On January 29, 2008, a group of women, together with activist organizations and individuals working on women's reproductive rights in Manila, filed a case to nullify an Executive Order which for over seven years has been the "official" basis for the de facto ban on contraceptives in city funded health facilities.

The Executive Order was issued by the former Mayor, Lito Atienza in 2000 and on paper "discouraged" the use of "artificial contraceptives," in the city's health and family planning programmes. For many years, advocates who wanted to challenge the order were unable to simply because nobody could produce the supposed policy. Not even local barangay (the smallest local government unit) chieftains at the community level could show advocates a copy of the order but swore they were informed by the Mayor's office it was very much in place.

In the past other local government officials also instituted similar "bans" at the provincial and city levels. Former Governor Joey Lina was said to have instituted such a ban during his term as Laguna Governor as early as the late 1990s. The former Puerto Princesa Mayor in the province of Palawan also imposed a similar ban in 2001.

What perhaps set the Manila ban apart was the sheer determination and political influence of its proponent, Mayor Lito Atienza, who was also the national president of Pro-Life Philippines when he was Manila Mayor. In fact, more than relying on a written policy (which no doubt the Mayor also shrewdly noted could always be questioned legally), he also systematically put into place, city health officials and employees (right down to the barangay health level) with his appointees who shared his restrictive beliefs on contraception.

Slowly but surely over the Mayor's nine-years in office, he was able to make both local officials and even hospital administrators comply with a policy that not only lacked legal basis but was also for many years, only vaguely (and inaccurately) alluded to as "an ordinance."

Even medical practitioners in the city-funded hospitals who were well aware of the legality of modern contraceptives and family planning methods such as surgical sterilization disclosed that it eventually became impossible to conduct these procedures when the hospital administration gave them warnings direct from the Mayor's office.

In the end, more than a written legal policy, the Mayor's main strategy to gain compliance was clearly also connected with his administrative power of control over the budgets of both barangay units and hospitals. Advocates responded by keeping the issue on the agenda, at times also gaining the ire of the Mayor who at one point announced a crackdown on "abortion clinics," all the while referring to family planning clinics giving out contraceptives. Keeping the pressure on in media, advocates were also featured on an on-line publication called "Medical Observer," where women's rights advocates working in health care and providing services in Manila, continued to criticize the baseless policy. On this occasion, an over-zealous apologist for the Mayor wrote to the editor of Medical Observer and proclaimed that the Mayor's acts had legal basis, and he cited the "Executive Order" which was issued in 2000. Ironically, the information on the exact number and date of the policy came straight from the Mayor's most ardent supporter. This allowed advocates to finally pinpoint the policy and later access it from the City's records office.

But the even greater irony of course was that in order to even bring the issue to court, a lot depended on more sacrifices on the part of women who themselves were already under the most pressure in Manila: those who were deprived of the services; denied access and experiencing direct discrimination and harm. Once more, theirs was the burden of bringing this issue to light.

The study conducted by the Center for Reproductive Rights and its local women's NGO partners last year entitled "Imposing Misery," already confirmed that indeed, there were many women who already experienced and were continuing to experience the harm because of the Mayor's policy. From being forced to make hard choices about risking pregnancy and allocating the meagre family budget to feed the family right down to the pressure of risking clandestine abortion, the report outlines the havoc the policy has wreaked upon the lives of Manila's poorest women. In the study, doctors from the city funded hospitals also noted the ever rising numbers of post abortion emergency cases that the hospital has had to deal with, making a direct link between the rise in abortions and the Manila policy.

Yet women also suffered the indignity of being paraded by the Mayor in his pro-life politics. At times they were given cash incentives and rewards that clearly augmented their family needs, but were also given publicly during the Mayor's sorties, as "a reward for having many children." These poor women were the convenient "campaign fodder," for the Mayor who was obviously only interested in projecting a popular public image of support for his position. The women who accepted the Mayor's "gifts" actually had little choice. In many ways, these cash rewards were barely even enough compensation for what the Mayor was already putting them through by his denial of basic health care and family planning.

Framing the legal issue as one of women's rights to reproductive health and family planning, Counsel for the Petitioners, Atty. Elizabeth Pangalangan (who is also a Professor of Law at the University of the Philippines) notes that the policy not only contravenes local laws like the Constitution and the Local Government Code but also international human rights standards.

Yet even as these claims are finally getting litigated in court, another challenge that advocates confront is the ensuing clash of positions which because of the Mayor's pro-life politics, has always tended to be framed as an issue about his "religious beliefs."

The policy itself very much reflects the Mayor's imposition of his "traditional Catholic views," which on the other hand, is hardly the only Catholic view on the matter. In fact, alternative and differing positions within the Catholic Church are well known elsewhere around the world not only around contraception but also HIV AIDS and abortion.

Womenlead Foundation, Inc. Executive Director, Atty. Claire Luczon notes: "Neither constitutional law, international law nor Catholic teaching on conscience supports any form of state imposition of religious beliefs, in this case, banning a legally mandated component of basic health and family planning at the local government level."

Arguably, there is hardly anything religious let alone moral in restricting women's access to health care and endangering their lives. In an opinion piece, Dr. Sylvia Estrada Claudio a Fellow of the Action for Economic Reforms underscores the importance of the case filed by the women of Manila:

"Within the context of this discrimination against them, the high point of the narrative lies in the women petitioners' nobility. Most of the petitioners cannot regain what they have lost. When asked, many of them say they are doing it for the sake of all women who still need and seek the means to decide over the size of their families. They remain fearful of reprisals even if a new mayor now sits in City Hall. Politicians of Atienza's mold strike fear into the hearts of those who disagree with them. That fear, no matter what his allies say, is not one that comes from Atienza's moral rectitude or his closeness to an avenging god."