Health is a human right. This principle is globally recognized and accepted as evidenced by its incorporation into various international human rights rights instruments, treaties and declarations,foremost of which is the 1948 Universal Declaration of Human Rights (UDHR), Article 25,which states:
"Everyone has the right to a standard of living adequate for the health, and well- being of himself and his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability,widowhood, old age or other lack of livelihood in the circumstances beyond his control."
In the Philippines, the 1987 Constitution recognizes the people's right to health as stipulated in Article II, Section 15:
The State shall protect and promote the right to health of the people and instill health Consciousness among them.
The recognition and application of the principle of health as a human right are significant in many respects. First, it signifies the awareness of the interrelationship and interdependence of health with the other types of human rights such as civil and political, economic, cultural and social rights. As asserted by Jonathan Mann, the founder and former chairperson of the Joint United Nations Programme on HIV/AIDS (UNAIDS), the promotion and protection of human rights is fundamentally linked to the promotion and protection of the right to health since all forms of human rights violations have consequences on the health of the individuals. (Mann,1997) The right to health is an embodiment of two basic rights of the human, i.e. the right to life and the right to human dignity, which is the essence of human development.
Second, the link between health and human rights indicates the centrality of the right to health in the attainment of the development. For human life and dignity to be promoted, the right to health must be held in highest regard by society. And since the realization of human dignity is the ultimate goal of development, this implies that health should be an essential component of any development program.
Crucial in the attainment of development is a healthy and productive people while a healthy population is an important indicator of development. Thus, the right to health is both a goal of and a means to development.
Third, since health is a human right, it is the state's obligation to promote, protect, respect and fulfill the right to health of its people. This means it is the duty of the government and its agencies to create the conditions, institute mechanisms and provide the necessary resources that will ensure the realization of this right of the people.
The paradigmatic shift in the approch and analysis of health in the context of human rights highlights the inseparability of societal and structural conditions with the state of the people's health. It points out the broader milieu upon which health issues and concerns are to be viewed, going beyond the levels of the individual and family. Moreover, the human rights framework in health stresses the fact that health cannot be treated separately from the socio-economic structure; that health is a multi-dimentional and multifaceted phenomenon, its realization of which is greatly determined by the dominant philosphy and character of the institutions in society. (Simbulan, 1993) To quote Jonathan Mann:
…..to take a health and human rights analysis---which is to say a societally-based analysis---seriously, requires uncovering the rights violations, failures of rights realization, and burdens on dignity which constitute a societal roots of health problems. This approach would consider a whole human being made vulnerable to a wide variety of pathogens and unhealthy conditions as a result of how the person is treated by society---expressed and articulated in the language of human rights and dignity. (Mann,1997)
The 20th century, which is about to end, has brought humankind to greater heights and has opened innumerable prospects for its growth and development. The fields of public health and medicine are among those where tremendous progress has been achieved. A few of these major breakthroughs are the discovery of drugs like antibiotics including penicillin in the 1930's-'40s, the production of polio vaccine in the 1950s and the expansion of immunization.
Yet, as the country approaches a new millennium, the goal of "health for all" as articulated in the 1978 Alma-Ata Declaration remains to be an elusive dream for majority of the world's population,including the Filipino people. Despite the economic growth and major advances in science, technology, public health and medicine, gross inequities and social injustice in the satisfaction of basic human needs such as food, clothing and shelter, and access to affordable and quality social services like health and education, continue to be a stark reality confronting humanity.
Health, as we all know, is a good indicator of the country's level of development and a reflection of the manner by which a country's resources or wealth are distributed to, and shared by, the population. The following statistics reveal the dismal and appalling state of the people's health worldwide, particularly in developing countries where majority of the world's population are found: (Heggenhougen, 1999; Health and Human Rights, 1998; Attaran 1999; Castelo, et. Al, 1995; Logie & Rowson, 1998)
Furthermore, the irony of the 20th century characterized by a period of rapid scientific and technological changes and development is vividly illustrated in the widening gap between developed and developing countries, as well as, within countries. For instance, in Great Britain, the average British child can expect to last a full 76 years of life while in Guinea, an average child can only expect 44 years. Over 99% of British children will survive to their fifth year, whereas 27% of Guinea children will not. Moreover, in Britain, the median age at death is 77 years. In Guinea, it is 2 years (Attaran, 1999)
The gross inequities between the developed and developing nations can likewise be seen in the field of health and medical research. According to Robert Livingston, chairperson of the U.S. House of Reprsentatives' Appropriation Committee, the United States government spends "$295 per patient on cancer research, $93 on heart disease, $54 on Alzheimer'' disease, $26 on Parkinson's----and $36,000 per AIDS patients on research." (Attaran, 1999)
The widening gap between haves and have-nots is also very much evident in affluent societies in the United States. According to Fernandez as quoted by Heggenhougen From 1979 to 1989, while the income of the poorest 20% of all the families in the U.S. fell by 10%, one percent of the richest families increased theirs by 105%. (Heggenhougen,1999)
The worsening concentration of wealth in the hands of a few is shown in the growing assets and properties of the richest families in the world, some whom are living in developing countries. For example, included the list of the wealthiest persons in the world with a fortune of at least US$1 billion are Sultan Hassanal Bolkiah of Brunei Darussalam, and Lucio Tan and Henry Sy of the Philippines. Moreover, based on recent estimates made by Unites Nations Development Program (UNDP), the world's 225 richest people have a combined wealth of over $1 trillion, an amount equal to the annual income of the poorest 47% of the world's people or 2.5 billion individuals. (Heggenhougen, 1999)
As old problems and obstacles causing a continuing violation of the people's right to health persist, new ones emerge as we approach a new millennium. The policy towards globalization is one major factor that not only threatens, but also started to further undermine, the state of people's health worldwide. The economic programs and strategies being pursued in the name of globalization by the World Trade Organization (WTO), have further heightened widespread inequities among countries in the world since these have trampled the people's fundamental right to life with their sources of existence being placed under serious attack. Workers are denied their right to decent wages; peasants and indigenous communities their right to the land they till and ancestral domains; the poor and marginalized sectors their right to have access to basic social services like education, housing and health care.
According to the UNDP: "the accelerating process of globalization is expanding global opportunities without distributing them equitably. The playing fields of globalization more often than not slope against the interest of people and countries" (Heggenhougen, 1999) Globalization has intensified the gaps between the rich and the poor nations. It has become associated "with corporate profit, growing income concentration, decline in workers' rights, environmental degradation, and increased corporate power." (Heggenhougen 1999)
For the Filipino people, globalization means further impoverishment, loss of jobs and sources of livelihood, exploitation of women and children, rapid environmental destruction. It entails a worsening of the present state of health of the people, characterized by the persistence of communicable diseases, malnutrition among children, high costs of drugs/medicines and health services.
The report of the Department of Health states:
The state of health of the Filipino people has greatly improved and continues to improve since the turn of the century. This is reflected in the trends towards decreasing death rates and changing disease patterns. (DOH, 1995)
A look at the health statistics, no doubt, supports this assessment. Figures on the country's crude, infant, maternal, neonatal and TB death rates from 1974-1994 have all registered a decline. (See Table 1) However, a closer scrutiny of these data shows that although there has been rapid decline in various types of death rates, the overall picture of health of the Filipino people has not significantly changed throughout the years. Everyday we witness widespread poverty, diseases and deaths in our midst. Communicable but preventable diseases continue to dominate the top causes of morbidity and mortality in the country. The changing disease patterns with non-communicable diseases landing on the leading causes of mortality as an indicator of improving health condition of the people is problematic. In developing countries like the Philippines, the increasing cases of lifestyle diseases of the heart and vascular system, diabetes, are primarily a result of the many problems and difficulties of the people have to face in the midst of poverty and worsening economic conditions. These are reflected in their diet, stressful lifestyle, ill health behaviors and coping activities. For instance, just recently the Department of Health (DOH) warned the public that the difficulty of the people to cope with the rising costs of basic goods can lead to "possible outbreak of stress-related illness"(Gonzales, PDI October 1999) Dr. Ivanhoe Escartin of the Mental Health Program of DOH said that the poor, especially, are "more vulnerable to stress-related ailments such as asthma attack, migraine and skin allergy, during hard times," (Gonzales, PDI, October 1999)
| Philippine Health Picture (1974-1994) | ||
|---|---|---|
|
Population Increased from 41,457,100 to 68,624,247 65.5% INCREASE | ||
|
Crude Birth Rate Decreased from 26.1 to 24.0 8.0% DECREASE | ||
|
Crude Death Rate Declined from 6.8 to 4.7 30.1% DECREASE | ||
|
Infant Death Rate Declined from 58.7 to 18.9 67.8% DECREASE | ||
|
Maternal Death Rate* Declined from 1.6 to 1.1 31.3% DECREASE | ||
|
Neonatal Death Rate ** Declined from 26.0 to 9.9 61.9% DECREASE | ||
|
Tuberculosis Death Rate Declined from 26.0 to 9.9 61.9% DECREASE | ||
Life Expectancy at Birth
| ||
|
The health crisis in the country is further manifested in the following indicators:
Communicable but preventable diseases still dominate the list of the ten leading causes of morbidity and mortality in the country. From 1989-1994, the ten leading causes of morbidity included diarrheal diseases (1), bronchitis (2), influenza (3), pneumonias (4), TB (6), measles (9) and malaria (10). Meanwhile the ten leading causes of mortality included pneumonias (3), all forms of TB (5), chronic obstructive Pulmonary diseases and allied conditions (7), diarrheal diseases (8) and other diseases of the respiratory system (9). (1994 Philippine Health Statistics)
Many of these diseases have been in these lists since the 1930s and have just changed their rank through the years. One classic example of a communicable disease which has never been out of the lists of the ten leading causes of mortality in the Philippines since the 1930s, is tuberculosis. In 1933, TB was the number one cause of death among Filipinos. It slipped to the number two slot in the 1950s and has stayed in that position till 1978. (Tan, April/May 1991) In 1987, it was the 4th leading causes of death. At present, despite the decline in the rate of TB mortality, the disease continues to be a major public health problem in the Philippines ranking as the 6th and 5th most common cause of illness and death respectively. (1994 Phil. Health Statistics) Moreover, TB is a leading cause of death among individuals in the most economically productive years i.e., between 15 – 49 years of age.
Furthermore, amidst the country's economic gains, filth-related diseases like diarrhea have consistently been the number one leading cause of morbidity and has remained in the top leading causes of mortality in the country for the past 50 years or more. This just proves that whatever economic growth has been achieved by the country through the years, this has not made much impact on the lives of ordinary Filipinos in terms of basic social services like decent housing, access to safe drinking water and good environmental sanitation. According to a study conducted by the College of Economics of the UP Los Banos, since 1986, public spending for social services or "human priority services", in both local and national governments, has not significantly increased in proportion to total public spending." These include basic education, preventive health care, water sanitation. (Tuano, November 1999)
Data from the National Statistical Coordination Board (NSCB) revealed that as of 1994, a total of 4.5 million families were living below the poverty line. In terms of distribution, most of these poor families were concentrated in 8 regions of the country, where more than half of the total population in these areas were living below poverty threshold. Among the regions with the highest incidence of poor population in 1994 were the following: (NSCB,1994)
In 1997, a slight increase of 0.5% was recorded in the number of families living below the poverty threshold, bringing the figure to 4.6 million families. This means these families were earning P11,388 a month, the poverty threshold set for a family of 6 to meet their food and non-food needs. (The poverty threshold refers to "the monthly income required to satisfy 100% nutritional requirements and other needs of a family of six") (NSCB, 1998) (See Table 2) Meanwhile, from 1997 to 1998, the poorest 10% of the population experienced a 29% decrease in yearly income, from P20,659 in 1997 to P14,644 in 1998. On the other hand, an 8% increase in income was experienced by the richest 10 % of the population. From P482,927 in 1997, their income went up to P520,928 in 1998. (Reyes, et al., 1998 was quoted by Tuano, November 1999)
| Area | Annual Per Capita Poverty Thresholds | Annual Poverty Incidence in Percent | Number of Poor Families | ||||||
|---|---|---|---|---|---|---|---|---|---|
| 1994 | 1997 | % change | 1994 | 1997 | % change | 1994 | 1997 | % change | |
| Phils. | P8,885 | P11,388 | 28.2 | 35.5 | 32.1 | (9.6) | 4,531,170 | 4,553,387 | 0.5 |
| Urban | 9,831 | 12,642 | 28.6 | 24.0 | 18.5 | (22.9) | 1,521,882 | 1,246,173 | (18.1) |
| Rural | 7,946 | 10,248 | 29.0 | 47.4 | 44.4 | (5.5) | 3,009,288 | 3,307,215 | 9.9 |
An essential social service which remains to be an elusive dream for Filipinos is decent housing. The absence of this basic social service exposes one to harmful elements in the environment and makes an individual highly vulnerable to various kinds of diseases. Based on the 1993 estimates of the Presidential Commission for the Urban poor (PCUP), out of the total 15 million urban poor population nationwide, about 9.75 million live in slum areas. The NEDA defines urban poor as low-income people commonly residing in one-room dwelling units made of second hand materials like light wood, rusty corrugated aluminum sheet and used cardboard. These makeshift houses are situated in congested neighborhoods and slum areas usually located near garbage dumpsites, beside railroad tracks, along riverbanks and creeks, along coastlines, in government designated relocation sites, etc. (NEDA, 1993)
The plight of urban poor people puts them in constant danger of losing their lives, houses and personal belongings because of demolition. From July 1,1992 to December 31,1997, the Task Force Detainees of the Philippines (TFDP) documented a total of 161 incidents of demolition. Thse incidents resulted to the destruction of 16,175 houses and affected the lives of269,106, (TFDP,1998) The violent nature of many of the demolitions conducted in urban poor communities because of the involvement of paramilitary forces, Special Weapons and Tactics Teams (SWAT), and heavily armed men, has led to the death and injury of many defenseless urban poor residents, including women and children.
The worsening housing problem in the country is exemplified not only by the growing number of urban and rural poor population. It is also manifested in the increasing visibility of families who because of extreme poverty are unable to rent a room or build a shanty in slum communities, and are forced to live in the streets and public places. Nowadays, it is very common to see families in pushcarts, on sidewalks and waiting sheds, along seawalls, under bridges, flyovers and LRT. (PCUP)
The government's commitment to providing the poor with decent housing has recently been questioned with the appointment of Jose Luis Yulo, a big time real estate developer, as co-chair of the Presidential Commission on Mass Housing, the body in charge of the government housing program. Of course, we all know that Yulo did not stay long in office because of his questionable reputation. The president's act of putting a wealthy person in this position has been viewed as making the rich spearhead the government's war against poverty; it signals the shift of the housing program from one oriented toward a socialized strategy to one that is directed by big developers. (Doronila, October 1999)
Concomitant with mass poverty is the deplorable environmental and living conditions of the people. As of 1992, close to 20% of the total population (7% urban & 23%) still do not have access to safe drinking water while the one-foutrth (25% do not have adequate excreta disposal facilities (155 urban; 35% rural). (1993 Phil. Health Statistics)
A look at the state of children's health further illustrates the health crisis in Philippine society. Consider the following data on the health of the Filipino children and youth:
Children's rights are among those grossly violated because of the state's negligence of its obligation to provide adequate and appropriate care, protection and guidance to them. At an early age, they are forced to abandon their childhood and face th adult world because of their premature entry into the labor force. As of July 1995, the total number of working children has been estimated at 3.7 million with 2.2 million exposed to hazardous conditions. (NSO,1995) Fragile and defenseless, they become highly vulnerable to various types of occupational hazards, diseases and accidents in their workplaces having detrimental consequences on their health and overall physical and mental development. Very often, children are employed in places that have poor ventilation and lighting facilities like sweat shops and garment factories. They are made to handle loads, harmful chemicals and substances and are exposed to intense heat, sunlight, wind and rain like those in vegetable farms, mining and fishing areas, and furniture shops or woodworks. In addition to the physical exertion demanded by their jobs, the stress and tension they go through in their daily activities, most child workers suffer from varying degrees of malnutrition, respiratory ailments and skin infections. (Simbulan, 1997)
A particular group of child workers whose numbers continue to rise primarily because of the deteriorating poverty and unemployment situation in the country are prostituted children. Usually between the ages 13-15 years, it is estimated that out of the 1.5 million street children in the country, 60,000 are engaged in the flesh trade. However, the UNICEF estimates them to be about 100,000. According to the Department of Social Welfare and Development (DSWD), the average annual increase of prostituted children is 3,266. (Simbulan, 1997;IFF 1996) Moreover, in the UNICEF country-by-country survey, the Philippines ranks second to India in terms of the number of prostituted children. India has about half a million. (Simbulan,1997)
Child prostitution has serious deleterious effects on children's physical, psychological and mental health. Prematurely, they become to the ugly and decadent side of the adult world characterized by violence, sex, alcohol and drug abuse and sexually transmitted diseases like AIDS. They are subjected to dehumanizing and brutalizing conditions and are forced to perform acts which their frail bodies and minds are unprepared to do. They learn to cultivate distorted values and adopt behaviors like stealing, lying, cheating, deceiving and abusing others which they come to believe are important qualities one should possess in order to survive and surmount the harsh social realities. (Simbulan, 1997)
Still another disturbing fact is that highly preventable diseases like diarrhea, pneumonia and malnutrition are among the leading causes of death among infants and children in the country. (1994 Phil. Health Statistics)
On the other hand, women continue to be a disadvantaged sector in the Philippine society. A serious social problem affecting them which reinforces the streotypical views and treatment of women in Philippine society is that of sex trafficking and prostitution. It is estimated that there are about 300,000 women who are engaged in prostitution. The International Labor Organization (ILO) estimates are even higher at 400,000 to 500,000 victims. Areas known for sex trafficking of women are Metro Manila, Cebu, Baguio and Davao which are also known either as tourist of growth areas. Their involvement into the kind of work exposes them primarily to violence and sexually transmitted diseases including HIV and AIDS.
Unlike in developed countries where males have a higher mortality than females in all ages, the reverse is true in many developing countries like the Philippines. One factor for this is the relatively high rate of maternal mortality which remains to be a major cause of death for adult women living in the developing world. (WHO,1992)
In the Philippines, the maternal mortality rate recorded in 1990 by the WHO was 280 per 100,000 live births. (http://who.int/hsp/a/country/phi2.htm) The most common cause of death is normal delivery and other complications related to pregnancy occurring in the course of labor, delivery and pueperium. (1994 Phil. Health Statistics) These include hemorrhage, eclampsia, sepsis, abortion and obstructed labor. (WHO), 1992) Moreover, close to half of these deliveries were not attended by a trained health personnel which may explain why the deliveries resulted to the death of the mother. (http://who.int/hsp/a/countrys/phi2.htm) There is also the absence or lack of prenatal care for many of these women.
The low level of education, poor nutritional status and lack of access to family planning services are some of the aggrevating factors contributing to the state of poor health of most women. This condition, consequently, affects the health status of the family because of women's traditional role as care givers or providers.
Based on the National Economic Development Authority (NEDA) figures, families belonging to the bottom 30% of income distribution had access to public health delivery systems comparable to the rest of the population. They frequented public health facilities like the barangay health stations and rural health units in both urban and rural areas. However, the most common form of service extended by the government health personnel is free consultation/check up and the issuing of prescriptions for their drug requirements that usually end up not being purchased by patients because of the lack of economic resources. Meanwhile health facilities suffer the lack of medicines and medical supplies like cotton, alcohol, syringes and needles. This situation got worse when the DOH became devolved starting 1993 with local government units (LGU's) carrying out many of the DOH functions. The low priority given to health by local officials as manifested in the inadequate budget allotted to health programs and activities has contributed to the poor state of health of the impoverished and marginalized sectors in Philippine society. This was illustrated recently when government health workers in Digos, Davao del Sur criticized the municipal government for its lack of financial support to basic health services.(PDI, August 1999) For 1999, a total of P144,050 was allocated for medicines and supplies to one rural health unit, an amount which Dr. Asuncion Tan, chief of the Rural Unit 1, considered not sufficient to meet the health needs of poor patients. (PDI, August1999)
The increasing costs of medicines and medical services have been greatly responsible for the growing inability of the people to respond to their health needs. Despite the passage of the Generics Acts of 1988 which was intended to provide safe and effective but affordable drugs particularly to low-income households, prices of drugs and pharmaceutical products have remained high. In fact, the price of drugs/medicines in the Philippines is one of the highest in Asia. According to Sec. Alberto Romualdez, the prices of drugs/medicines in the country are 250 to 1,600% higher than neighboring Asian countries like Indonesia, Malaysia, India, Bangladesh and Sri Lanka. (See table 3) (Feria,1999)
| Country | Amoxycillin (250 mg) |
Tagamet (200 mg) |
Cotrimoxazole (480 mg) |
Septrin (480 mg) |
Valium (10 mg) |
Adalat (5 mg) |
|---|---|---|---|---|---|---|
| Philippines | 22 | 95 | 20 | 53 | 52 | 40 |
| Indonesia | 10 | 56 | 7 | 25 | 42 | 18 |
| Malaysia | 16 | 35 | 8 | 16 | n.a. | 25 |
| Thailand | n.a. | 34 | 4 | 8-14 | n.a. | 20-26 |
| Hong Kong | n.a. | 73 | n.a. | 12 | n.a. | 31 |
| India | 9 | n.a. | 3 | 3 | 3 | 2 |
| Nepal | 8 | n.a. | n.a. | 3 | 3 | n.a. |
| Pakistan | 5 | 14 | 3 | 5 | 3 | 2 |
| Bangladesh | 6-9 | n.a. | 3 | n.a. | n.a. | 20 |
| Sri Lanka | 4 | 23 | 1 | 9 | 3 | n.a. |
The high cost of medicines and medical services is one reason why many Filipinos resort to harmful self-medication methods and are passive about their health conditions. Due to lack of resources and low-level of production, people rarely engage in health-seeking and preventive behaviors. Oftentimes, they seek the help of a health personnel or consult a doctor if their health problem or condition is already worst and difficult to treat. Being immobilized and experiencing unbearable pain are commonly the signs that trigger people to start acting decisively on their health problem.
Furthermore, there are those who resort to traditional medicine as an alternative method in responding to their health needs and problems. The use of herbal medicines, accupressure, change in diet and eating habits, etc. are among its components. Although the development of traditional medicine as a means to improve the quality of health delivery care to the people through the passing of the Traditional and Alternative Medicine Act of 1997, there is still much to be done in making the law meaningful. For instance, the advocacy and popularization of this alternative system of medicine particularly among the economically disadvantaged members of society need to be encouraged and supported by the government through the DOH.
Meanwhile, to respond to the problem of high prices of drugs/medicines, Sec. Romualdez is contemplating on allowing parallel imporatation of medicines from cheaper sources in neighboring countries even if the same drugs as locally available and marketed. (Feria, 1999) Parallel importation consists of purchasing drugs from a third party in another country, rather than directly from the manufacturer, and taking advantage of the fact that pharmaceutical companies impose different prices for their products in different countries depending on several factors. (ICASO, 1999) Prices of imported drugs in a country can be influenced by differences in intellectual property rules, differences in local incomes, and the degree of competition among the producers. (ICASO,1999)
The WHO states that "majority of health problems in the developing world could be solved by better nutrition, clean water, sanitation, access to maternal care and family planning, prevention of infections, immunization and the availability of essential drugs." (WHO, 1992) Yet, budgets for basic social services like health and education have consistently been cut by national governments in developing countries through the years. What has been prioritized in terms of budget allocation are debt servicing and national defense and security. These distorted priorities have been intensified with the recent Asian economic crisis.
The Philippine government is no different from other developing nations. Since the late 80's the health budget did not go beyond 4.0% of the total national appropriations. Under the Estrada administration, it has been cut down for two consecutive years. In 1999, the budget for the DOH amounted to P11.2B or a P1.7B less than the 1998 allocation under the Ramos government. (Contreras, 1999) For th year 2000, the health budget has been set at P11.1B or P168M less than the present budget. (Contreras, 1999)
The share of health in the gross national product (GNP) further reflects the government's low priority for health care. The percentage share of health in the GNP is much lower than the 5% recommended by the WHO for middle-income developing nations. This figure is lower than the that of Thailand (at least 3%), China and India (at least 4%) and South Korea (at least 5%). (Phil. Healthcare Industry: A Country Report 1992)
The unabated debt burden shouldered by peoples of developing countries, destruction of the environment and now, globalization, are among the major factors perpetuating widespread violations of human rights in the world, including the right to health.
By the end of 1999, the Philippine government would have paid P235.1B(US$5.9B)
to its creditors. The total foreign debt per capita through the years were as follows:
| '85 | '88 | '92 | '99 |
|---|---|---|---|
|
P2,604 ($139.93) |
P7,805 ($369.91) |
P11,591 ($454.38) |
P20,354 ($525.27) |
The debt burden has had tremendous consequences on the people's health. Among these are the following: (Logie & Rowson, 1998)
Recent developments particularly those manifesting the views and responses of civil society worldwide to the policies and strategies being put forward by the World Trade Organization (WTO), no less indicate that in the coming millenium, globalization stands as one, if not the greatest, threat to the survival of peoples in the developing countries. For the Philippines, globalization means integrating the economy to the world making the country "globally competitive" and transforming it into a newly industrialized country (NIC) by the year 2000. These goals have been stipulated and mapped out in the government's Medium Term Philippine Development Plan which was popularly known during the Ramos administration as "Philippine 2000" and "Angat Pinoy" under the present dispensation. To achieve these goals, the government has embarked on the following strategies, namely: (IFF, 1993)
The determined efforts of the government to be in step with the phenomenon of globalization as exemplified in the implementation of its development program has undermined the people's livelihood and has resulted to increased human rights violations. It has likewise intensified its abandonment of its obligations to the people through the provision of basic social services like health, water and electricity. This can be gleaned from the implications and repercussions of its policies and programs to the sources of income, well being including the state of health of the people.
Among the key policies and programs having detrimental effects on the people's existence are the following:
Furthermore, land conversion has also affected the country's food security with the conversion of lands formerly used in the production of rice and corn to that of high value crops as means of raising dollars from exports. Through RA 7900 or the High Value Crops Development Act of 1995, rice and corn fields have been converted to commercial crop plantations, especially those believed to be highly marketable in the world market. Among these are fruit crops like mango, citrus, watermelon, papaya and pineapple; vegetables like garden peas, asparagus, broccoli, tomato, cabbage and carrot; ornamental plants like orchids, gladiolas and chrysanthemum.
Prior to the implementation of MTDP, about 5 million hectares of land were devoted to rice and corn production (2.5M for rice and another 2.5million for corn Under the MTDP, the target is to convert 3.1 million hectares of rice and corn lands for livestock and HVC's and the remaining 1.9 million hectares for the production of these staple crops. (IFF, 15 March 1996)
One serious repercussion of massive land conversion taking place in the rural areas is the crisis in food production. As experienced in the past, onced this problem is encountered the usual response of the government is to resort to rice and corn importation. Thus, offsetting whatever economic gains and dollars have been raised with the exportation of HCV's.
The influx of agricultural imports as a result of trade liberalization policies has contributed to the further impoverishment of peasants and agricultural workers. Through RA 8178 or the Agricultural Tariffication Act, restrictions formerly imposed on the importation of basic agricultural products which are produced sufficiently in the country, have been removed. This means products like corn, onions, garlic, cabbage and meat products like pork, beef and chicken can now enter and be sold in the domestic market. RA 8178 nullifies existing laws like RA 1296 (1955) which protect peasants engaged in the production of said products from competition. (IFF,15 & 30 July 1996)
This early, producers of agricultural products like onions and garlic have started to experience the negative consequences of trade liberalization on their lives with the influx of imported garlic and onions from Taiwan, China and other Asian countries into the domestic markets. While imported onions from China are sold for P35 to P40 a kilo, locally produced ones are sold at P80 per kilo. (PDI, September 20 1999) On the other hand, imported garlic sells at P25 to P35 a kilo, while the locally grown ones at P130 a kilo. (PDI, September 20, 1999)
This is the likewise the experience of those in the fruit industry who recently shared the problem of the local fruit growers/producers in terms of preparedness in competing with other countries once free trade is fully implemented. According to Onofre Grino, Jr., president of the Philippine Fruits Association, there is a four year gap in fruit production in the country in terms of technology, production volume and efficiency. (PDI, December 3, 1999) Aside from the high cost of transportation, fertilizers and chemicals, local fruit growers do not have the capability to produce big volumes of fruits unlike other countries. Thus, the high production costs and relatively low production of fruits in the country result to high prices. Moreover, there is lack of government support to the industry like funds and sources of credit.
To consumers, this means being able to buy fruits and vegetables at much lower prices. However, for those employed in the agricultural sector, this means their gradual destruction with the loss of jobs, displacement, worsening of the poverty situation, etc., because of their inability to compete in the market and eventually,
the taking over of local production by foreign companies which will be able to
produce these goods more easily.
The further opening up of the economy to foreign investors through the expansion of economic incentives and foreign participation in the economy. The "silent" policy on wage freeze, the Mining Act of 1995 and the controversial charter change are but examples of the government's moves to encourage foreign investors into the country.
There is no doubt that the coming millenium will not only be an exciting one considering the many challenges that we face as a people. It will likewise be a time for strengthening and devising new strategies and forms of action that will make us effectively respond to the calls and needs of the times.
For those of us involved in the health sector, the struggle toward the realization of "health for all" and "putting health back in the hands of the people" continues. Sharpening and enriching existing forms of collective actions like advocacy and networking, education and information, work, lobby and active involvement in all levels of policy and decision-making processes, international solidarity work, are important tasks to accomplish.
In the field of information and education where many of us can become active participants, raising the people's level of human rights consciousness is a crucial task. This is an important step in making people aware of the need for collective and determined action if the right to health and development is to be realized.
The fight against globalization particularly in the health sector requires building and consolidating ties and linkages with peoples of other countries, both developing and developed. The need to share experiences, resources and expertise with one another is urgent.
The road ahead is rough and stormy, but with our determined will and unity as a people, we will surely triumph.
