With enough funds, DOH willing to give out contraceptives
Thursday, 25 February 2010
Health chief Cabral: Some bishops can be ‘vicious,’ but I have a job to do
While Catholic bishops were intensifying its campaign against candidates backing the reproductive health bill, their attention was caught by a Cabinet member who gave away condoms at a flower market in Manila on Valentines’ Day.
Newly appointed Health Secretary Esperanza Cabral has since been tagged as immoral by the Catholic Bishops’ Conference of the Philippines (CBCP) and is being asked to resign.
Cabral clarified that the distribution of condoms was not meant to promote artificial birth control methods, but a way to remind the public the need for a “responsible sexual behavior” to combat Human Immunodeficiency Virus or Acquired Immune Deficiency Syndrome (HIV/AIDS), a disease that reached an epidemic level in just a year.
In an interview with ABS-CBN News Channel’s “Dateline Philippines” on February 24, Cabral was far from giving in to pressure from the religious. The Department of Health’s anti-AIDS program will continue, she said in so many words. In fact, if funds won’t run dry, she said the department will be willing to distribute pills and other contraceptives—just like how she gave out rubbers in Dangwa.
This was expected that you would get opposition from the Church, but why are you doing this?
Because I think it’s the right thing to do in order to promote the health of the people of the Philippines. That is the mandate of the secretary of health and the DOH (Department of Health), and we are just doing what we are supposed to do.
How bad is the HIV problem?
Over the last few months, investigators and doctors have been alarmed by the escalating incidence of HIV/AIDS in the Philippines. And our figures are like this: it took 20 years for the number of HIV/AIDS to go to 2,000. It took 5 years to go to 3,000, and it has taken just 1 year to go to 4,400. And at the rate that we are going in three-year time, we are going to have more than 3,000 people with HIV/AIDS in the Philippines
And these are just reported cases?
Of course we consider that as the tip of the iceberg. Our calculation is that for every one case of HIV/ AIDS that we diagnose, there are 10 more that we have not diagnosed.
So how do you plan to do this? Is it going to be the DOH that’s going to do it directly? How do you plan to continue the program?
The program for condom distribution is just one component of the entire program that we have. The first, of course, is abstinence. That is the sure-fire way of not contracting HIV/AIDS through sexual transmission. The second is to be faithful to your partner, so that you don’t transmit it to anybody else except your partner. Let’s put it that way, if you have AIDS. And the third is for people who cannot be good, we help them to be careful by providing them with the means to prevent HIV/AIDS, which is with the use of condoms.
How realistic are you expecting people to abstain?
I think it’s very unrealistic. There are a few of us who will be able to do it, but certainly, most people are going to have to heed their natural inclinations.
The Church says it’s immoral?
The Church is the guardian of morality and, therefore, they should exert every effort to ensure that their teachings are heard. The DOH is the guardian of the people’s health. Those are 2 different things.
Are you not at all affected by the threats of the Church against you?
Of course I am. I’m very afraid of the Church. They are very powerful, and they can sometimes be very vicious. And I’m not exactly one who likes to live dangerously. But if I have to, I will do it.
You have the support of the president. Do you still have it?
So far, I have not heard the president stop me from doing all of these things. I’m sure that she knows that when she appoints a person to a position of responsibility, she has to give that person some authority.
Have you spoken to her about that, since the Church has come out with the threat?
Only once, when she noted that we were giving away pamphlets together with the NGOs and the manufacturers of the condoms. And she didn’t say, “You should stop your activity.”
What was her reaction?
So far, nothing negative.
She didn’t say, she supported it or opposed it?
She’s not stopping you, that’s support?
Well at this point, we can take it as like that.
Was it the vice-chair of the CBCP, “One foot in hell...” Would you like to react to that?
No. That is the opinion of the bishop. He is entitled to that opinion.
Is that because of the fact that condoms are contraceptive instruments or from a family planning point-of-view rather than an HIV one?
Yes, I think. In fact, that is correct. They do not want the use of condoms as they don’t want the use of other modern means of contraception. Because for them, anything other than abstinence is abortion.
What about that element of it? The idea of family planning is also a component of the ditrn of condoms?
Let’s put it this way, a condom is both, a contraceptive and a preventive for STD's (sexually-transmitted diseases) such as HIV/AIDS, if in the process of preventing STDs, there is this element of preventing pregnancy, then we accept that.
What is the stand of the DOH with regards to family planning, artificial or natural?
The principle that the national government abides with is informed choice, responsible parenthood. And in this case, we leave it to the families to do whatever they want to do.
Will the DOH facilitate or assist families who want to do family planning?
Yes, certainly, we will assist families through the NGOs, through the LGUs (local government units), and through our own organization, if they wish to practice family planning.
Is the DOH willing to give out pills, condoms, contraceptives to help out families keep their family small?
We will be at the moment; however, we do not have funds to do that. However, we partner with a lot of non-government organizations, with international aid agencies, and with LGUs to make sure that people are given the proper information, so that they can make an informed choice, as well as access to the services they need, if they cannot afford to buy it themselves.
Do you think there might be some middle ground, without earning the ire of the bishops?
We would love to have a middle ground with them. And we would love to discuss it with them, if they wish to discuss it with us.
Are you hopeful there might be something?
There is always hope.
Funds? GFATM (Global Fund to Fight AIDS, Tuberculosis and Malaria)?
The Global Fund is a large organization to which many countries and philanthropists, like Bill Gates contribute. And over the last few years, they have approved grants amounting to more than US$215 million of which US$85 million have been released to the Philippines. Our government has signed the grants with them. And part of the grant for the HIV/AIDS program is actually the purchase and distribution of condoms for those who need it but cannot afford it.
How much are you allotting for this in a year?
I think in the Global Fund there is something like P2.5 million for the purchase of condoms.
How much is a condom?
About P10. That’s a considerable number, but that is not our requirement. Our requirement actually is much more than that, but people who need it should be able to buy it. We are only providing for those, for whom it is absolutely necessary, but who cannot afford it.
What would you consider a successful number, consider the program successful? If the number of people diagnosed to have AIDS does not increase, meaning, every year, we remain at, say 2000, 3000 people diagnosed with AIDS, and it doesn’t go up, then, I think, we can say that we have been successful. If it goes down instead of just remaining stable, then that would be even greater.
But you only have less than 3 months to go?
What kind of success can we see here?
Nothing from me outside of the advocacy that this is something that needs to be done by the next secretary of health and the next administration.
You know you don’t have enough time to do this. If the next administration asks you to stay on, would you do it?
Well, I think we will cross that bridge when we get theres.
Are you eager to get back to private practice?
I’d love to get back to private practice, but I am also happy serving the people this way.
Which department do you prefer?
I love working in the DSWD (Department of Social Welfare and Development). The people there are very special. But I’m also very happy, because I’m a doctor, to be at the helm of the DOH that also has a lot of special people.
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