Jim M.**, a Filipino who has been HIV positive for almost 10 years now, gets his antiretroviral (ARV) medicines from, among others, India, “where they are much, much cheaper,” he says, adding that “in this stage of my life, cost is always a factor, so wherever I can buy what I need the cheapest is where I will get them."

HOPEFUL SCENARIO. Various groups are now supplying ARVs to infected Filipinos.

Taking a cocktail of ARVs to contain the proliferation of AIDS-inducing virus (what, if uncontrolled, can destroy his immune system, so that his body will eventually succumb to various infections that can cause his untimely death), Jim M. spends from P5,000 for his monthly medicines, “a figure that can balloon well over P30,000 (if branded medications are used).”

Jim M. is in some ways lucky, able to afford to pay for his ARVs, estimated to cost per one person living with HIV and AIDS (PLWHA) some $550 per month.  In the latest reports on HIV-AIDS, the UNICEF (Unicef.org) estimates that only about 20% of the 40 million of the world’s people with HIV and AIDS have access to ARVs.

Currently, in the Philippines, ARVs are available through Global Fund's (GF) Round 3 and Round 5 HIV projects, thus far benefiting about 400 patients.

“Every person living with AIDS has the right to have access to proper treatment and care,” Colin Davis, deputy representative of UNICEF Philippines, says.  “But the high cost of ARVs in the country limits access to the very few who can afford it.”

The Department of Health (DOH) spends an average of P5,000 a month per recipient for the generic ARVs, with the drugs dispensed through several government hospitals all over the country, including the San Lazaro Hospital and the Philippine General Hospital in Metro Manila, Ilocos Training and Regional Medical Center in Ilocos Province, Davao Medical Center  in Davao City, and the Vicente Sotto Memorial Medical Center in Cebu City. 

Obviously, because of the high cost of ARVs, the DOH is unable to Filipino PLWHAs in need of them – a sad case, considering that ARVs can significantly reduce the number of illnesses and deaths due to HIV and AIDS.

Waxing positive, Dr. Gerard Belimac, program manager of the National AIDS-STI Prevention and Control Program of the DOH, says that not all people with HIV necessarily need ARVs, though the figure of those availing ARVs is disappointing, at the same time, since “the possibility that the fear of stigma has kept other PLWHAs away.  Though we guarantee them 99% confidentiality, some HIV-positive individuals still hesitate to come out to access health services including free supply of ARVs,” he says in a Philippine Daily Inquirer (PDI) report.

The government’s effort, albeit welcome, is not without flaws.

In the same PDI report, a beneficiary cum complainant notes how the DOH runs out of ARV supplies, so that he is forced to buy more expensive versions (P4,100 vs. P5,200 for generic vs. branded Stocrin).  Worse, the ARVs have to go through the Philippine bureaucracy, prompting the beneficiary cum complainant to say, “When will they give us the drugs?  When we’re dying?”

And then there is the lack of monitoring among Filipino PLWHAs taking ARVs, mainly because of the lack of funding – a curious response because a big percentage of the PLWHAs in the Philippines are former overseas Filipino workers (OFWs), whose contributions to the economy reached $14 billion as of end-2007 alone.

Worst, not many know of the government’s effort – most of those who now receive ARVs happen to have “connections,” knowing or even having worked in non-government organizations dealing with sexual and reproductive health, and HIV and AIDS specifically.

Other initiatives have been started, e.g. UNICEF’s procurement of $186,000 worth ARVs for the DOH this year (five-year program), thereby allowing the government to obtain ARVs at lower prices than currently offered in the market; and the DOH’s programs to “capacitate several treatment hubs to do counseling and testing, and to provide technical assistance to social hygiene clinics on STI case management,” Belimac says.

Still, Jim M. sees the effort as “worryingly amounting to nothing.”  “Instead of giving us help through dole-outs, the focus should shift in making us secure a more regular (and permanent) supply of ARVs,” he says.  “Because until this is dealt with, we’ll continue adding stress to the government’s already stressed-out care and support efforts, something we don’t want to do, as we search for self-sufficiency.”

*REFER TO GAYrectory FOR INSTITUTIONS SUCH AS THE TROPICAL DISEASE FOUNDATION INC., REMEDIOS AIDS FOUNDATION INC., HEALTH ACTION INFORMATION NETWORK, PINOY PLUS, ET CETERA FOR MORE INFORMATION ON ARVs IN THE PHILIPPINES.
**NAME CHANGED FOR ANONYMITY