fullman*

This June, UN Secretary Ban Ki Moon will announce that HIV is on the average stabilizing or declining all over the world. That is, except in seven countries – including the Philippines.

Being part of this ‘Horror Roll’ would lead many Filipinos to ask why this is happening. We actually know the explanation. Right now, the right question to ask is this: Mister Health Secretary, where is the money?

In the same UN General Assembly this June, the Philippines will give an update on its commitments to combat HIV and AIDS. The initial commitment was done in 2001, with targets that were set for 2003, 2005, and 2010. While the epidemic was raging in many countries, the Philippines had been considered to belong to the ‘low and slow’ category.

Everything changed beginning 2007. The infection rate began to increase, with reported cases reaching one new infection everyday. It doubled by 2009, and by 2010, the rate of new infections reached 4 to 5 a day. The infection became domestic, and while the epidemic hasn’t reached the general population yet, the prevalence rate has spiked in urban centers, especially Metro Manila, Davao City, Cebu City, and cities adjacent to these sites, with the increase driven by new infections among men who have sex with men, injecting drug users, and female sex workers.

Advocates expect the actual infection rate to be higher, and ‘low and slow’ became ‘hidden and growing’.

Ironically, despite the increase in new infections, public spending on HIV and AIDS has steadily declined. It defies logic – one would assume that with the rate of increase, the government would move to spend more on its HIV and AIDS program.

Is it assuming that most of the programs would be financed by foreign donors? The average share of private financing for HIV and AIDS interventions in the Philippines, whether implemented by government agencies or non-govermental groups, is 80%. Most of our external funding for HIV and AIDS come from the Global Fund for HIV/AIDS, TB and Malaria (GFATM). But of the multi-million investment that was done by GFATM in the Philippines, only 14% went to HIV and AIDS.

Relying on foreign grants to fund a country’s response to a simmering epidemic is irresponsible and risky. For instance, the GFATM money that we got to finance the purchase and distribution of free anti-retrovirals (ARVs) will be depleted in 2012. With the current prevalence rate, we’d be needing more ARVs. This is for treatment alone. Logically, the spending for prevention to reduce the number of individuals who would require ARV treatment should be higher. For the past few weeks, advocates from the civil society, with the help of experts from NEDA and UNAIDS, have been crunching numbers to check how much is needed for a minimum package of interventions to help stop the spread of disease, and the needed amount definitely exceeds the miserable P65 million that the government allocated for this year. (A report on this civil society will be released soon.)

Is the government dragging its feet because the infection is happening in communities – among immoral men who have sex with men, prostitutes and drug users – that the society in general would rather shun? The politics of this is that if this were happening among innocent mothers and children, the government would have responded differently. Responding to epidemic would have been politically palatable.

But an epidemic is an epidemic. HIV and AIDS is a public health issue, and the correct political response is to leave ideology behind and focus on evidence, which incidentally points to fact that if the epidemic is halted and controlled in these populations, HIV and AIDS won’t reach the general population.

So with the alarming increase of HIV infection in the country, it is high time that we ask Department of Health Secretary Ona: where is the money?