Reproductive Health Bill (Philippines)

Birth control pill: The Reproductive Health Bill provides for universal distribution of contraceptives and other family planning
methods, and its enforcement

Reproductive Health Bill (Philippines), or commonly known as the RH Bill, is one of the most contentious
issues in the country, being a bill espoused by Congressman Edcel Lagman which proposes to guarantee
universal access to reproductive health care services, supplies and information. There are several bills that
spouse the same goals, but they are all referred to in the country as the RH Bill as they have the common
purpose of promoting reproductive health, responsible parenthood and informed choice in conformity with
internationally recognized human rights standards.

There is general agreement in the country on the importance of its provisions on maternal and child health,
promotion of breastfeeding, adolescent and youth health, elimination of violence against women, and setting up
of obstetrics and birthing services.

The contentious aspect of the bill which has spawned a national debate is its key proposal that the government
funds and undertakes widespread distribution of family planning devices such as contraceptives and IUDs,
dissemination of information on their use, and enforcement of their provision in all health care centers and
private companies, as a way of controlling the population of the Philippines.[1] The bill is based on the premise
that present population growth impedes economic development and exacerbates poverty.[2][3]

Opposition to the bill is based on several views of the bill: (1) The latest studies in scientific journals and
organizations show that the birth control pill,[4] theIUD,[5] and RU-486 kill the young human embryos, who as
such are persons worthy of respect,[6] and that the pill is carcinogenic,[7][8] and confers other serious health risks,
[9][10]
while there are many high priority medical needs among women in the Philippines that its limited budget
should fund,[11][12][13] (2) Secular studies show that contraception is an intrinsic moral evil, and has deleterious
social effects (abortion, female empoverishment, illegitimate children, spread of AIDS, etc);[14][15][16] and "It is
never lawful, even for the gravest reasons, to do evil that good may come of it,"[17] (3) the people's access to
contraceptives is not restricted by any opposing law, being available in stores, and the country is not a welfare
state: taxpayer's money should not be used for personal practices that are considered harmful and immoral, (4)
it promotes sex education of the youth which promoters themselves have considered as having brought about
more illegitimacy and teenage pregnancies,[18] (5) the bill is based on a wrong premise since there is no
consensus among economists that rapid population growth constrains economic development, and Noble-prize
winning economists say that there is no correlation between the two,[19][20] (6) one survey showed that 92%
rejected the bill when they are informed of its detailed provisions and its penalties,[21] (7) the penal provisions
constitute a violation of free choice and conscience, and establishes religious persecution.[22]

Proponents argue that (1) Economic studies show that rapid population growth and high fertility rates,
especially among the poor, exacerbate poverty and make it harder for the government to address it,[3] (2)
Empirical studies show that poverty incidence is higher among big families, and that the lack of services and
information regarding reproductive health results in the untimely death of women and children,[3][23] and smaller
families and wider birth intervals allow families to invest more in each child’s education, health, nutrition and
eventually reduce poverty and hunger at the household level,[1][3][24] (3) 11 women dying daily while giving birth
are preventable deaths if they have access to reproductive health information and healthcare,[23] (4) studies
show that 44% of the pregnancies in the poorest quintile are unwanted, and among the poorest women who
would like to avoid pregnancy, at least 41% do not use any contraceptive method because of lack of
information or access,[3][23][24] (5) use of contraception, which the World Health Organization has listed
as essential medicines,[25][26] will lower the rate of abortions as it has done in other parts of the world,[2] (6)
Several surveys have shown that a majority of Filipinos favor passage of a reproductive health bill; an SWS
survey of 2008 showed that 71% of the Filipinos are in favor of the bill,[27] (7) at the heart of the bill is the free
choice given to people on the use of reproductive health, enabling the people, especially the poor to have the
number the children they want and can care for.

[edit]Background

[edit]Stated purpose
One of the main concerns of the bill, according to the Explanatory Note, is that population of the Philippines
makes it “the 12th most populous nation in the world today”, that the Filipino women’s fertility rate is “at the
upper bracket of 206 countries.” It states that studies and surveys “show that the Filipinos are responsive to
having smaller-sized families through free choice of family planning methods.” It also refers to studies which
“show that rapid population growth exacerbates poverty while poverty spawns rapid population growth.” And so
it aims for improved quality of life through a “consistent and coherent national population policy.”

[edit]History

According to the Senate Policy Brief entitled Promoting Reproductive Health, the history of reproductive health
dates back to 1967 when the Philippines signed the United Nations Declaration on Population by which
countries agreed that the population problem be considered as the principal element for long-term economic
development. Thus, the Population Commission (Popcom) was created to push for a lower family size norm
and provide information and services to lower fertility rates.[1]

One of the roots of population control programs is the National Security Study Memorandum 200: Implications
of Worldwide Population Growth for U.S. Security and Overseas Interests (NSSM200)which was completed
under the direction of Henry Kissinger, and adopted as official U.S. policy by President Gerald Ford in
November 1975. The policy advocates population control measures and the promotion of contraception among
13 populous countries, including the Philippines, to control rapid population growth which they deem to be
inimical to the socio-political and economic growth of these countries and to the national interests of the United
States, since the "U.S. economy will require large and increasing amounts of minerals from abroad"(Chapter
III).[13] It states the need for the US to work with UN agencies and with these governments to achieve zero
population growth in these countries in view of the national security and economic interest of the US.

In 2003, USAID started phasing out US$3M annual grant for contraceptives.

Starting 1967, the USAID started shouldering 80% of the total family planning commodities (contraceptives) of
the country, which amounted to US$ 3 Million annually.[1]

Different presidents had different points of emphasis. The Cory Aquino administration focused on giving
couples the right to have the number of children they prefer, while the Ramos presidency shifted from
population control to population management. Estrada used mixed methods of reducing fertility rates, while
Arroyo focused on mainstreaming natural family planning, while stating that contraceptives are openly sold in
the country.[1]

In 1989, the Philippine Legislators’ Committee on Population and Development (PLCPD)was established,
"dedicated to the formulation of viable public policies requiring legislation on population management and
socio-economic development."

In 2000, the Philippines signed the Millennium Declaration and committed to attain the MDG goals by 2015,
including promoting gender equality and health.

In 2003, USAID started its phase out of a 33 year old program by which the free contraceptives where given to
the country. Aid recipients such as the Philippines faced the challenge to fund its own contraception program.[1]

In 2004, the Department of Health introduced the Philippines Contraceptive Self-Reliance Strategy, arranging
for the replacement of these donations with domestically provided contraception.[1]

In August 2010, the government announced a collaborative work with the USAID in implementing a
comprehensive marketing and communications strategy in favor of family planning called "May Plano Ako."
[edit]Key definitions

The bill defines Reproductive Health as "the state of physical, mental and social well-being and not merely the
absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and
processes. This implies that people are able to have a satisfying and safe sex life, that they have the capability
to reproduce and the freedom to decide if, when and how often to do so, provided that these are not against
the law. This further implies that women and men are afforded equal status in matters related to sexual
relations and reproduction."

Reproductive Health Rights are defined as "the rights of individuals and couples do decide freely and
responsibly the number, spacing and timing of their children; to make other decisions concerning reproduction
free of discrimination, coercion and violence; to have the information and means to carry out their decisions;
and to attain the highest standard of sexual and reproductive health."

The definition of reproductive health is taken from the World Health Organization. While the RH bill proponents
clearly state that the bill proposes the prevention of abortion and that abortion remains a crime, the definition
used by the bill is under intense scrutiny because the United States Secretary of State, Hillary Clinton, has
stated that "reproductive health includes contraception and family planning and access to legal, safe
abortion."[28] Opposition say that by supporting such definitions, the country will guarantee this same right of
having "a satisfying and safe sex life" and the freedom of decision to unmarried children and teenagers, since
they are "people" and "individuals." They argue that this will lead to promiscuity among the young.[29] They say
that the terminology is part of deceptive "verbal engineering" since RH is not in favor of reproduction and
childbearing, and contraceptives are not healthy, but RH is presented as something good.

[edit]Provisions and sections

The basic content of the Reproductive Health Bill contains the following, assigned as sections in the bill.

 Midwives for Skilled Attendance - minimum ratio of 1 for every 150 deliveries

 Emergency Obstetric Care - one hospital per 500,000

 Maternal Death Review

 Hospital-Based Family Planning - availability of tubal ligation, vasectomy,

intrauterine device insertion and other methods

 Contraceptives as Essential Medicines - Hormonal contraceptives and IUDs

 Mobile Health Care

 Mandatory Age-Appropriate Reproductive Health Education

 Additional Duty of Family Planning 0ffice

  Certificate of Compliance

 Capability Building of Community-Based Volunteer Workers

 Ideal Family Size - two children are encouraged

 Employers’ Responsibilities

 Support of Private and Non-government Health Care Service Providers

 Multi-Media Campaign

 Reporting Requirements

 Prohibited Acts

 Penalties
[edit]Economic and demographic premises

Lagman states that the bill "recognizes the verifiable link between a huge population and poverty. Unbridled
population growth stunts socioeconomic development and aggravates poverty."[2] The University of the
Philippines' School of Economics have presented two papers in support of the bill: Population and Poverty: the
Real Score (2004), and Population, Poverty, Politics and the Reproductive Health Bill (2008). According to
these economists, which includeSolita Monsod, Gerardo Sicat, Cayetano Paderanga, "rapid population growth
and high fertility rates, especially among the poor, do exacerbate poverty and make it harder for the
government to address it," while at the same time clarifying that it would be "extreme" to view "population
growth as the principal cause of poverty that would justify the government resorting to draconian and coercive
measures to deal with the problem (e.g., denial of basic services and subsidies to families with more than two
children)." They illustrate the connection between rapid population growth and poverty by comparing the
economic growth and population growth rates of Thailand, Indonesia, and the Philippines, wherein the first two
grew more rapidly than the Philippines due to lower population growth rates.[3] In 2008, they stressed that "the
experience from across Asia indicates that a population policy cum government-funded [family planning]
program has been a critical complement to sound economic policy and poverty reduction."[24]

In Population and Poverty, Aniceto Orbeta, Jr, showed that poverty incidence is higher among big families:
57.3% of Filipino families with seven children are in poverty while only 23.8% of families having two children
live below the poverty threshold.[30]

Percentage of population living below poverty line (2003). Darker areas mean more poverty.
In A National Perfdidy, opponents such as Dr. Bernardo Villegas and Roberto de Vera, economists of
the University of Asia and the Pacific refer to Nobel prize winner Simon Kuznets's study which says that “no
clear association appears to exist in the present sample of countries, or is likely to exist in other developed
countries, between rates of growth of population and of product per capita." Julian Simon compared parallel
countries such as North and South Korea, East and West Germany whose birthrates were practically the same
but whose economic growth was entirely different due to different governance factors. De Vera says that
"similar conclusions have been arrived at by the US National Research Council in 1986 and in the UN
Population Fund (UNFPA) Consultative Meeting of Economists in 1992" and the studies of Hanushek and
Wommann (2007), Doppelhoffer, Miller, Sala-I-Martin (2004), Ahlburg (1996), etc.[19][20]

Villegas and de Vera also state that in the Philippine experience, poverty incidence actually went down as
population got larger. From 1961-2000, population increased almost threefold, from 27 million to 76 million,
while population incidence decreased from 59% to 34% of all families in the country.[31] They stressed that
larger family size is not the cause of poverty, since the more probable cause of poor families is the limited
schooling of the household head: 78% to 90% of the poor households in each family size had heads with no
high school diploma, which prevents them from getting good paying jobs.[19][20]"Substantial evidence shows that
many families in LDCs (especially the poor) consciously prefer to have numerous children for a variety of
economic and social reasons," stated Kissinger's NSSM 200.

Instead of aiming at population decrease, they stressed that the country should focus on cashing in on a
possible “demographic dividend,” a period of rapid economic growth that can happen when the labor force is
growing faster than the dependents (children and elderly), thus reducing poverty significantly. The focus should
be giving the workforce training and education that will allow them to get well-paying jobs. Since poverty is
usually caused by poor governance and inappropriate policies which lead to corruption, poor tax collection, lack
of education, etc., then the government should apply the management principle of focus, or first things first, and
work on these items.[19][20]

On the other hand, proponents argue that smaller families and wider birth intervals resulting from the use of
contraceptives allow families to invest more in each child’s education, health, nutrition and eventually reduce
poverty and hunger at the household level.[24] At the national level, fertility reduction cuts the cost of social
services with fewer people attending school or seeking medical care and as demand eases for housing,
transportation, jobs, water, food and other natural resources.[1][3][23] The Asian Development Bank in 2004 also
listed a large population as one of the major causes of poverty in the country.

The Philippines's population growth rate is at 2.04 (2007 Census) or 1.957% (2010 est. by CIA World Fact
Book).

[edit]Maternal health and deaths

Birthing services are key to solving maternal deaths

The proponents state that RH will mean: (1) Information and access to natural and modern family planning (2)
Maternal, infant and child health and nutrition (3) Promotion of breast feeding (4) Prevention of abortion and
management of post-abortion complications (5) Adolescent and youth health (6) Prevention and management
of reproductive tract infections, HIV/AIDS and STDs (7) Elimination of violence against women (8) Counseling
on sexuality and sexual and reproductive health (9) Treatment of breast and reproductive tract cancers (10)
Male involvement and participation in RH; (11) Prevention and treatment of infertility and (12) RH education for
the youth.

There is general agreement on the health provisions of the RH bill, except for the provisions on contraception
and family planning devices that have moral and health implications.

The Department of Health states that family planning can reduce maternal mortality by about 32 percent.[25] The
bill is "meant to prevent maternal deaths related to pregnancy and childbirth," said Clara Padilla of Engender
Rights. She reported that "Daily, there are 11 women dying while giving birth in the Philippines. These
preventable deaths could have been avoided if more Filipino women have access to reproductive health
information and healthcare."

Regarding these figures, Francisco Tatad of the International Right to Life Federation and former Senator said
that "If correct, experience has shown (as in Gattaran, Cagayan and Sorsogon, Sorsogon) that the incidence of
maternal death arising from such complications could be fully mitigated and brought down to zero simply by
providing adequate basic and emergency obstetrics care and skilled medical personnel and services," without
any need for a law on the distribution of contraceptives.[13] They key to solving maternal deaths, according to
theSenate Policy Brief on reproductive health, is the establishment of birthing centers.[1]

[edit]Family planning
[edit]Unmet need
Majority of Filipinos are in favor of family planning. The Catholic Church teaches the necessity of responsible
parenthood and correct family planning, while at the same time teaching that large families are a sign of God's
blessings. It teaches that modern natural family planning is in accord with God's design. The RH bill intends to
help couples to have government funded access to artificial contraception methods as well. Using data from the
2008 National Demographic and Health Survey, Lagman stated that "Twenty-two percent of married Filipino
women have an unmet need for family planning services, an increase by more than one-third since the 2003
NDHS." "Our women are having more children than they desire, as seen in the gap between desired fertility
(2.5 children) and actual fertility (3.5 children), implying a significant unmet need for reproductive health
services," state some Ateneo professors. The Bill provides that "The State shall assist couples, parents and
individuals to achieve their desired family size within the context of responsible parenthood for sustainable
development and encourage them to have two children as the ideal family size."[23][24]

Basing itself on demographic surveys, Likhaan stated that the most common reasons why women with unmet
need in the Philippines do not practice contraception are health concerns about contraceptive methods,
including a fear of side effects. 44% reported these reasons in 2008. The second largest category of reasons is
that many believe they are unlikely to become pregnant—41% in 2008. Their specific reasons include having
sex infrequently, experiencing lactational amenorrhea (temporary infertility while nursing) and being less fecund
than normal.[32]

Opposing the bill, Dr. Bernardo Villegas wrote about the Myth of Unmet Family Planning Needs, citing
development economist Lant Pritchett who said that the term "unmet need" is an elitist construct, an imposition
of a need on the poor, disrespectful of their real preferences. Pritchett said that it is "based on a
discrepancy...identified by the analyst through the comparison of responses to items in separate blocks of the
questionnaire" and is "an inference on the part of the researcher, not a condition reported by the respondents
themselves." Villegas argued that "Because [the poor] have been deprived of the infrastructures they need,
such as farm-to-market roads, irrigation systems, post-harvest facilities and other support services that the
State neglected to provide them, the only economic resources they have are their children. Common sense
would tell me that mothers in these households would not express a desire for only two or three children, as
implied by the 2008 Demographic and Health Survey. The fact that they actually have 4 or 5 children jibes with
economic reality."[33]

Intrauterine device (IUD)

[edit]Access

One of the main concerns of the proponents is the perceived lack of access to family planning devices such as
contraceptives and sterilization. The bill intends to provide universal access through government funding,
complementing thus private sector initiatives for family planning services, such as those offered by
the International Planned Parenthood Federation (IPPF) which supports the Family Planning Organizations of
the Philippines and the 97 organizations of the Philippine NGO Council.

The opposition argues that "Access to contraceptives is free and unrestricted" and that the proposed law is
pushing an open door.[13] They say that these family planning items are available to the citizens and many local
government units and NGOs provide these for free. Congressman Teddyboy Locsin argued, echoed by
a Business Mirror editorial, that the poor can afford condoms since they can pay for other items such as
cellphone load. Opponents also argue that Philippine government is not a welfare state, and taxpayers are not
bound to provide for all the wants and desires of its citizenry, including their vanity needs, promiscuous actions
and needs artificially created by elitist, imperialist and eugenicist forces; nor should taxpayers pay for drugs that
are dangerous (carcinogenic) and that are deemed immoral by a large part of the citizenry. They argue that the
Philippines should give priority to providing access to medicines that treat real diseases.[11][13]

The UP School of Economics argues that there is lack of access especially for poor people, because
contraceptive use is extremely low among them and "Among the poorest families, 22% of married women of
reproductive age express a desire to avoid pregnancies but are still not using any family planning
method."[24] They say that lack of access leads to a number of serious problems which demand attention: (1)
"too many and too closely-spaced children raises the risk of illness and premature deaths (for mother and child
alike)," (2) "the health risks associated with mistimed and unwanted pregnancies are higher for adolescent
mothers, as they are more likely to have complications during labor," (3) women who have mistimed
pregnancies are "constrained to rely more on public education and health services and other publicly provided
goods and services," further complicating limited public resources, (4) families are not able to achieve their
desired family size. Thus the UP economists "strongly and unequivocally support" the thrust of the bill to enable
"couples and individuals to decide freely and responsibly the number and spacing of their children and to have
the information and means to carry out their decisions.”[24]

[edit]Abortion

One of the bill's components is "prevention of abortion and management of post-abortion complications." It also
states that "abortion remains a crime and is punishable," as the Constitution declares that “the State shall
equally protect the life of the mother and the life of the unborn from conception.”

Still, strong opposition comes from pro-life citizens, who view each human being as sacred, inviolable, and of
inestimable dignity, accusing the bill of promoting family planning methods such as the IUDwhich, according to
the American Journal of Obstetrics and Gynecology (2005), brings about the "destruction of the early
embryo,"[5] thus is deemed to kill five-day old babies.[29] The latest findings (2000) also show that the estrogen-
progestogen pill also works after fertilization, and is abortifacient.[4] Jo Imbong, secretary of the Catholic
Bishops Conference of the Philippines, reported that "Lagman said in a House hearing that the bill would
protect human life 'from implantation,'"[34] and not from fertilization, noting at the same time that the Records of
the Constitutional Commission state that “Human life begins at fertilization.”[35] After referring to standard
textbooks of medicine and human embryology to affirm this as true, the anti-RH bill groups argue that the
human embryo is a distinct human life beginning a new life cycle, with a particular and complete genetic code.
They say that the embryo is an individual, self-coordinated and self-organizing subject belonging to the
species homo sapiens: a human being by nature and thus a person worthy of respect.[6]
8-cell human embryo, 3 days after fertilization

The Southeast Asian Center for Bioethics, Philippine Nurses Association, Catholic Physicians’ Guild of the
Philippines stated that “the antiabortion stance of the bill is contradicted by the promotion of contraceptive
agents (IUD and hormonal contraceptives) which actually act after fertilization and are
potentiallyabortifacient agents.”[36]

Lagman argues that research by the Guttmacher Institute, involved in advancing international reproductive
health, reveals that the use of contraceptives can reduce abortion rates by 85%. The bill, said Clara Padilla of
EnGender Rights Inc, will "help reduce the number of abortions by providing increased access to information
and services on modern contraceptive methods, that in turn will reduce the number of unwanted --and often
aborted-- pregnancies."[37]

Opponents argue that new data thwarts the "myth" that contraception lowers abortions,[38] that the Guttmacher
Institute is the research arm of the pro-abortion IPPF, and that the contraceptive mentality of not wanting
children leads to more abortion when an unwanted human being is conceived.

Both sides of the debate accuse the other side of deception and misleading the public. The anti-RH advocates
accuse the RH supporters of deceiving the public regarding the true meaning of reproductive health, which they
believe includes abortion according to Western and international standards, and that RH includes pills and
devices that are abortifacient. The pro-RH people accuse the anti-RH group of misleading the public by calling
the bill an abortion bill, when in fact the bill states that abortion remains a crime and is punishable.

[edit]Contraceptives

[edit]Morality and social effects

Another central issue is the morality of contraception, especially since Filipinos are generally religious. Around
81% of Filipinos are Catholics, and the Catholic Church teaches that contraception is evil since it desecrates
sex which is intrinsically linked to new human beings, whose lives are sacred, and since it makes spouses lie
about their total self gift to their spouse, by not surrendering their fertility.[39]

However, several professors from Ateneo de Manila University, a prominent Catholic University, considering
the empirical evidence of the dire socio-economic conditions of the Filipino poor, urged that the bill be passed
to help them, and announced that "Catholic social teachings recognize the primacy of the well-formed
conscience over wooden compliance to directives from political and religious authorities," urging Catholic
authorities to withdraw their opposition the bill.[23] Citing Catholic documents and scientific studies, they
reasoned that "the RH Bill is pro-life, pro-women, pro-poor, pro-youth, and pro-informed choice." They
emphasized that the bill "promotes quality of life, by enabling couples, especially the poor, to bring into the
world only the number of children they believe they can care for and nurture to become healthy and productive
members of our society."[23]
The Ateneo administration announced its unity with Catholic teaching and that it had "serious objections to the
present bill."[40] 42 prominent international Catholic scholars, including Janet E. Smith,Peter Kreeft, William E.
May, and Joseph W. Koterski, S.J., responded to the faculty of the Ateneo, saying that “It is never lawful, even
for the gravest reasons, to do evil that good may come of it," that the bill disrespects poor people, and "focuses
primarily on providing services to curb the number of children of the poor, while doing little to remedy their
situation."[17]

Lagman also stressed that official Catholic teaching itself, expressed in the Encyclical Humanae Vitae issued
only forty years ago in 1964, is not infallible.[2] He said that the Papal Commission on Birth Control, which
included ranking prelates and theologians, recommended that the Church change its teaching on contraception
as it concluded that “the regulation of conception appears necessary for many couples who wish to achieve a
responsible, open and reasonable parenthood in today’s circumstances.” The editorial of the Philippine Daily
Inquirer, moreover, stated that Catholic teaching is "only" a religious teaching and should not be imposed with
intolerance on a secular state.

Responding to the Inquirer, opponents of the bill said that it is the "dictatorship of relativism" that is imposing
itself on people, and that Catholic Church doctrine on contraception has been the same since its beginning,
[41]
taught by bishops around the world, thus part of infallible ordinary magisterium.[42] They also referred to 15
non-religious reasons provided by the Ethics Guide of the secular BBCthat shows the intrinsic evil of
contraception, including the loss of potential beneficent human life, causing widespread moral promiscuity,
weakening family life, being unnatural and anti-life.[41] Secular and anti-Catholic social scientists are also
reported to have found empirical evidence linking contraception and a variety of social ills: illegitimacy and
abortion (George Akerlof);[14] heightened spread of AIDS (Edward C. Green);[16] breakdown of families, female
impoverishment, trouble in the relationship between the sexes, and single motherhood (Lionel Tiger).[15]

[edit]Health reasons
In Medical Issues in the Reproductive Health Bill, Dr. Angelita Miguel-Aguirre refers to meta-analyses at
scientific journals that show oral contraceptives (OCs) are unsafe.[11] A meta-analysis of theStroke
Journal concluded that OCs confer "risk of first ischemic stroke."[10] The World Health Organization (WHO)
announced the findings of The International Agency for Research on Cancer (IARC) in 2005 that "there
is sufficient evidence in humans for the carcinogecity of combined estrogen-progestogen contraceptives."[7]
[8]
The Journal of Clinical Endocrinology & Metabolism also concluded in 2005 that "a rigorous meta-analysis of
the literature suggests that current use of low-dose OCs significantly increases the risk of both cardiac and
vascular arterial events."[9] In its list of essential medicines, WHO stated that these drugs "have been
questioned" and "will be reviewed" by its Expert Committee.[26]
World Health Organization: The WHO announced the IARC findings about the carcinogecity of the pill and also included
them in its list of essential medicines

Opponents also say that being pregnant with a child is not a disease but a blessing, and that there are real
diseases among the leading causes of mortality that should take on a higher priority, given the limited budget:
1. Heart diseases, 2. Vascular diseases, 3. Pneumonia, 4. Cancer, 5. Tuberculosis, 6. Diabetes, 7. Lower
chronic respiratory diseases.[12]

E. Ansioco of Democratic Socialist Women of the Philippines argued that "The World Health Organization
(WHO) includes contraceptives in its Model Lists of Essential Drugs" and thus are safe medicines.[25]
[26]
"Medical and scientific evidence," says the main proponent, "shows that all the possible medical risks
connected with contraceptives are infinitely lower than the risks of an actual pregnancy and everyday
activities...The risk of dying within a year of using pills is 1 in 200,000. The risk of dying from a vasectomy is 1
in 1 million and the risk of dying from using an IUD is 1 in 10 million. ... But the risk of dying from a pregnancy is
1 in 10,000."[2]

In Facts on Barriers to Contraceptive Use in the Philippines, Likhaan, a non-government organization for
women's health, made the following projection: "If all women who wanted to avoid pregnancy used modern
methods, there would be 1.6 million fewer pregnancies each year in the Philippines. Unintended births would
drop by 800,000, abortions would decline by 500,000 and miscarriages would decline by 200,000. Expanding
modern contraceptive use to all women at risk for unintended pregnancy would prevent 2,100 maternal deaths
each year. It would also reap savings on medical care for pregnant women and newborns that would more than
offset the additional spending on modern contraception."[32]

[edit]HIV/AIDS prevention
The RH bill provides for "prevention and treatment of HIV/AIDS and other, STIs/STDs," especially since the
number of HIV cases among the young nearly tripled from 41 in 2007 to 110 in 2008.[37]Primary among the
means is distribution of condoms. The proponents applauded government efforts last February 2010 when it
distributed condoms in some areas of Manila.

On the other side of the debate, Dr. Rene Josef Bullecer, Director of AIDS-Free Philippines, said that in 1987,
Thailand had 112 AIDS cases, more or less the same number as the Philippines (135). By the year 2003, there
were around 750,000 cases in Thailand, where there was an intense campaign for the "100% Condom Use
Program", while there were only 1,935 cases in the Philippines, whose population is around 30% greater than
Thailand's.[43][44] Pro-life groups refer to the Director of Harvard's Aid Prevention Center, Edward C. Green, who
said that the "best evidence" agrees with Benedict XVI's statement that condom distribution risked
exacerbating the spread of the virus, because availability of condoms leads to riskier sexual behavior.[16]

[edit]Sex Education
To achieve its goals, the bill provides for mandatory reproductive health education and that it be taught in "an
age-appropriate manner... by adequately trained teachers starting from Grade 5 up to Fourth Year High
School." Opposition to the bill was concerned about early sexualization of the youth and say that sex education
promoters themselves state that it has led to more teenage pregnancies and illegitimacy.[18] They stressed that
what is needed is chastity education rather than sex education. Proponents refer to the latest UNESCO study
dated December 2009 which concluded that sexuality education did not encourage early initiation into sex.[45]

[edit]Opinion Surveys

Proponents refer to surveys conducted which show majority support for the bill. A survey conducted in 2008 by
the prestigious Social Weather Stations, commissioned by the Forum for Family Planning and Development
(FFPD), a non-government advocacy group, showed that 68 percent of Filipinos agree that there should be a
law requiring government to distribute legal contraceptives.[46] As to the RH Bill, SWS President Mahar
Mangahas reported that "The survey found 71 percent in favor, 21 percent undecided, and a mere 8 percent
opposed. Among those who originally knew of the bill, the score is 84 percent in favor, and 6 percent opposed.
Among those who learned of the bill for the first time because of the survey, the score is 59 percent in favor,
versus 11 percent opposed.[27][46]

President of Prolife Philippines, Lito Atienza, said that these surveys were misleading, and referred to a survey
of December 2009 which stated that 92% of people in Manila rejected the bill when informed of its provisions,
including its penalties, something that previous surveys failed to do, he said.[21] While Mangahas acknowledged
that the SWS surveys did not include the penal aspects, advocates of the bill point out, however, that the
December 2009 survey used leading questions, and therefore is not an objective survey.

[edit]Penalties

One of the strongest criticism against the bill, even from its supporters, centers on the penal provisions, which
have been called "coercive," and a violation of free choice and conscience. There is "mandatory" sex education
starting grade 5, and malicious "disinformation" is penalized. Health care service providers may be imprisoned
or fined if they fail to provide reproductive health care services such as providing services like ligation and
vasectomy. The same may happen to employers who do not provide free services to employees. Imprisonment
ranges from (1) month to six (6) months or a fine ranging from Ten Thousand Pesos (P10,000.00) to Fifty
Thousand Pesos (P50,000.00). Former Finance Secretary, Roberto de Ocampo, stated that these punitive
provisions "are tantamount to an affront to civil liberties and smack of religious persecution."[22] Defending the
bill, Dr. Felipe Medalla, former dean of the School of Economics of UP, said that "Although the poor’s access to
family planning services can be improved even without the law, the absence of the law makes it easier to block
the program."

[edit]Separation of church and state

Because the vast majority of Filipinos are Catholics, the Catholic church exerts a strong influence in public life.
Its staunch opposition to the bill has drawn the ire of non-Catholics and Catholics alike who support the bill, and
they invoke the separation of church and state to stop the church.

Fr. Joaquin Bernas, S.J, one of the drafters of the Philippine Constitution and a prominent lawyer and writer,
explained that the concept of separation of church and state is directed towards the state, rather than the
church, as it is a political concept. Technically it means “non-establishment of religion”, as the Constitution
stated that "“No law shall be passed respecting an establishment of religion ...” It means that the state should
be guided by the principle that it should support no specific religion. This means that government funding
should not be allocated for building churches or mosques, and not favor any particular religion. It does not
prevent the church, nor any other person with religious views, from expressing their views on religion and
morality. Proponents, on the other hand, state that the church should not meddle in matters of the state, and
should focus on religious matters, not political matters.

[edit]Implications

The national debate is seen as part of a wider culture war.[47][48] Passage or non-passage of the bill have
negative implications depending on the views. Proponents state that the non-passage of the bill will mean
keeping the Philippines in a backward state and unable to achieve the Millennium Development Goals,
especially the points on poverty alleviation and maternal health. It will mean reneging on international
commitments and will slow down modernization. They accuse the Catholic Church of holding the Philippines
"hostage" and violating the separation of church and state.[49] They argue that a decreased population growth
will lead to improved quality of life and economic development.

Opponents of the bill see the bill as part of Malthusian thinking, a hedonistic lifestyle, and eugenicist
intervention. They see it as a manipulative move of American imperialism, using United Nations agencies. It will
destroy the God-centeredness and family values of the Filipinos. They accuse the Philippine Legislator's
Committee on Population and Development as "essentially a foreign body," and that its "2008 lobbying fund of
two billion pesos comes from the David and Lucile Packard Foundation, IPPF and UNFPA the latter two both
well known for their global agenda to legalize abortion."[48]They say that a two-child policy will make the country
fail to cash in on a possible demographic dividend of rapid economic growth, and great reduction of poverty, a
chance for complete modernization.[19][20]

[Status

President Noynoy Aquino

In May 2010, Dr. Bernardo Villegas, one of the foremost economists of the country, says that the "RH Bill is a
dead issue," because (1) "there is absolutely no consensus among leading economists both here and abroad
about the correlation between population growth and poverty," (2) countries which avoided the recent recession
are populations with large domestic market, (3) there are other tried and tested methods for economic growth,
(4) it is highly divisive and will distract from nation-building. Writing in December 2009, Fr. John Carrol, S.J.
proposed a ceasefire, and that the bill "be put on the back burner for the present, and its provisions examined
dispassionately by mixed groups of the various stakeholders."[47]

Speaker of the House, Feliciano Belmonte, in a recent statement, assured that the Reproductive Health Bill
which has been pending in the House since the 10th Congress will be voted on in plenary during the present
Congress. Two bills, authored by House Minority Leader Edcel Lagman of Albay and Iloilo Rep. Janet Garin
have been refiled in the 15th Congress.

In the Senate, Sen. Miriam Defensor Santiago has filed her own version of the RH bill which, she says, will be
part of the country’s commitment to international covenants.

On September 16, 2010, Congress leaders, Senate President Juan Ponce Enrile and House Speaker Feliciano
Belmonte, were noncommittal on the approval of the bill In an interview after the ceremonial handover of the
Citizens’ Report on the Millennium Development Goals held at the House of Representatives, the two
mentioned the contentiousness of the bill.

President Noynoy Aquino said that it confounds him why he is always associated with the Reproductive Health
(RH) Bill and reiterated that he is neither an author nor a co-author, much less did he sign the committee report
regarding the bill. He pointed that a better resolve is responsible parenthood and the state's role is simply to
remind the parents of their obligations. Aquino also puts forth the establishment of an ecumenical forum among
religions to develop the values and conscience of the people, and help them have an informed decision.

During the “Women Deliver Philippines” Conference held September 2010, Dinky Soliman, his Secretary of
Social Welfare and Development, said that "choice and access” constituted the keystone of the Aquino
government’s policy, reiterating the administration’s support for the pending reproductive health bills.[50]

While there is no national law on reproductive health, 67 out of 122 local chief executives have created
reproductive health policies and programmes. Sixty-four of them are using their own budgets as of 2008.

In September 2010, the President said that he is in favor of responsible parenthood and respects the decision
of each couple as to the number of children they way, and if they need the government support for
contraception, then the government will provide it. This statement has created a furor as Catholic church
leaders say that Aquino has sold out the Filipino soul for some "measly" aid from the United States. The
President of the Catholic Bishops Conference said that there can possibly be an excommunication of the
President if he continues on with his stance. Pro RH Bill Senators encouraged the President to be steadfast to
do his duties towards the state. The President's spokesperson explained that the President is reaching out to
the prelates and said that the President himself has not made any decision in support of the Reproductive
Health Bill as he is still studying the document.

[edit]Supporting the RH Bill

 Edcel Lagman (2010-06-01). "House Bill No. 96: An Act Providing For a
National Policy on Reproductive Health, Responsible Parenthood and
Population and Development and Other Purposes".Philippine NGO Council on
Population, Health and Welfare Inc.

 "Full text of House Bill No. 5043 (Reproductive Health and Population
Development Act of 2008)". web log. Jaromay Laurente Pamaos Law Offices.
2008-09-22.

 Elizabeth Angsioco (2008-10-08). "Arguments for the Reproductive Health

Bill". The Manila Times (The Manila Times Publishing Corp.).

 Edcel Lagman (2008-08-03). "Facts and Fallacies on the Reproductive Health

Bill". Philippine Daily Inquirer.

 Ruperto P. Alonzo, Arsenio M. Balisacan, Dante B. Canlas, Joseph J.

Capuno, Ramon L. Clarete, Rolando A. Danao, Emmanuel S. de Dios,
Benjamin E. Diokno, Emmanuel F. Esguerra, Raul V. Fabella, Ma. Socorro
Gochoco-Bautista, Aleli P. Kraft, Felipe M. Medalla, Nimfa F. Mendoza, Solita
C. Monsod, Cayetano W. Paderanga, Jr., Ernesto M. Pernia, Stella A.
Quimbo, Gerardo P. Sicat, Orville C. Solon, Edita A. Tan, and Gwendolyn R.
Tecson (December 2004) (PDF). Population and Poverty: the Real
Score. University of the Philippines School of Economics. DP2004-15.

 Elizabeth Angsioco (2010-03-04). "KALUSUGAN NG KABABAIHAN: Making

Women Matter in the 2010 Elections". Rational Hero. Oplan Pepe.

 (PDF) Promoting Reproductive Health: A Unified Strategy to Achieve the

MDGs. Senate of the Philippines Economic Planning Office. July 2009. PB-09-
03.

 Ernesto M. Pernia, Stella Alabastro-Quimbo, Maria Joy V. Abrenica, Ruperto

P. Alonzo, Agustin L. Arcenas, Arsenio M. Balisacan, Dante B. Canlas,
Joseph J. Capuno, Ramon L. Clarete, Rolando A. Danao, Emmanuel S. de
Dios, Aleli dela Paz-Kraft, Benjamin E. Diokno, Emmanuel F. Esguerra, Raul
V. Fabella, Maria Socorro Gochoco-Bautista, Teresa J. Ho, Dennis Claire S.
 Mapa, Felipe M. Medalla, Maria Nimfa F. Mendoza, Solita C. Monsod, Toby
Melissa C. Monsod, Fidelina Natividad-Carlos, Cayetano W. Paderanga,
Gerardo P. Sicat, Orville C. Solon, Edita A. Tan, and Gwendolyn R. Tecson
(2008-08-11). "Population, Poverty, Politics and the Reproductive Health
Bill". 2010 Presidentiables.

 Marita Castro Guevara, Raymond Aguas, Liane Pena Alampay, et al (2008-

10-15). "CATHOLICS CAN SUPPORT THE RH BILL IN GOOD
CONSCIENCE". 2010 Presidentiables.
[edit]Opposing the RH Bill
 Jo Imbong (2008-08-16). "Reckless and irresponsible". Philippine Daily
Inquirer.

 Francisco "Kit" Tatad (2008-09-14). "The Truths and Half Truths about
Reproductive Health, The Bishops-Legislators Caucus of the
Philippines". First Things First.

 Roberto de Vera (2008-08-11). "A Primer on the proposed Reproductive

Health, Responsible Parenthood, and Population Development Consolidated
Bill". Scibd.

 Angelita Miguel-Aguirre (2008-08-11). "Medical Issues in the Reproductive

Health Bill". The Truths and Half Truths about Reproductive Health, The
Bishops-Legislators Caucus of the Philippines.

 Pro life Philippines. "On the Reproductive Health Bill". Prolife Philippines.

 Gregory Gaston (2008). "Misconceptions and Clarifications on Issues Related

to Humanae Vitae and the Reproductive "Health" Bill in Philippine
Congress.". Avenues (San Carlos Seminary Graduate School of Theology).

 Society of Catholic Social Scientists Philippines (2005). "A National

Perfidy". Catholic Social Science Review (Society of Catholic Social
Scientists) 10: 325–338.

 Prof Janet E. Smith, Robert G Kennedy, PhD, Richard S. Meyers, Romanus

Cessario, O.P., Rev. Joseph W. Koterski, S.J., et al (2008). "AN
INTERNATIONAL ACADEMIC RESPONSE TO SOME ATENEO DE MANILA
PROFESSORS’ STATEMENT ON REPRODUCTIVE HEALTH". First Things
First.
 Peter Kreeft. "Human Personhood Begins at Conception". Medical Ethics
Policy Monograph. Castello Institute.