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Fighting HIV/AIDS in Asia and the Pacific: Strengthening Philippines Response to HIV/AIDS among High-Risk Groups (RETA 6321)

Opening Statement by
Tom Crouch
Country Director, Philippines Country Office
Asian Development Bank

At the Inception Workshop

2 July 2007
Astoria Plaza, Ortigas Centre, Pasig City

A very warm welcome to all participants¹ to the first of a series of participatory stakeholder workshops. In particular, I acknowledge Undersecretary Ethelyn Nieto, Department of Health, our keynote speaker; and Ms Elvira Ablaza, President and CEO, PRIMEX, our consultants. This inception workshop follows soon after the consultant's inception report, and officially launches the project and secures participation of the wide group of stakeholders.

I will spend a few moments contextualizing the workshop, which focuses on the Philippines response to HIV/AIDS among high risk groups. It is useful to consider how this workshop locates itself within three areas of increasing specificity: first, global trends; second, regional transformation; and third, national dimensions.

On the global front, we live in an increasingly interdependent world, in which things like money, goods and services, and people move with ever-greater fluency and frequency across artificial national borders. In the Philippines, this is nowhere more dramatically evident than with the huge number of overseas Filipino workers (OFWs). More than 8 million Filipinos – about 10% of the population – live overseas; and an estimated 40% of these are OFWs. Last year, remittances from overseas Filipinos were about $13 billion, almost 12% of GDP. This is one dozen times the amount of foreign direct investment (FDI) and a similar multiple amount of the disbursement of official development assistance (ODA) from multilateral agencies like ADB and bilateral partners. The remittances are an extremely potent economic force. But they come with some downsides – social dislocation is one; another is that the highly mobile workforce, which provides a route out of poverty for many families, is also a transmission route for diseases. This has implications for health care at the national level, and also for the sustainability of income flows for individual families.

On the regional front, east Asia, of which the Philippines is part, is the world's most dynamic region economically. Although there is variation in the performance of the economies that make up east Asia, as a whole it is expected to continue to be an engine for global economic growth. Just as the significance of some dimensions of national boundaries is diminishing globally, so it is regionally. The Philippines stands to gain tremendously from this. However, it must not lose sight of the associated vulnerabilities. Philippines growth lags behind many of its ASEAN neighbours, and a large number of Filipinos remain economically and socially marginalized. This can contribute to dangerous intravenous drug use, which is a major cause of AIDS.

The Philippines is a signatory to a number of global and regional initiatives to foster higher, sustainable growth, and to reduce poverty more quickly. These include things like the Millennium Development Goals (MDGs), with a target date of 2015; and economic and trade arrangements, such as those of ASEAN. This brings us to the third dimension: on the national front, it is important that the Philippines customizes global and regional paradigms for its own country circumstances and country systems. For example, in the Philippines we must take into account the decentralized nature of service delivery for health (a devolved responsibility under the Local Government Code, 1991), and the central role of local governments. To ensure efforts gain real traction, we must customize global and regional aspirations and visions of things like achieving the Millennium Development Goals (MDG 6, target 7 – HIV/AIDS) for Philippine circumstances – or else they will remain as aspirations and visions, without results.

We must crowd in everyone: government, civil society, business, academe, development partners, the media. In short, every Filipino. We must ensure the program has buy-in from all stakeholders through understanding of the issues, acknowledgement of domestic concerns, and respect for local values and ways of "doing business". For example, the Philippines has, in fact, emerged as a leader in customizing for its own circumstances the Paris Declaration on Aid Effectiveness (March 2005), which rests on five pillars: country ownership, alignment of development partners with country priorities, harmonization of development partner policies and practices to reduce transaction costs for the country, adopting a results oriented approach for resource use, and joint accountability of all stakeholders for results. For the MDGs, Congress has a framework for mainstreaming the country's commitments, including establishing a special committee to oversee resources allocated for MDG initiatives.

Addressing issues of HIV/AIDS is a daunting and urgent challenge. It must be undertaken systematically. It is worthwhile remembering that as the Philippines has a population of about 84 million,

• any success we have needs to be divided by 84 million – let modesty prevail, avoid unnecessary hubris, never become complacent;
• any mistake gets multiplied by 84 million – small errors quickly transform to large problems.

Applying this to the Philippines and the challenge of HIV/AIDS means, for example, that each of the 84 million Filipinos is made aware of the problem and what needs to be done to stop it becoming larger. Each Filipino is a stakeholder, and everyone must be involved. In that way, all 84 million will benefit (we multiply a success by 84 million).

ADB's Strategic Response to a Growing Epidemic (April 2005) guides our overall HIV/AIDS engagement with developing member countries. Recognizing the links between development, poverty and HIV/AIDS, the purpose of ADB's support is to have an effective response to HIV/AIDS in place at the country and regional level in Asia and the Pacific.

ADB's Cooperation Fund for Fighting HIV/AIDS in Asia and Pacific was established in February 2005 with an initial contribution of $13 million from the Government of Sweden. The fund focuses on three areas of support:

• Knowledge-based activities, to support a cost-effective and evidence-based approach to the AIDS epidemics in Asia and Pacific;
• Operational support, to ensure that HIV/AIDS concerns are adequately addressed in ADB core business activities (physical infrastructure, energy, and education); and
• Capacity Development, to increase capacity at country and regional levels to address HIV/AIDS

The project that we are officially launching today falls within the area of knowledge-based activities and capacity development.

The Fund is financing an $8.6 million Regional Technical Assistance (RETA) approved in May 2006. The RETA comprises 11 subprojects, one of which is the Philippine Sub-Project on Strengthening Country Response to HIV/AIDS Among High Risk Groups. Another sub-project, which is for supporting NGO initiatives, also covers the Philippines through a modest grant award to a well-established Philippine NGO. Strong synergy can be established between these two ADB-supported projects as they have a common objective as well as share a common target.

The amount of the Project we are launching today may be small compared to other social sector or health projects, but it's impacts and outcomes are by no means small. This is a well-targeted project that seeks to weaken the intravenous drug use engine that drives the Asian HIV epidemic. This is also a project that seeks to the pave the way for a more strategic and effective preventive response to the threat of HIV to the very engine that fuels the Philippine economy - the OFWs - who are also among the most vulnerable groups.

ADB is grateful that you have chosen us to partner with you in this important endeavour. We accept our part in this shared responsibility, and will work with you to be jointly accountable for the results.

Maraming salamat po.

¹Government agencies: Department of Health (including Undersecretary Ethelyn Nieto) and its attached agencies; Department of Foreign Affairs; Department of Interior and Local Government; Department of Labor and Employment; Philippine National Aids Council; Overseas Workers Welfare Administration; Philippines Overseas Employment Administration; Maritime Industry Authority; Foreign Service Institute; Philippine Dangerous Drug Enforcement Agency; Dangerous Drug Board; Local governments: Local AIDS Councils and Social Hygiene Clinics of Cebu, Zamboanga, and General Santos; Development partners: UN Agencies (UNAIDS, WHO, IOM); NGOs: Philippine NGO Council on Population, Health & Welfare; Tropical Disease Foundation Global Fund; PATH Foundation Philippines; Human Development and Employment Services; Family Health International; Pinoy Plus Association; Positive Action Foundation Philippines; BABAE+; University of Southern Philippines Foundation; Social Health Environment and Development Inc; Consultants: PRIMEX CEO Elvira Ablaza, and team leader Vincente Salas.