Because Filipino Congressional elections were held in May last year, reproductive health advocates faced tougher-than-usual challenges in 2007. Filipino politicians more interested in re-election began posturing for the upcoming elections early in the year, losing interest in the passage of urgent legislation. For the embattled President Gloria Macapagal Arroyo, who faced impeachment charges before the 13^th Congress, ensuring her allies' political dominance in the 14^th Congress was no less than a bid for political survival. And although controversial largely because of the Catholic hierarchy's sentiments against it, the Reproductive Health Bill never really lacked champions in Congress, a number of them even from the President's party. On the other hand, President Gloria Macapagal Arroyo was always the bill's most consistent opposition in government. Under her influence, even the Department of Health began a focus on "Natural Family Planning" (NFP), to the detriment of its more comprehensive reproductive health and family planning programs of previous years, under different administrations. Even past budgets for family planning and reproductive health successfully passed in the previous Congress ended up unspent in 2007, blocked through bureaucratic impositions by the President.

Among these many challenges, I discuss three key themes, the politics of reproductive health policy making and spending, media's coverage of RH and finally local initiatives in RH advocacy. In the last part of this three-part roundup, I also discuss the RH movement's most urgent challenges in 2008, also incorporating the views of experts and advocates in the field. I especially focus on RH in the context of the overall status of health policy and what remains of the threatened local public health system.

Reproductive Health's Strange Bedfellows

Bills on reproductive health which faced an uphill battle ever since they were filed in the 12^th Congress (2001-2004) had only till then reached the Committee level. By 2006, a version of the Bill sponsored by Rep. Edcel Lagman, came even closer to being passed before the House of Representatives in the 13^th Congress, and was inches away from floor deliberations that could have ensured its adoption in Congress and eventual transmittal to the Senate for approval. By end of 2006 however, it seemed, all bets were off all over again.

While advocates faced the challenge of elections head on by helping focus on the issue of health care within political agendas and platforms, when the dust settled, GMA's allies had won a majority of seats in the 14^th Congress. Yet as just like the past Congress, support for and opposition to Reproductive Health measures didn't necessarily fall along party lines. Finding its staunchest support in some of the administration's party members, versions of the Reproductive Health Bill were filed anew before the 14^th Congress that convened in July. By August, the champions found themselves under attack again by the Catholic hierarchy's lobby.

Representative Janette Garin, who hails from Iloilo (a province where the Catholic hierarchy remains powerful) attempted to assuage RH's staunchest Catholic critics by proposing a bill that only focused on "information dissemination" about family planning methods. Yet in response, legislators on the side of the Catholic hierarchy led opposition to RH suggested that the measure should first be taken up and discussed with the Catholic Church since the President listens to the hierarchy. Digging her heels, Garin, who is a Medical Doctor by profession appealed for an informed debate about the issue of Reproductive Health and rejected the suggestion, pointing out that the legislative branch and executive were separate co-equal branches and that Congress in its law making mandate need not seek the approval of the President.

She could have (and should have) also noted that consulting the Catholic hierarchy and seeking its approval would also have smacked of violations of no less than the Constitutional principles of non-establishment and the separation of church and state. The fact that majority of institutional religions like the Iglesia ni Kristo (Church of Christ), the United Church of Christ of the Philippines (UCCP ) and even Muslim clerics who issued a fatwah (official ruling) in support of RH shows the extent of the influence of the Catholic hierarchy, that is mostly over Filipino politicians. Majority of Filipino Catholics have always professed to favour modern family planning methods, leaving these matters according to their own exercise of conscience, rather than the dictates of the Catholic hierarchy.

Yet another champion of RH from the ranks of the administration's party, Rep. Edsel Lagman decided to up the ante in the RH debate. Instead of trying to appease naysayers of RH by avoiding the terminology of Reproductive Health, he made a bold decision after consulting with advocates to place it front and center in the earliest version of the bill filed in the 14^th Congress. (In previous blogs I have noted how even Lagman's earlier bill's was one of many versions which "avoided" reproductive health by burying the term within the bill and adopting "less suspect" titles.)

Lagman's move was a welcome change and one that signaled the comeback of reproductive health's legitimacy. For many years since Arroyo became President, "RH" was labeled and singularly equated with abortion by its critics. This made it difficult if not nearly impossible to discuss reproductive health and even abortion intelligently and compassionately (even as its legalization was never a part of the legislative measure).

Death by Red Tape and "The Catholic hierarchy's watch dogs"

Soon after the 14^th Congress convened, Rep. Lagman began inquiring about the budget and line items for family planning and reproductive health services for the Department of Health (DOH), and whether these funds were ever utilized.

He soon discovered that while the President didn't veto the line items per se, she made the release of funds conditional on the creation of guidelines, and Memorandum of Agreements executed between the DOH and the local government units for which the funds were intended. In August, the Philippine Center for Investigative Journalism disclosed while some of the conditions depended on the capacity of LGUs to provide free assistance for poor clients, one particular condition being imposed is that "clusters of LGUs can only be awarded funds based on their ability to meet the minimum standards on local availability and access to natural family planning."

While initially unfolding as a "tug-of-war" between the two branches of government, in the end, the Executive's stubbornness prevailed with the DOH Secretary insisting that spending for contraceptives is not in accordance with the GMA administration's policy whose aim is only to strengthen "Natural Family Planning."

In fact, as early as 2004, the DOH even awarded 50 million pesos to a Catholic organization, the Couples for Christ (CFC) to conduct the NFP program. And while advocates have come out in criticism against this move, it only got as far as becoming the subject of a Resolution filed by no less than opposition Senator Luisa Ejercito (wife of the former President Joseph Estrada), calling for an investigation into the highly "suspect" government award which did not go through bidding.

By September last year however, news about a fall out and a split within the ranks of the Couples for Christ reached the media. Tony Meloto, the leader and founder of a key project of the CFC called "Gawad Kalinga," a housing project which had till then garnered accolades and often compared in its success to the Grameen bank, was under attack by the more conservative wing of the CFC represented by Frank Padilla.

It seemed that while neither faction differed in their views about family planning and echoed the Catholic stance against modern methods, Padilla thought Meloto and his camp were being too inclusive in running the housing project which benefited not only Catholics who differed in their views about family planning, but also other communities like impoverished Muslim communities.

Yet rather than a minor skirmish, the power struggle within CFC also reflected the rise of the departing faction into "official" power within government. Many of them have secured key posts.

Frank Padilla's wife holds appointments to both the Population Commission currently under the Department of Health and the National Commission on the Role of Filipino Women (NCRFW). Both positions place her well within policy making, among others, in matters of women's sexual and reproductive health.

According to PCIJ, another Presidential appointee in the POPCOM, Jose Sandejas is a close adviser of the Archbishop of Pampanga, Paciano Aniceto, and has been a trustee of Pro-Life Philippines since 1987.

PCIJ's Jaileen Jimeno aptly noted, "Arroyo's political accommodations in favor of the Catholic Church are also clear and out in the open, leaving even career government officials in fear of losing their jobs should they go against the anti-contraceptives policy."

Unfortunately, despite the bravado of legislators and RH champions among law makers, GMA has proven more the more brazen. Apart from frustrating the realization of reproductive health care through the politics of red tape, by handing out key posts to persons closest to the Catholic hierarchy, she succeeded in sending a clear message to everyone else under these key agencies. As things stand, the Catholic hierarchy literally has all the agencies strategic to any state led reproductive health program by a chokehold.

By November 2007, Rep. Lagman and his allies in Congress were again being lauded for the increased budgetary allocation for health for 2008. This early we can already predict tirades anew back and forth between the two branches and notably even within the President's own political party. But last time I looked there are actually three branches, lest we forget the recently applauded independent "pro human rights," judiciary. Indeed, given how the GMA administration has consistently quashed the reproductive health allocation in the past, the question that begs asking really is what are advocates willing to do this time around?