Alternative Perspectives on Contraception (Some Notes on the Reproductive Health Bill/RH Bill) David Michael M.

San Juan De La Salle University-Manila dmmsanjuan@gmail.com “Forget na lang the land reform/forget the debt moratorium/ forget na rin the behest loan/but don’t forget the condom.” (“Just forget the land reform/forget the debt moratorium/ forget the behest loan too/but don’t forget the condom.”) – From Gary Granada’s satirical song “Kung Alam Mo Lang Violy” (“If You Just Knew It Violy”) After being shelved out by the Gloria Macapagal-Arroyo regime, President Noynoy Aquino reiterated his support for the Reproductive Health Bill (RH Bill), which aims, among others, to provide free contraceptives to Filipino couples. The president announced such reiteration while on an official trip to the United States, and a few days after the Philippine government received a grant of $434 million from the Millennium Development Corp., a US government agency. This curious coincidence prompted Church officials to declare that US pressure bolstered Noynoy’s support and enthusiasm for the RH Bill. It must be noted that, as the Philippine Daily Inquirer reported, “until recently, the Philippines relied on international organizations, mainly the US Agency for International Development (USAID), to fund its population control program. USAID gave $3.5 million annually to subsidize condoms, birth control pills and injectable and intrauterine contraceptives.” Former Department of Social Welfare and Development Secretary Esperanza Cabral acknowledges that the USAID is an active DOH partner in the government’s family planning program (which includes contraception). Due to limited funding sources, USAID ceased supplying the Philippines with condoms in 2003, birth-control pills in 2007 and injectable contraceptives in 2008. Led by USAID, other international agencies formed the Global Fund for Contraception which was utilized to buy $84,237,070.95 worth of male condoms from 2005-2007 (not to mention the purchase of female condoms). Such amount is equivalent to P4,211,853,547.5 or around 140,395,118.25 kilograms of rice. Meanwhile, for a time, the World Bank supplied condoms for Uganda, a nation hard hit by an AIDS epidemic. The role of both the USAID and the World Bank in promoting contraception in the Third World is thus confirmed.

Pharmaceutical Giants’ Lobby For Contraception: Propagating A Myth for Profits Surprised by the sudden revival of the pro-contraception RH Bill, Pampanga Archbishop Paciano Aniceto asserted that some pharmaceutical giants are lobbying for the RH Bill, making it more difficult for the Church to lobby against the said bill. Ostensibly, pharmaceutical giants will profit from the government’s promotion of and funding for contraception. Almost all condom brands in Philippine markets are imported. It is in this context that the current version of the RH Bill should be taken with a grain of salt: far from being an innocent document, the RH Bill is a dangerous ploy of foreign aid and lending agencies to further propagate the myth of so-called “overpopulation.” Reading the text of the RH Bill gives the reader the impression that “overpopulation” is the root of Philippine poverty, contrary to the saner perspective which emphasizes elite control on political institutions, land holdings and huge corporations as the main problem that automatically results to the huge income gap between the richest segments of society and its poorest members. Renewed Anti-Imperialism Among the Clergy The maintenance of such myth will necessarily benefit huge pharmaceutical companies interested in reaping profits on their surplus contraceptive products. At the very most, the RH Bill could be a smokescreen aimed at diluting the people’s aspirations to resolve the real causes of Philippine poverty by struggling for sweeping socio-economic reforms such as building a self-reliant economy, instituting land reform, jumpstarting agricultural modernization and reviving nationalist industrialization (considering that the USAID and the World Bank consistently campaign for contraception and the RH Bill). Thus, it is not surprising if the Church has adopted antiimperialist rhetoric in opposing the current version of the current RH Bill. Just like singer-composer Gary Granada, principled opponents of the RH Bill are wary of development programs that emphasize contraception while neglecting the implementation of sweeping socio-economic reforms that will upset the oppressive and unjust status quo where a tiny minority monopolizes the country’s wealth and political power. Guaranteed Funding for Artificial Contraception The whole RH Bill is replete with passages emphasizing the state’s responsibility to protect the rights of women and children but just the same, the bill’s overly procontraception stance puts clouds of doubts over its real agenda. The following provisions directly or indirectly promote the use of artificial contraception and guarantees State funding for such: Section 2. The State likewise guarantees universal access to medically-safe, legal, affordable and quality reproductive health care services, methods, devices, supplies and relevant information thereon even as it prioritizes the needs of women and children,among other underprivileged sectors.

(listed as part of the Population Commission’s duties) Section 5 d. To ensure people’s access to medically safe, legal, quality and affordable reproductive health goods and services; i. To direct all public hospitals to make available to indigent mothers who deliver their children in these government hospitals, upon the mothers request, the procedure of ligation without cost to her; l. To strengthen the capacities of health regulatory agencies to ensure safe, highquality, accessible, and affordable reproductive health services and commodities with the concurrent strengthening and enforcement of regulatory mandates and mechanisms; m. To take active steps to expand the coverage of the National Health Insurance Program (NHIP), especially among poor and marginalized women, to include the full range of reproductive health services and supplies as health insurance benefits; and SEC. 9. Hospital-Based Family Planning. -Tubal ligation, vasectomy, intrauterine device insertion and other family planning methods requiring hospital services shall be available in all national and local government hospitals, except: in specialty hospitals which may render such services on an optional basis. For indigent patients, such services shall be fully covered by PhilHealth insurance and/or government financial assistance. (Listed as one of the matters to be discussed among students undergoing the madatory sex education:) Section 12 f. Use and application of natural and modern family planning methods to promote reproductive health, achieve desired family size and prevent unwanted, unplanned and mistimed pregnancies; Section 17 All Collective Bargaining Agreements (CBAs) shall provide for the free delivery by the employer of reasonable quantity of reproductive health care services, supplies and devices to all workers, more particularly women workers. In establishments or enterprises where there are no CBAs or where the employees are unorganized, the employer shall have the same obligation. To secure the cash-strapped government’s regular funding for costly artificial contraceptives, the RH Bill declares that contraceptives are essential medicines:

SEC. 10. Contraceptives as Essential Medicines. - Hormonal contraceptives, intrauterine devices, injectables and other allied reproductive health products and supplies shall be considered under the category of essential medicines and supplies which shall form part of the National Drug Formulary and the same shall be included in the regular purchase of essential medicines and supplies of all national and lord hospitals and other government health units. With these things in mind, one wonders how the acquisition of contraceptives will be funded. Section 23 states that “The amounts appropriated in the current annual General Appropriations Act for reproductive health and family planning under the DOH and POPCOM together with ten percent (10%) of the Gender and Development (GAD) budgets of all government departments, agencies, bureaus, offices and instrumentalities funded in the annual General Appropriations Act in accordance with Republic Act No. 7192 (Women in Development and Nation-building Act) and Executive Order No. 273 (Philippine Plan for Gender Responsive Development 1995-2025) shall be allocated and utilized for the implementation of this Act. Such additional sums as may be necessary for the effective implementation of this Act shall be included in the subsequent years’ General Appropriations Acts.” With the mere mention of the General Appropriations Act (the national budget), it is possible that in the future, the government will be acquiring more foreign debts to fund the regular purchase of costly artificial contraceptives. No wonder the USAID and the World Bank are very supportive of contraception-inclined family planning. Laudable But Suspicious Generally, the RH Bill is a laudable piece of legislation, especially when it comes to promoting gender equality, and broadening access to information on family planning and reproductive health issues. Unfortunately, the bill’s pro-contraception bias makes it a suspicious piece of policy, especially within the context of USAID and the World Bank’s prior and continuing support for such pro-family planning measures. The involvement of the private sector in “reproductive health care service delivery and in the production, distribution and delivery of quality reproductive health and family planning supplies and commodities” (e.g. contraceptives) further bolster the possibility that this bill might be exploited for private sector profits. While it is true, as Section 3.e of the RH Bill says that “sustainable human development is better assured with a manageable population of healthy, educated and productive citizens,” it is nevertheless doubtful if at this particular time, the Philippines can afford the regular purchase of artificial contraceptives. Moreover, it must be emphasized that the RH Bill seems to set aside the more pressing Philippine problems such as the lack of land reform and nationalist industrialization which virtually condemns our country to its current miserable state.

The Way Forward: Anti-Dynasty Law, Debt Moratorium, Land Reform and Industrialization The overpopulation myth is misleading, as evident in China’s case: despite its massive population, it was able to achieve industrialization (and though they instituted a one-child-only policy, their population nevertheless remains massive). Also, it must be mentioned that historically, Europe was able to rapidly industrialize due to its then soaring population. Indeed, without huge manpower, any industrialization endeavor will fail. After these countries succeeded in their industrialization endeavors, their population growth suddenly steadily dropped. Their governments are thus now compelled to institute creative ways to increase the population. In some parts of Italy, they' now re giving free land parcels to couples who produce many children. In Taiwan, the government pays for the fertility treatment of couples. In many industrialized countries, people just don' like to produce children. Some governments literally beg their citizens t to reproduce! This means we don’t need to control population growth. We need to industrialize first and sooner or later, after industrialization, the population growth will steadily decline (in fact, recent data from the Philippine Population Commission indicates that the population growth rate has been decreasing in the past years). How can we be so sure? To be sure, nothing is certain except the fact that since the time of Fidel Ramos, the government has been providing funds for contraception; that for the past more than 100 years of our independence, we never really tried to industrialize our country; that the gap between the rich and the poor remains broad nationwide; and that all throughout the same period, our political institutions and the country’s economy have been under the tight control of the country’s tiny elite in cahoots with large multinational corporations and foreign lending agencies. Perhaps a genuine paradigm shift is necessary. Perhaps we should now pass an enabling law for the Constitution’s Anti-Political Dynasty provision. Perhaps we should democratize our political institutions by shunning elite and elitist candidates and officials that perpetuate the unjust status quo. Perhaps we need to jumpstart sweeping economic reforms now by supporting land reform and agricultural modernization which will provide the backbone for any industrialization endeavor, instead of bickering over contraception. How do we fund these development programs? Impose a moratorium on debt payments, just like what Argentina and other countries did. Repudiate debts acquired by thieves in the government (e.g. loans that were illegally used for private corporations and/or directly pocketed by corrupt officials). The problem is, an antidynasty law, debt moratorium, debt repudiation, genuine land reform and nationalist industrialization are not exactly the things elite politicians and foreign aid agencies and lending institutions (like USAID and the World Bank) will prioritize. We’ll have to learn the value of self-reliance, after all...

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