Saturday, July 4, 2015

Problems of HIV and AIDS in the Philippines?


TRR's Care Assistance for Hubs reported that we had eight (8) deaths due to AIDS under our care. This is the sad reality that Project Red Ribbon has been experiencing with the implementation of its Care Assistance Program (CAP) for Hubs and with the continuous increase in the number of cases of HIV in the Philippines. Every month TRR's CAP handles difficult cases of people living with HIV with late diagnosis, late treatment for HIV and opportunistic infections, problems with the Philippines' health care system and poverty.

Late HIV Testing.

HIV Testing is one of the most important ways in controlling and preventing the spread of HIV. Early diagnosis leads to early treatment which leads to arresting the virus and not progressing to full blown AIDS. However, with grave issues surrounding stigma and discrimination, people especially the "at risk population" still don't want to get tested. Information campaigns about HIV and AIDS are weak in the country that people are scared not only about being humiliated because of their sexual orientation but also are misinformed about HIV treatment, care and support. Even though there is an HIV Law protecting the rights of individuals, still it goes skin deep. A lot are still scared about the future when it comes to employment, education and the heath care system. 

Last May 2015 showed the impact of the Department of Health's National HIV Testing Week which showed 748 newly diagnosed with HIV. However, are we really seeing the actual number when in fact only a small fraction of the total population has gone out to get tested? The international community has been clamoring for a drastic action for the Philippines as it is still one of the few countries where HIV cases are on the rise. 

Late HIV Treatment.

Unfortunately, still many get tested when they are already feeling something.. when they are already sick. In the Philippines, the antiretroviral drugs are free however, the greater population is not informed about it and this poses a "scare" about HIV and AIDS. There are now 22 HIV and AIDS Treatment Hubs all over the Philippines but because of stigma and discrimination which are very strong in the provinces because of culture, religion and close family ties people still get afraid to get treatment until they already suffering and weak. 

Delivery of adequate health service and poverty are major factors too. Because the HIV and AIDS Treatment Hubs are limited in terms of facilities and most medicines and services are not given for free for opportunistic infections, the economically challenged individual with HIV succumbs to lining up for financial and medical assistance from Philippine Charity Sweepstakes Office (PCSO), the Department of Social Welfare and Development (DSWD), asking for assistance from their Mayor, Congressmen, Barangay Captains, Churches, etc. There are some indigent people with HIV who just give up trying to get treatment because of these challenges. 

Compounding Problems.

The Philippines HIV and AIDS scenario is one big problem that can explode any minute. Since 1984, the country had witnessed how the HIV and AIDS scene had been addressed by the entire world. The start of the increase of HIV cases came around 2012 in the country, the time when almost the entire world has contained the epidemic. The model of prevention that was designed previously for sex workers now has moved to a model for males having sex with males which now comprise almost 87% of the HIV cases. Alarmed by this increase came the full effort of the Department of Health-National AIDS/STI Prevention and Control Program with menial budget to work with. The focus was greatly on awareness and prevention however, with the increase of cases, the budget of the health department now goes to purchasing the antiretroviral medicines, again with menial budget to work with. 

The non-government agencies are now sprouting out to help and align their missions with the government. International organizations are also helping: studying , training, extending arms to help stop the impending epidemic. The Philippines is one of the few countries that failed to meet the millennial development goal of 2015 of zero HIV cases and zero AIDS related deaths.

For four years now, TRR has seen the compounding problems of HIV and AIDS in the Philippines. These can be summarized below:

1. Unaddressed Human Rights Related to HIV and AIDS
   
 a. Right to Information
       i. The government needs to sound the alarm that the country has an epidemic by 
          aggressively disseminating information through media, Department of Education for 
          strong awareness and prevention campaigns, the use of condom as prevention, of 
          educating people for behavioral change.
      ii. The Department of Labor and Employment (DOLE) should start punishing companies 
          that don't have HIV in the Workplace Policies instead of continuously allowing 
          companies to pay less that P500 if by chance they are inspected and found out that 
          they don't have one. This need for a policy is part of the HIV law and only a handful 
          companies have this policy in place.
      iii. Educating the use of condom can't be effective if the conservative members of the 
          government
          keep on blocking policies and laws blocking the use of condoms
       iv. Educating the general population that HIV is NOT a disease of the males having sex 
           with males only but can be a disease of everybody. Anyone can be infected with HIV 
           and this information has to be disseminated to every school, offices, churches and 
           communities.

    b. Stigma and Discrimination
       i. The Anti-discrimination bill needs to be signed fast so that the rights of the LGBTI 
          can now be addressed. HIV and AIDS for 30 years now are issues of the LGBTI 
          because of stigma and discrimination and by addressing these human rights issues 
          can we fully address the issue of HIV and AIDS in the Philippines.
       ii. The education system needs to be fortified that HIV and AIDS is a growing threat 
           and by allowing stigma and discrimination, people, even with the strongest 
           information, can't still feel that the HIV testing centers and HIV treatment hubs (or 
           getting to an infectious disease doctor for that matter) are "safe" places.
       iii. Because of stigma and discrimination, people don't want to be associated with 
           topics about HIV and AIDS. In the country, even the TV and movie personalities 
           don't want to talk about virus because of the fear of gossips that they have it
       iv. Because of stigma and discrimination, people living with HIV (PLHIV) are not coming 
           out even though they have the power to be the voice to stop the epidemic.
   
 c. Right to Quality Health Service
        i. With menial budget, the DOH has been trying to implement programs, however it 
           can't catch up with the growing need.
        ii. Inadequate facilities in treatment hubs for CD4 and VL testing
       iii. Inadequate manpower. In big hubs, there are only 2 infectious disease doctors 
            catering to 100 patients a day.
       iv. Majority of the budget of HIV goes to ARV treatment. Less budget is allocated for
           awareness and prevention.
       v. Because of menial budget to work with, there were 2 instances of ARV stockout in 
           2014.
      vi. Promotion of Condom Use which is one of the most effective ways to prevent the 
           spread of HIV is being blocked by the conservative and religious members of the 
           government
     vii. Because of inadequacy of equipments, for HIV testing, a client will have to wait for 2 
           weeks to one month for the confirmatory of a positive HIV test before giving the 
           ARVs.
    viii. Because of the cost of the test, the CD4 and VL test result will come out after a 
           month.
      ix. Health insurance and HMO don't cover HIV and AIDS in the Philippines. 
       x. Some hospitals reject patients with HIV and AIDS  
      xi. There are no welfare programs specific for HIV and AIDS.
     xii. Poor access to treatment especially in provinces. A client sometimes have to travel 
           for more than 3 hours to get to the nearest treatment hub.
    xiii. Scarcity of infectious disease doctors lead to opening of hubs with just trained 
          medical practitioners 

d. Right to be free from cruelty, inhuman or degrading treatment or punishment
     i. There should be strong laws and policies against hostile home environments. 
     ii. PLHIV can't be evicted from their homes because they have HIV
     iii. PLHIV should not be rejected from hospitals even though their are in a life ad death 
          situation
    iv. PLHIV can't be rejected from health services like hospitals and clinics or be in 
        isolation rooms as if HIV is contagious.

e. Issues of Confidentiality.
    a. Even with an HIV Law, some medical practitioners still don't follow proper disclosure 
       procedures in both testing and treatment.

2. Inadequate Funding for HIV and AIDS

    a. DOH has inadequate budget for HIV awareness, HIV Testing, treatment, care and 
        support.
    b. The Philippine Government has no line item for HIV 
    c. No government support specifically for financially challenged PLHIV    

There are more problems in the Philippines about HIV and AIDS that don't meet the eyes. For now, until the community won't take action or the government won't take strong action againts HIV and AIDS, more and more people will die because of stigma and discrimination, because of late medical intervention and inadequacy of treatment. The cases will continue to increase for the years to come.

When will we listen? When do we really need to stop the impending epidemic? 

Last month, TRR experienced 8 deaths under its care. It will continue to increase. That's the harsh reality until we do something impactful about it.
 






QUESTIONS ABOUT HIV AND AIDS?
WANT TO GET TESTED?
CALL US!

TRR HIV Hotline Numbers 


0919-642-9286
0977-131-2046
0906-389-2402
 0917-899-0473
0927-823-0300 
0917-932-3122
0916-216-2066


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-Pozziepinoy-



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