in HIV advocacy continue to not know much about… HIV. Or even if they do, they continue to be sources of HIV-related discrimination.
One of the (aforementioned) guys who only recently got tested for HIV told me that – when the attending doctor was informed that his CD4 count is 60 – he was sarcastically told: “Ha, good luck!”.
I saw for myself how one nurse told a PLHIV “not to have sex anymore, ever. Para di na kayo dumami (So your number won’t grow).”
Try bringing up U=U in the country, and among the staunchest deniers are those working in HIV advocacy. I remember one of them tell me before: “Magkakalat pa (You’re giving them excuse to spread HIV)!”.
I also know of doctors who won’t even touch people they suspect to have HIV – due to disgust or fear or whatever, I can only surmise…
And so here’s another fact: Unless these are dealt with, expect for the worst to come.