The Philippines

Health and HIV Situation

In 2007, 7,490 people were estimated to be living with HIV in the Philippines, out of which 1,788 (23.9%) were women. An average of 29 new HIV infection cases were reported per month in 2007. The national HIV prevalence among adults remains below 0.1%. The cumulative number of AIDS cases reached 3,061 and 782 respectively in the 1984-2007 period.

Currently, a total of 336 patients receive free ARV treatment. HIV prevalence among most-at-risk populations, including injecting drug users (IDUs), female sex workers (FSWs) and their clients, and men who have sex with men (MSM), is low at 0.08%. Unprotected sex remains the most common mode of HIV transmission (88%).

In the 2007 Integrated HIV Behaviour Serologic Studies conducted in 10 sentinel sites, 48% of IDUs reported using sterile injecting equipment the last time they injected.

The same year, 48% of interviewed FSWs, 49% of MSM, 27% of male IDUs and 65% of male clients of FSWs reported to have had more than one sexual partner and to have used a condom during their last sexual intercourse. In relation to HIV and mobility, approximately 35% of the total reported HIV infection cases were among overseas Filipino workers (OFWs).

By the end of 2007, 33% of the sero-positive cases among OFWs were seafarers and 17% were domestic workers, 74% of them were male and 94% of them acquired HIV through unprotected sexual contact.

National HIV Programme and Response

In 2005, the Philippines launched its 4th AIDS Medium Term Plan, a road map for the national HIV response from 2005-2010.

The Plan includes a new push to expand universal access to HIV prevention, care and treatment among highly vulnerable groups, including FSWs and their clients, IDUs, MSM, and OFWs.

The national strategy against HIV includes mobilizing and involving all sectors including the Catholic Church, continuing implementation of surveillance and research systems on the HIV epidemic, and focusing on local HIV interventions. Now, 32 public VCT centres are available with trained staff.

Generic ARV drugs are provided free of charge to adults and children living with HIV.

Foreign Service Officers receive training from the Foreign Service Institute in collaboration with the career development arm of the Department of Foreign Affairs (DFA), the Office of the Undersecretary for Migrant Workers Affairs of DFA and the Overseas Workers Welfare Administration. In addition, the Positive Response: Guidebook on Handling Migration and HIV/AIDS Issues for Foreign Service Personnel has been developed and made available in all 89 foreign posts along with a 33 minute HIV awareness video for OFWs.

Most receiving countries require departing migrants to undergo mandatory HIV testing. Despite this, the government mandated pre-departure seminars do not always deliver accurate health information and quality HIV counseling and testing services.

Overseas workers must undergo a medical examination after the recruitment agency or the destination country employer interviews and pre qualifies them. Tests for HIV, TB and pregnancy are also mandatory. Some destination countries require overseas workers to go through another round of medical tests upon arrival.

The AIDS Law in the Philippines guarantees confidentiality of HIV test results, but test results including HIV are sent directly to the recruitment agency.

By 2010, the 4th Aids Medium Term Plan aims to provide all migrants with access to improved HIV prevention and information services, information and referral sites in destination countries, reintegration programmes, and testing centres with quality assurance surveys and strategies.

Pre-departure and post-arrival prevention and care programmes need to be further developed.

Migration Patterns

International migration is an integral part of the Government's poverty alleviation programme. The Philippine Overseas Employment Administration reports that in 2006, 1,092,055 Filipinos were employed abroad, 24% of them sea-based. This is a 10% increase compared to 2005.

There are an estimated 3.6 million contract workers overseas at any point in time working in more than 160 countries, with an additional 1.3 million undocumented Filipinos working abroad. The Philippines received an estimated USD 12.8 billion in remittances in 2006.

The Phillipines is a source country for trafficked men, women and children. In 2005 UNHCR reports 100 refugees and 40 asylum seekers present. The Internal Displacement Monitoring Centre estimates that 91,905 people were internally displaced during 2006. Little is known about HIV infection rates and vulnerability among these groups.

Recently, the Philippines Senate proposed a bill, Improving Philippine Commitment to Human Rights Promotion and Protection by Providing the Necessary Mechanisms for the Prevention of the Occurrence and Protection from the Adverse Effects of Internal Displacement and for Other Purposes (Internal Displacement Act of 2006), with health provisions for internally displaced persons with a focus on women's reproductive health. However, the bill does not ensure HIV prevention, care, treatment and support for them.

HIV Response for Migrant Populations: Gaps and Opportunities

The Philippines renewed its commitment to increase access to improved HIV prevention and information services for overseas workers through its 4th AIDS Medium Term Plan. Moreover, the GFATM guarantees expanded prevention, treatment, care and support services for migrants (before departure and upon return).

To fully address HIV vulnerabilities among OFWs, quality comprehensive pre-departure, post-arrival and reintegration programmes need to be strengthened. The new counseling referral programme for Filipino migrants testing HIV positive overseas needs to be expanded in the Philippines and replicated in other countries.

Strengthening surveillance and gender sensitive data collection mechanisms is crucial to develop strategic HIV prevention, care and treatment services for mobile populations.