The bustling northern Philippine city of Olongapo has defied the politically influential Roman Catholic Church by passing its own reproductive health code advocating sex education for high school students and the mass distribution of condoms, among other things.
Olongapo hosted one of the US military's largest naval bases in Asia until 1992. The base fuelled an unregulated commercial sex trade that flourished in the 1970s and '80s, propping up the local economy. In recent years the base has been transformed into a regional hub housing some of the region's biggest firms, and the resurgent economy has revived the city's sprawling red light district.
Realising the potential for the spread of HIV, and concerned that the annual population growth rate of 1.8 percent could strain resources, the local government decided to pass its own version of a national reproductive health bill that remains bogged down by intense debates in Congress.
"We don't want to pick a quarrel with the Catholic Church. We are of different opinions, but what we enacted here is a code that enables women to have informed choices on birth control and reproductive health," city health officer Arnildo Tamayo told IRIN/PlusNews.
Local church parishes have tacitly backed the code, but the church hierarchy in the capital, Manila, has expressed anger and disappointment.
About 80 percent of the country's 90 million people belong to the Roman Catholic Church, giving it a key role in shaping public opinion and influencing government policy. The Church has sought to block the reproductive health bill in Congress, saying the law would promote abortion and promiscuity. It is particularly opposed to a provision calling for the promotion of condoms and other family-planning methods.
Proponents of the law say it is needed to control the country's annual population growth rate of over two percent - one of the highest in Asia - and to control the spread of diseases, including HIV.
|We don't want to pick a quarrel with the Catholic Church...but what we have enacted here is a code that enables women to have informed choices|
The Church has threatened to use its considerable moral authority to campaign against those backing the bill when they run for congressional and presidential elections in 2010, and at least one bishop has warned that he would withhold sacraments from those backing the bill. The Church has also appointed its own lobbyists to pressure the 238 sitting congressmen to toe the church line.
President Gloria Arroyo - a staunch Roman Catholic - has pledged her commitment to the UN Millennium Development Goals, which include combating HIV and AIDS and improving maternal health by 2015, but her waning political fortunes have made her highly dependent on the Church's approval.
Meanwhile, the Olongapo reproductive health code was passed quietly in 2007, while the first round of debates in Congress was taking place. "Localising reproductive health bills in various towns and cities across the country is the way to go," Tamayo said. "If Olongapo managed to pass its own code, others can do it. We would be willing to share our experience with others."
Focus on sex workers
The code allows the city government to set aside funds for reproductive and sexual health; it also calls for "100 percent" condom use by commercial sex workers, who are closely monitored during weekly check-ups at health facilities. An HIV/AIDS hotline has been set up and a local task force created to track cases of HIV and other sexually transmitted diseases.
The UN Population Fund (UNFPA) has been providing technical assistance, including training for local health workers, and equipment and medicine for clinics.
There are less than 20 known cases of HIV in Olongapo, but officials acknowledge there could be many more undiagnosed cases. Dyezebel Dado, the city programme coordinator at UNFPA, said that with the reproductive health code in effect, authorities could closely monitor sex workers and quickly prevent any diseases from spreading.
"The HIV/AIDS surveillance system works well in this area, and I tell these girls to insist on condom use if they are to go out," she said.
Technically, prostitution is illegal in the Philippines, but solicitation happens openly in bars and in the streets. "We know it happens, but that is a police matter," Tamayo said. "What we are concerned about is the health aspect; it's better that we try to regulate it and therefore can monitor it clearly."
As a result of Olongapo's reproductive health code, members of the local gay community, who were once ostracised by the largely Catholic public, now actively help with information dissemination, teaching high school children about HIV/AIDS.
"I respect the Catholic Church and its teachings, but everyone has a right to know how to protect themselves," said Rey Catalan, 50, president of the Olongapo City Community Theatre Group, a gay dance troupe that performs HIV/AIDS awareness shows.
Aniceto Nortega, another member of the theatre group and a city government volunteer, said he had multiple partners at any given time, but was now a strong advocate of condom use.
"We used to go about our sexuality in the dark, and HIV/AIDS information was hard to come by. The local gay community didn't know where to run, but now we are helping not just our sector but the public with this problem," he said.
Discrimination blocks access
Over 1.3 million people in the Western Pacific region were estimated to be living with HIV/AIDS in 2007, according to World Health Organisation (WHO) statistics.
Shigeru Omi, the outgoing regional director of the Manila-based western Pacific office of the WHO, noted that while most countries in the region had established national AIDS policies, "most have not been fully implemented and many aspects still lack funding."
"Governments must deliver on the promises they have made," Omi said in a recent statement. "Communities must encourage leadership; individuals must be empowered to access treatment, to know their rights and to take action against stigma and discrimination."
He said groups such as sex workers, injecting drug users and men who have sex with men still encountered legal barriers to HIV services, and that discrimination continued to be a "major barrier" to accessing treatment.
This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions
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