(Speech delivered by Rep. Edcel C. Lagman at the 2nd National Family Planning Conference at the Waterfront Hotel, Cebu City
on 08 November 2017)
When people and policymakers realized that here is urgent need to moderate population growth rate and to conserve depletable resources, the concern on reproductive health and family planning meandered from the privacy of the couple’s bedroom to the arena of public discourse and eventually to the domain of politics.
Policymaking is inherently political. The crystallization of a policy in the midst of confrontation between proponents and oppositors is an exercise in politics. The enactment of a law is the product of politics. And I believe that good politics eventually prevail.
Thus, the passage of the Reproductive Health Bill on December 17, 2012 by the Congress after 13 years of arduous struggle; its signing into law as Republic Act No. 10354 on December 21, 2012 by President Benigno Aquino III in the privacy of his study; and the controversial measure’s constitutionalization by the Supreme Court on April 8, 2014 with a few non-pivotal provisions declared unconstitutional.
The actions of the two political departments – the Congress and the Executive – are truly political. But even the adjudicatory process before the Supreme Court, albeit judicial, has political underpinnings.
The odyssey of family planning and reproductive health did not end with the enactment of R.A. No. 10354. It also did not end with the Supreme Court’s declaration that the RH Law is constitutional in the whole.
Reproductive health and family planning continue to navigate the challenging terrain of politics.
There is politics in the full and faithful implementation of the Reproductive Health Law and family planning; there is politics in sourcing adequate funding for RH and FP; and there is politics in the ultimate survival of this overridingly important statute.
Politics in Implementation
The test of a law’s efficacy is its full and expeditious implementation. And we all know that the enforcement of a statute does not prosper in a vacuum.
The implementation of the Reproductive Health Law and its core program on family planning needs an enabling environment of strong political will. Without the political will of the impementors – the Presidency, the Department of Health and the Local Government Units – this historic law will become irrelevant and dormant.
The implementation is principally the onus of the Executive and the Department of Health (DOH) with the Congress exercising oversight functions.
Verily, the political departments are in the forefront of the Reproductive Health Law’s implementation.
Politics with its most benign influence as well as its most obstructionist aspect could either elevate or debase the law’s enforcement.
The implementation of the law on reproductive health and the program on family planning is not yet in full speed, and in many instances even struggling, because of the following principal reasons:
The leadership and bureaucracy of the Department of Health, the principal implementor of the law, are still at best ambivalent in prioritizing the full enforcement of the law given the various programs the DOH has to implement and oversee. Reproductive health and family planning have to compete for attention and priority with other important health agenda.
But the prioritization of reproductive health is an antecedent program to all other health issues like overall health care, disease prevention and health facility enhancement program. A deceleration of the population growth rate and the improvement of maternal and infant health will ease the burden of other health concerns.
Compounding the problem of DOH on the full implementation of the RH Law is the recurrent changes in its leadership.
Since the enactment of the RH Law almost five years ago, four Secretaries had been at the helm of DOH. The fourth is the “comebacking” Sec. Francisco “Pingcoy” Duque.
Each Secretary has a varying level of approach to RH and family planning, which individual inclination may defy consistency in the implementation of the law. It is for this reason that there is need for a career Undersecretary who must be exclusively in charge in pursuing the full implementation of the RH Law.
At the positive side of the ledger is the continuing existence of the National Implementation Team (NIP) which is a strong back-up to the DOH and a precursor in innovating policies to implement the law. The NIP must be institutionalized and adequately funded.
Another positive aspect is the incumbent President’s continuing advocacy for the full implementation of the law like his issuance on January 9, 2017 of Executive Order No. 12, entitled “Attaining and Sustaining ‘Zero Unmet Need For Modern Family Planning’ through the Strict Implementation of the Responsible Parenthood and Reproductive Health Act, Providing Funds therefor, and for other purposes.
But the President’s endorsement must be actualized in adequate appropriations, sufficient personnel complement, reduction of teenage pregnancy, containment of maternal and infant mortality and morbidity, increasing the contraceptive prevalence rate, and promoting reproductive health and sexuality education in both public and private schools.
The President must walk the talk in his advocacy on reproductive health and family planning, his only agenda which has gained credit for him, unlike the continuing summary killings, dismal failure in solving the drug menace and the traffic mess and persistent inclination toward authoritarian rule.
With a few exceptions, Local Government Units do not have the fiscal and technical, as well as the requisite political will, to help fully implement the law. The Reproductive Health Law requires the National Government to give financial and technical assistance to LGUs. This has to be effectuated so that LGUs will be competent partners of the National Government in the enforcement of the Reproductive Health Law and its principal component on family planning.
In fine, there is yet much to be desired from the Executive, DOH and LGUs in fully implementing the RH Law, even as the Congress has not yet exercised its oversight functions, through the Congressional Oversight Committee on Reproductive Health, both of the House of Representatives and the Senate, which still has to jointly meet midway in the 17th Congress.
Another factor which delays the implementation of the RH Law is the recourse to the Supreme Court by detractors like the petition to ban Implanon and Implanon NXT as abortifacient, which are among the contraceptives of choice of countless women acceptors because pregnancy is over 99% prevented for a period of three years, while there is no problem restoring fertility once the implants are removed.
The Supreme Court did not declare the said contraceptives as abortifacient because the Food and Drug Administration (FDA) has the primary jurisdiction to determine the non-abortifacient character of contraceptives with a caveat to afford oppositors due process. However, the petition took almost two years to resolve. Meanwhile the supply of contraceptives has cascaded to precarious levels.
With regards to the issue on certification and recertification of contraceptives as non-abortifacient, the ball is now with the FDA. From April 26, 2017 when the motion for reconsideration by the DOH and FDA was denied by the Supreme Court and the issue was remanded to the FDA, almost six months have elapsed. The FDA must act with deliberate alacrity even as the oppositors are given notice and summary hearing as ordered by the High Court.
The Supreme Court in its Resolution dated 26 April 2017 categorically ruled that “[a]fter compliance with due process and upon promulgation of the decision of the Food and Drug Administration, the Temporary Restraining Order would be deemed lifted if the questioned drugs and devices are found not abortifacients.”
I hope the politics of obscurantism by the ecclesiastics and their lay cohorts has not invaded and infected the certification and recertification processes being conducted by the FDA.
We are expecting the FDA to make the certification and recertification of product registration based solely on unimpeachable available medical and scientific evidence, the expert pronouncements of the World Health Organization and consistent with the inspiring objective of Executive Order No. 12 on zero unmet need for modern family planning for poor households by 2018 and subsequently for all Filipinos and the ennobling mandate of the Reproductive Health Law.
The more contraceptives and contraceptive devices, including IUDs, are certified as non-abortifacient, the faster and better will the mandate of R.A. No. 10354 and E.O. No. 12 be fully served and realized.
Politics in Appropriation
Adequate appropriation is an indispensable key to the implementation of the RH Law and family planning. The importance of proper funding is highlighted by the law’s mandate for the State to afford marginalized sectors free RH and family planning services and supplies.
The allocation of funds in the annual General Appropriations Act is a continuing battleground between advocates and detractors.
Thus, it is imperative to succeed in electing more RH advocates in the House and in the Senate, and defeating at the polls intransigent critics.
Surprisingly, since the enactment of the RH Law, the appropriations for family planning supplies have been inconsistent, erratic and sometimes dwindling.
For example, in 2013 a year after the enactment of RA 10354 the appropriation for family planning supplies was P530,719,000; in 2014 it was P1,307,218,000; in 2015 it went down to P1,010,616,000; in 2016 it was further reduced to P599,921,000; in 2017 it was drastically downgraded to P165,403,000; and the proposed budget for 2018 is P342,482,000. This proposed budget next fiscal year should be increased in the bicameral conference committee considering the expectation that more contraceptives will be certified and recertified soonest.
The inconsistency and reduction of funding for family planning supplies and contraceptive commodities must be reversed in faithful compliance with the mandates of RA 10354 and Executive Order No. 12.
Politics of Survival of the RH Law
Politics will determine the survival of the Reproductive Health Law. Whether it will be repealed, diluted or denied adequate appropriation is a question of politics.
But I assure all of you fellow RH advocates that the Reproductive Health Law is a superior statute and family planning is a superior program. They will both survive the vicissitudes of politics with the enduring collaborative support of NGOs and civil society.
Thank you and good day.