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Philippines faces up to Aids epidemic

Health officials respond to surge of reported cases, but prevention strategy clashes with the Catholic church.

Women's rights groups are among those supporting the health department's HIV/Aids campaign.
Women's rights groups are among those supporting the health department's HIV/Aids campaign.

MANILA // After years of denial, the Philippines has acknowledged it is sitting on an HIV/Aids epidemic and for the first time the department of health is ordering condoms to help fight the spread, much to the annoyance of the Roman Catholic Church. The number of reported cases has spiked to 835 from 342 in 2007, according to data from the Philippine National Aids Centre (PNAC). In December alone, 126 new HIV cases were reported, up 232 per cent on the corresponding period in 2008.

The health secretary, Esperanza Cabral, said the increase was alarming. "From one case a day just a few years ago we are now looking at four - and this is just the tip of the iceberg." According to PNAC data, the actual number of people living with HIV in the Philippines totalled 4,424 at the end of 2009 while data from the UN's HIV and Aids programme estimated the numbers to be almost double at 8,300.

Even so, the number is small compared with the figures in Thailand, where UNAids estimates 610,000 are living with the virus, Indonesia with 270,000, Cambodia with 75,000 and Malaysia with 80,000. With an infection rate of less than one per cent of the population, the Philippines has the lowest prevalence of HIV/Aids in the region. "The actual numbers reported may be low when compared with other countries in the region, but we estimate that for every case reported there are 10 that go unreported," Ferchito Avelino, the director of the Philippine National Aids Council, said in an interview.

He said no one knows why the Philippines has a relatively low prevalence of HIV/Aids, especially since more than 10 million Filipinos live and work overseas and the acknowledged local sex industry thrives. "I can't say why with any certainty - no studies have been done. But what I do know is that we do have all the right ingredients for an epidemic," Dr Avelino said. "Why the sudden jump in cases reported? We are better at collecting data today than we were back in 1984 when the first case of HIV/Aids was reported. Also, people are becoming more aware of HIV/Aids; but we still have a long, long way to go educating people in this country, especially where the Church has a major say over the vast majority of the people's moral behaviour," he said.

More than 85 per cent of this country's population of 90 million is Catholic. Dr Avelino said one concern was the sharp rise of HIV/Aids rates among people below the age of 30, "most of whom are young urban professionals". A study, yet to be published, by the University of the Philippines Population Institute, details of which were obtained by The National, has shown a dramatic increase of as much as 35 per cent over the past 10 months in the number of young urban professionals affected by HIV/Aids.

Edsel Salvana is the Philippine General Hospital infectious disease treatment unit said that of the 80 HIV cases documented last November, most of the people were well educated. What worries the Philippine authorities is that new studies show the so-called 10-year doubling effect could see the actual number of cases double in one year rather than in 10. "It is quite possible that we could have 8,800 cases by the end of this year, prompting the health department to declare an epidemic," Dr Cabral, the health minister, said.

"If the doubling time remains stable in the coming years, you could have 17,600 actual cases by 2011, 35,200 by 2012 and so on," she added. Despite strong objections from the Church, Dr Cabral said the health department would push through with its Aids prevention and information campaign, which includes the distribution of free condoms. For the first time in the department's history, it will actually buy condoms for distribution to non-governmental organisations and government clinics in the fight against HIV/Aids, Dr Avelino said.

Ligaya Acosta, the executive director for Asia of Human Life International, which reflects the views of the Catholic Church in the Philippines, said: "Condoms do not protect people against HIV/Aids. Studies have been done that show countries with high incidents of HIV/Aids have high condom use. Other studies show that condoms leak and that the HIV virus can seep through condoms." The archbishop of Lipa, Ramon Arguelles, recently called for Dr Cabral to resign, saying it is "immoral to be pushing for the use of condoms, which we all know are not a deterrent to Aids".

Dr Cabral said: "We are a secular state where the church and state are separate. We are always willing to discuss and negotiate the matter with Catholic Church officials. "What should be concerning us now is that we were diagnosing two people a day last year and since January four a day with HIV/Aids. Two years ago, it was one," he said. "Instead of getting in the way of government programmes aimed at preventing the further spread of the virus, the Church should just co-operate with us."

On national television recently, Dr Cabral described the Church's opposition to condom use as "vicious". She pointed out that aside from promoting the use of condoms, her department also prioritises abstinence and faithfulness among couples - views in line with what the Catholic Church advocates. "Our programme to prevent HIV/Aids has failed because the Church is blocking the third component of our programme, which is to encourage the use of condoms," Dr Cabral told local media recently.

She said the health department has an "ABC programme" to combat HIV/Aids: abstinence from sex, faithfulness to your partner and use of condoms. She said the only foolproof strategy against HIV/Aids is to avoid multiple partners, but added that condom use, although not totally reliable, can still lower the risks. @Email:foreign.desk@thenational.ae