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THE RH BILL CHAMPIONS
THE RIGHTS OF THE YOUTH

(Speech delivered by Rep. Edcel C. Lagman at the Sangguniang Kabataan National Congress in Cebu City on 29 October 2008)


A senior citizen relishes the opportunity of being among young people. The vibrance and vitality of the young radiate. They are contagious in a most welcome affliction.

It is said that one does not have to search in vain for the Fountain of Youth, or concoct an elixir of life.

All one has to do is to commune with the youth, to dialogue in an assemblage of the young.

I immerse myself this morning in the fountain of youth – in your enviable and invigorating company.

Give yourselves a resounding applause to underscore your power and strength.


As leaders of the Sangguniang Kabataan National Federation, I know you are fully aware of your unique position of influence among your peers. However, you are not only instrumental in opinion formation within your age group; as elected representatives of the youth, you actually have the power to influence national policy.

I am, therefore, heartened that among the numerous issues that confront our nation, it is the Reproductive Health Bill that you have chosen for me to discuss today.

Since all of you here are teenagers, I shall focus on the provisions on sexuality education and adolescent reproductive health which are both advocated by the bill.

The current adolescent population in the Philippines is close to 20 million and this is the biggest in our history. This age group of 10-19 year olds, defined by the United Nations as the period of adolescence, comprises a whopping 22.5% or almost a fourth of the entire Philippine population of 88.5 million as of August 2007.

To put it more descriptively, the total number of adolescents in the Philippines is more than the combined number of all the citizens in the Scandinavian countries of Norway (4.7 M), Sweden (9.0 M) and Denmark (5.3), which have an aggregate population of only 19 million.

Even the entire citizenry of the whole sub-continent of Australia is only 1.3 million more than all the adolescents in a little archipelago called the Philippines.

The number of adolescents in the country is even a little bigger than the whole population of New York State which is 19.3 million.

The Philippines is the 12th most populous country in the world, indeed a dubious distinction because we have admittedly limited resources and a huge young population which demands and deserves more benefits but gets much less.

Verily, the health concerns of adolescents should be an indispensable and integral component of public health.

Adolescence is a time of both diverse physical and emotional changes in a young person. It is also characterized as a period fraught with vulnerability and insecurities even as it is also a time when young people like you are most receptive to new ideas and values.

It is during this period that young persons are most likely to engage in risky behavior typical of the young but at the same time it is also the period wherein they naturally progress towards physical and psychological maturity and thus develop their adult identities and solidify their belief systems. Clearly, this is a time when young people need an environment that encourages them to seek proper and adequate information and guidance.

I am certain that most of you would say that you are in good health. I expect that most, if not all of you, do not have hypertension, diabetes, arthritis and other ailments common to older people. Given your young age, this is to be expected. But how about your reproductive health?

Reproductive health refers to 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 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.” (Sec. 4[c])

Lack of RH information and services equal
Increased risks of unplanned pregnancies and STDs

Experts assert that although this is generally a period of good health for most young people, “many adolescents often are less informed, less experienced, and less comfortable accessing family planning and reproductive health services than adults.” It is precisely because of your age that you are also most likely to meet resistance or even outright hostility and opposition from adults when you do try to seek reproductive health information and services.

Making sure that the reproductive health needs of young people are met means that you should have access to accurate information about sexuality, family planning, pregnancy, childbearing and related diseases. It also means ensuring your access to values, information and measures that will prevent unplanned pregnancies and sexually transmitted diseases.

The lack of information and access to reproductive health services exposes you to an increased risk of unplanned pregnancy, contracting HIV-AIDS and other STDs, unwanted sexual advances and other problems which may have health consequences that could affect your future.

The WHO says that young people between the ages of 14 and 24 have the highest rates of sexually transmitted diseases worldwide and half of all new HIV infections occur in people under 25.

It important to underscore that adolescent girls face serious reproductive health risks primarily because of their age. Because young girls’ bodies are not yet ready for pregnancy and childbirth, 75% of all maternal deaths happen to girls aged 14 to 19 years old. Out of every 100 pregnant women in the Philippines, 30 are adolescent girls (State of the Philippine Population Report 2004). It is alarming that almost 10% of all Filipino women aged 15-19 have already given birth even as this age group also has the lowest prevalence of contraceptive use (National Demographic and Health Survey 2003).

If these data were not disturbing enough, according to the Department of Health (DOH), not only is it more probable that girls below 20 years old will die from pregnancy and childbirth related causes, their children are also more likely to die before they reach the age of five.

Young men are also at greater risk of contracting STDs not only because peer pressure may force them to take on the services of sex workers but also because they are ignorant of methods that can protect them from disease and protect their partners from unplanned pregnancies and, moreover, they are not imparted with the proper moral values on delaying initiation into sexual relations and abstinence before marriage.

House Bill 5043 or the “Reproductive Health, Responsible Parenthood and Population Development Act of 2007” will ensure that relevant information and appropriate life-saving services will not be withheld from young people.

Sexuality education means accurate information
and life skills for young people

I am sure that when you and your parents have arguments, they’ve told you with some exasperation to “grow up” or “act your age” or “act more responsibly”. That’s what parents usually tell their children when they get into disagreements with them.

But I think it is about time that you tell the adults who are insisting that sexuality education for the youth will make them sex maniacs that it’s about time they grow up and act their age.

If we want to drastically decrease the number of teenage pregnancies and effectively combat the spread of STDs and if adults truly want young people to act more responsibly, then it’s about time we adults grew up and trust young people enough that pertinent information and correct values about sex and sexuality will not make them immoral and promiscuous.

Comprehensive sexuality education has been shown to make adolescents more sexually responsible and adds a level of maturity to their attitudes towards sexual relations.

Programs and projects that ensure access to reproductive health services, provide accurate information, and help adolescents develop life skills like the ability to resist peer pressure when it comes to sexual initiation, are fundamental to their future.

These are precisely what House Bill 5043 aims to ensure. Section 3 (l) of the bill clearly states that “respect for, protection and fulfillment of reproductive health rights seek not only to promote the rights and welfare of adult individuals and couples but those of adolescents’ and children’s as well”. Adolescent and youth health is also one of the 11 elements of reproductive health under the bill [Sec. 4(g5)].

Ideally, it should be your parents who should be teaching you about sexuality and reproductive health. But who among you here can honestly claim that your parents sat down with you to talk about sex and sexuality? Most parents and children are uncomfortable discussing sex at home which is considered taboo in our culture.

Majority of teenagers get their information from the least reliable of sources – their barkada and the entertainment media. These result in myths about sex and sexuality like the claim that Colgate is a spermicide or that a girl cannot get pregnant if it is her “first time” or even that taking pills will create a hole in one’s stomach. To counter such widespread myths about sex, formal education is the answer.

But what will the youth learn if sexuality education becomes part of the curriculum? Adolescents will not be taught sexual positions or be encouraged to be hedonistic. You are going to be taught correct sexual values. You will be taught to understand, respect and value the reproductive functions of your bodies. You will be taught how not to give in to peer pressure when it comes to sexual initiation. You will be taught that men and women are equal. You will be taught to view abstinence before marriage as an ideal that should be aspired for. You will be taught that should you decide to engage in sexual relations, which is not encouraged before or outside marriage, it is important to protect yourselves from unwanted pregnancies and STDs. You will be taught to have greater appreciation for the joys and responsibilities of parenthood and a greater understanding of its challenges.

Moreover, these courses shall be taught in an age-appropriate manner by adequately trained teachers. Even if the bill mandates the teaching of sexuality education in the 5th Grade, teachers will not be teaching 11-year olds about contraception. “Age-appropriate” is the operative term and Grade 5 pupils will be taught about their reproductive system and the changes they will be experiencing as they mature into adults. Younger students will also be taught to recognize and report immediately unwanted sexual advances while older students will be taught how to assert themselves (like saying no to sex) and the importance of equality between men and women in all types of relationships.

Teachers will also be properly trained to ensure that they will be not only be comfortable about discussing family planning and intimacy within relationships; they will be confident in their ability to impart to their students correct values and attitudes towards sex and sexuality.

Sexuality education will not be a separate subject. It will be integrated into the various subjects already taught in school. This is similar to what other countries are now doing. It will be taught less from a detached scientific standpoint and more from a positive, dialogue-based approach that emphasizes values and mores and highlights sexuality as an integral aspect of physical and emotional wellbeing and sexuality education as a key component of health education.

Sexuality education will lead to more responsible sexual behavior, not promiscuity


Sexuality education seeks to assist young people in cultivating a positive view of sexuality; providing them with information and skills about taking care of their sexual health; and helping them make sound decisions now and in the future.

According to the United Nations Population Fund: “it has been repeatedly shown that reproductive health education leads to responsible behavior; higher levels of abstinence, later initiation to intimate sex, higher use of contraception and fewer sexual partners.”

A report released by the US National Campaign to Prevent Teen Pregnancy in 2001, concluded that: “(1) sexuality and HIV education do not hasten sexual activity; (2) education about abstinence and contraception are compatible rather than in conflict with each other; and (3) making condoms available does not increase sexual behavior.”

Moreover, the study entitled The Hidden Epidemic: Confronting Sexually Transmitted Diseases states that the most effective reproductive health and sexuality education programs include: “stressing the importance of delaying sexual activity, providing contraceptive information, addressing social and media influences, and building communication and negotiation skills.” Again, this shows that teaching the youth about contraception together with abstinence is not contradictory.

Recently, the WHO published a review of 1,050 articles on sex education programs and it asserts that there is no proof that sex education encourages sexual experimentation or increases sexual activity. It concludes that sexuality education leads to “postponed initiation of sexual intercourse and/or effective use of contraception." 

An effective reproductive health education program will not only instill in you the consciousness of freedom of choice but responsible exercise of your rights. The failure to provide adolescents with appropriate, accurate and timely information and services concerning reproductive health will be a disservice to the youth because keeping them ignorant and misinformed is tantamount to putting both their health and future at risk.

The youth want less children and more FP information and services

Surveys have shown that adolescents are receptive to reproductive health and family planning services and results of youth surveys reveal that an increasing number of young people want no more than two children.

The State of the Philippine Population Report (2nd Report. Pinoy Youth: Making Choices, Building Voices) reveals that 90% of the youth believe that government should provide family planning services and 80% believe that these services should be provided to the youth.

Preference for a two-child family is increasing among adolescents. In 2002, the Youth and Adolescent Fertility Survey (YAFS) reported that 50.6% of young people preferred to have two children at most, a very significant increase from the 36% in 1982 and 38.3% in 1994.

If you take a survey among yourselves today, I am sure that it will show that the trend is to have smaller families because even Filipinos as young as you understand that having less children means an increased capacity to respond to the needs of the family and a better chance of becoming responsible parents.

While we’re in the subject of surveys, the latest SWS survey released last October 15 revealed that an overwhelming 76% of Filipinos favor the teaching of family planning in schools and a clear majority (54%) do not believe that sexuality education will lead to promiscuity.

RH bill not only for adults

The RH bill is not only for couples and adults. The bill is also for young people like you because it will ensure your right to correct reproductive health information and guarantee that should you need RH services, they will not be denied you.

Moreover, the enactment of this bill into a law will ensure that when you grow older and get married, you and your spouse will have the basic human right to determine when and how many times you will have children. You will have the right to plan your family using the method of your own choice. You will not be dictated upon nor will your freedom of choice be curtailed or derogated.

So it is incumbent upon you to join the debate on reproductive health and family planning. Stand up and be heard on this crucial issue. It is your right to be heard, do not surrender this right to voice out your opinions.

The RH bill will protect the health of adolescents, not put their wellbeing in jeopardy. It will be instrumental to their education on sexuality and reproductive health even as it will be crucial in getting rid of the fallacies on sex and reproduction that keep the youth not only ignorant but at greater risk of unplanned pregnancies and STDs.

The passage of HB 5043 will ensure that young Filipinos are not deprived of the necessary information and services that will secure their reproductive self-determination and guarantee good health for them and their future children.

Generations of Filipinos before you were denied the opportunity to have access to relevant information and services that they needed to plan their families. Do not allow yourselves to be similarly shortchanged.

The brunt of the ill-effects of high fertility in the past is being borne by the youth – instead of going to school, more children are working to augment the income of a growing family; more young people are deprived of quality education; more children are dying from preventable diseases; and increasing number of adolescents face unemployment.

A ballooning population impacts negatively on all indicators of human development – education, health, employment, mass housing, food security and the environment. Chronic poverty and high population growth rates are inextricably linked. A rapidly growing population all but negates any progress we may achieve in terms of economic growth and cancels out government’s efforts in poverty reduction.
You deserve more from your government. Demand more in terms of services for the youth. Demand more in terms of information that will be relevant to decisions that will affect your future.

Your endorsement of the Reproductive Health Bill will be invaluable to its enactment into law. You are the chosen leaders of the youth of this country. Study the issue of reproductive health and population development carefully. Take part in the debate. Do not forfeit the opportunity to be a part of the enactment of a policy that will have long term effects on your lives and the lives of your future children.

The UNICEF has declared that “family planning could bring more benefits to more people at less cost than any other single technology now available to the human race.”

Your sheer number alone makes you a powerful force to contend with. And if you are organized, well-informed and vigilant, then there is a greater chance that policymakers will not only listen but heed your advice.

You are not only the fountain of youth. You are the fountainhead of good counsel.
REPRODUCTIVE HEALTH AND
CORPORATE SOCIAL RESPONSIBILITY

(Keynote Speech delivered by REP. EDCEL C. LAGMAN at the American Chamber Foundation Philippines on 30 September 2008)

In business and industry circles, the acronym CSR means Corporate Social Responsibility. However, among women’s organizations and reproductive health advocacy groups, the term CSR has a different meaning. It means Contraceptive Self-Reliance.

As dissimilar as Corporate Social Responsibility and Contraceptive Self-Reliance may seem at first, they are in fact interrelated.

The meaning of Corporate Social Responsibility has changed from simply connoting “good corporate citizenship” which translated mainly to the payment of correct taxes to the government by companies; ensuring that employers do not shortchange their workers on their wages and benefits; and other similar principled business practices. It has since evolved to mean companies, like member companies of the American Chamber of Commerce in the Philippines, taking proactive steps and undertaking projects that will make a definitive positive difference in people’s lives.

In pursuit of fulfilling its corporate social responsibility, the American Chamber Foundation, Inc., the socio-civic arm of the American Chamber of Commerce, has found innovative ways of giving back to Filipino communities. AmCham Foundation has concentrated on education, health and poverty reduction programs and it is precisely in the promotion of the right to education, health and a life free of poverty where the similarities between Corporate Social Responsibility and Contraceptive Self-Reliance become more obvious.

Both CSRs deal with health, rights and development, especially of the marginalized. It is obvious how Corporate Social Responsibility, particularly the kind that AmCham is practicing, is directly linked with promoting genuine human development. But how is Contraceptive Self-Reliance linked with ensuring progress and improvement of human lives?

Contraceptive Self-Reliance is firmly anchored on the concept that all governments must be self-sufficient when it comes to ensuring something as basic and essential as providing its citizens with legal and medically safe family planning methods and quality contraceptives. This is because family planning, as a component of reproductive health, does not only help improve lives. Family planning also saves the lives of mothers and infants.

Moreover, reproductive health and rights are inextricably linked to sustainable human development. Providing women and couples with information and access to all forms of legal and medically safe family planning methods, as espoused by House Bill 5043 or the “Reproductive Health, Responsible Parenthood and Population Development Act”, will not only guarantee Contraceptive Self-Reliance for the country. More importantly, it will ensure that women and couples will have the chance to plan their families and if they chose to do so, government will be prepared to help them meet their fertility goals by providing much needed RH services.

This will lead to a dramatic decrease in fertility and lower population growth, which will enable government to address more fully crucial determinants of human development such as education, healthcare, food security, employment, housing and environmental protection.

It should be underscored that the social ills directly linked to poverty – ignorance, disease, unemployment, environmental destruction, the low status of women – simply cannot be overcome without also directly confronting the issue of reproductive health and population.

The State and Church need not clash on the issue of population and reproductive health because both modern and natural methods of family planning have a common objective – to prevent unplanned pregnancies.

According to the National Statistics Office there are 12.9 million married women of reproductive age in the country. Of this number, 4.6 million use modern methods compared to 1.75 million who use natural family planning and traditional methods.

But there are 2.6 million women who would like to plan and space their children but are unable to do so for of lack of information and access to FP services. The balance of approximately 4.0 million women do not use or do not care to use any family planning method.

Our total contraceptive prevalence rate remains at a low of 50.7% and the contraceptive unmet need of the poorest Filipino women is a high of 26.7%

I am therefore heartened that AmCham Foundation’s programs are currently concentrating on reproductive health education of the youth by helping them “make the right decisions as they fulfill their dreams” through Peer Education Programs and Information, Education and Communication Sessions.

Moreover, the AmCham’s Leonard Benjamin Program Development Center provides reproductive health services including family planning counseling and referrals to Filipinos who need them most.

Critics of the bill claim that “overpopulation” is a myth being perpetuated by western nations, particularly the United States because the “depopulation” of Third World nations supposedly ranks high in US foreign policy. They also allege that the United States is pushing for population and family planning programs in developing countries like the Philippines because it is afraid that these nations will not as easily succumb to western dominion if their populations continue to increase. I have heard this argument against HB 5043 so many times and I have yet to decide whether to laugh or cry.

It is ironic that the authors of House Bill 5043 have been accused of promoting Western interests, particularly that of the United States, by championing the reproductive health rights of Filipinos. I say ironic because since I have been in politics, I have always espoused purely the interests of the Filipino people and the Filipino nation. And I am certain that this is also true for another principal author of HB 5043, the Hon. Risa Hontiveros-Baraquel of Party-list Akbayan, like invariably all of our co-authors.

In fact this is the first time I have ever addressed an American organization.

If all nations which have strong population policies are in effect subservient to American and western interests, then the biggest lapdog of Uncle Sam would be China which has a stringent and punitive one-child policy!

Levity aside, we should bear in mind that if the Philippines can effectively promote and protect the reproductive health of its citizens and it succeeds in sensibly managing its population, it shall have healthier, more prosperous, and certainly more educated, critically-aware and issue-oriented citizens who cannot be muzzled or cowed by interventionist foreign countries or any dominating power.

HB 5043 is primarily about health, rights and human development. It seeks to enact a comprehensive, rights-based and adequately-funded national policy creating an enabling environment for couples and women to exercise freedom of informed choice in planning the number and spacing of their children.

Family planning is more than just a tool to help women and couples to responsibly plan their families. Its principal benefits are:

(1) Lower maternal mortality;

(2) More benefits for children since smaller-sized families assure they will be better nourished and will receive better health care;

(3) Higher human capital investment at the family level that would lead to bigger investments in health and education;

(4) Increased income generating and educational opportunities for women that will, in turn, benefit them and their families; and

(5) Significantly lower abortion rates.

The World Health Organization (WHO) report “Reducing the Risks of Pregnancy – the Role of Contraception” declared with absolute certainty that “increased use of contraception would also have an obvious and direct effect on the number of maternal deaths” simply by reducing the number of unplanned pregnancies.

The WHO estimates that around 515,000 women die each year from complications of pregnancy, childbirth and unsafe abortion. It reports that 90% of all maternal deaths worldwide happen in developing countries like the Philippines.

It concludes that with the correct and consistent use of contraceptives “the fall in maternal mortality is likely to be even greater than the fall in the pregnancy rate.” This would imply that the risk associated with each individual pregnancy is reduced.

Together with the UNFPA and the medical journal Lancet, the WHO also asserts that family planning can reduce maternal deaths by one-third and 1 million infant deaths worldwide can be avoided if women and couples are given the opportunity to use safe and effective contraceptives.

Fewer children will also enable women to seek remunerative work and allow them more opportunities to advance their education, thus diminishing gender inequality.

Studies have also consistently shown that since any pregnancy that ends in induced abortion can be considered unwanted, the precise and regular use of reliable contraception significantly reduces abortion rates by as much as 85%.

Indeed, family planning is an indispensable element in reducing poverty and underdevelopment and a vital factor in the human development equation. It is an essential tool to help families live fuller, more meaningful lives.

In its State of the World Population Report 2002, the UNFPA states that ensuring good reproductive health is essential to reducing poverty. According to the report, had countries like the Philippines reduced its fertility by a mere five births per every one thousand women of reproductive age in the 1980s, the current poverty incidence would have been reduced by one-third.

Local studies conducted by Filipino economists and social scientists also point to the tangible connection between population and poverty.

In the 1970s, Thailand and the Philippines were virtual Siamese twins because their total population, infant mortality rate, and the life expectancy at birth were almost identical. Thailand, however, successfully implemented a serious population program whereas the Philippines continued to dillydally on the issue of family planning and population management.

Today, the Philippines has some 20 million more people than Thailand. Thailand’s poverty incidence was pegged by the Asian Development Bank at 8.5% while the Philippines’ remains at a high of 32%.

These studies show that if the Philippines had Thailand's population growth rate:

•    Poverty incidence would have been 5.5 percentage points lower.

•    The number of poor people would have been 3.3 million less.

•    Estimated savings from basic education would have amounted to P128 billion.

•    Estimated savings from basic health would have reached P52 billion.

•    The average income per person would have increased by at least 0.76 percent per year, for the period 1975 to 2000. This would have meant a cumulative increase of about 22% on the average income per person in the year 2000.

These are missed opportunities that the country will not be able to recover because of government’s long history of an appalling lack of political will in enacting a national policy on reproductive health and population development coupled with its inordinate fear of the Catholic Church.

It must be emphasized that as the population growth rate decelerates, more government resources are liberated for basic social services such as healthcare, education, food security and employment opportunities, all fundamental determinants of human development which will register marked improvement. This will result in a significantly higher standard of living and better quality of life for more people.

I am confident that we can work together in the promotion, protection and fulfillment of the basic human right of everyone to reproductive health and reproductive self-determination.

Thank you.
THE IMPORT OF REPRODUCTIVE HEALTH
ON THE MILLENNIUM DEVELOPMENT GOALS

(Speech delivered by REP. EDCEL C. LAGMAN at the
National Convention of the Philippine Nurses Association
at the Manila Hotel on 23 October 2008)

It has been said that nurses are not only at the heart of healthcare; they have become great blessings to humankind.

In a country where a large number of people live and die without even seeing a doctor, nurses have become the frontliners of the healthcare system. 

Although nurses cannot write out prescriptions, they can be counted on to dispense essential medical care, compassion and genuine care.

I am certain that those of you who have opted to stay in the country all have despairing stories to tell about the state of our healthcare system, what with the migration of trained health professionals to other nations, the lack of funds for basic equipment and medicines in hospitals, and the tremendous increase in the number of people seeking medical help.

But these problems are not unique to the healthcare sector. The education sector is also experiencing similar problems because government simply cannot keep pace with the continuously growing number of enrollees in terms of providing adequate number of classrooms, textbooks, desks and tables and even teachers.

The same is also true for the agricultural sector. It just cannot produce enough to feed the growing multitude of Filipinos. The Philippines’ Population Growth Rate (PGR) of 2.04% outpaces the country’s annual growth in rice production of only 1.9%. The menace of hunger stalks densely populated communities where the family budget for food is spread too thinly with so many mouths to feed.

In the 2008 Global Hunger Index conducted by the International Food Policy Research Institute, the Philippines was included in the 33 countries worldwide where the problem of huger and malnutrition is of critical concern.

Certainly, you are fully aware of the relevance of adequate healthcare, quality education and food security to my topic on House Bill No. 5043 or the proposed “Reproductive Health, Responsible Parenthood and Population Development Act of 2008”.

I. A Ballooning PGR Impacts Negatively on All
Human Development Indicators

We cannot achieve genuine and sustainable human development if we continue to default in addressing the population problem. It is beyond debate that a huge population growth rate impacts adversely on all indicators of human development such as health, education, shelter, food security, employment and the environment. 

Chronic poverty and high population growth rates are inextricably linked. A high PGR all but negates any progress we may achieve in terms of economic growth and cancels out government’s efforts in poverty reduction.

Government can help curb a ballooning population by simply helping women and couples realize their fertility goals. House Bill 5043 will help ensure that women and couples will achieve their desired fertility through the creation of an enabling environment where they will have information on and access to both natural and modern methods of family planning and will have the freedom to decide which method is best suited to their needs, personal convictions and religious beliefs. It is freedom of informed choice, freedom of conscience.

II. RH and the Millennium Development Goals

The Philippines has committed to achieve the Millennium Development Goals (MDGs) by 2015. The noble and ambitious objective of the MDGs is the quantifiable improvement in the lives of people through the achievement of the following human development goals:

1.    Eradication of extreme hunger and poverty;
2.    Achievement of universal primary education;
3.    Promotion of gender equality;
4.    Reduction of infant mortality;
5.    Improvement of maternal health;
6.    Combating HIV-AIDS, malaria and tuberculosis;
7.    Ensuring environmental sustainability; and
8.    Promoting global partnerships for development.

Virtually all of these goals, but especially the goals which pledge elimination of gender-based discrimination; decrease in infant deaths; safe motherhood; and the prevention of the spread of HIV-AIDS, are closely related to reproductive health and family planning which are indispensable in addressing the pressing concerns on rights, health and sustainable human development.

The interrelatedness of reproductive health to the MDGs underscores the urgent need for the passage of HB 5043 that will promote and protect the right of all Filipinos to health and development, more particularly that of women and children.

III. Reproductive Health and Family Planning
are Basic Universal Human Rights

I have always emphasized that the RH bill is not principally about pills, condoms and IUDs. It is also not about sex and certainly not about religion. It is primarily about the right to health and the right to development.

Reproductive health is a fundamental human right and was affirmed as such in the Proclamation of Tehran during the International Conference on Human Rights 40 years ago in 1968.

The right to reproductive health and family planning was subsequently reiterated in numerous other UN Conventions of which the Philippines is likewise a signatory.

IV. RH and FP are Essential to the
Achievement of Key MDGs

Reproductive health and family planning are indispensable to the promotion of gender equality; safe motherhood; the reduction of maternal and infant deaths; and the drastic decrease in abortion rates.

It is important to underscore that six of the eight MDGs are linked to reproductive health and are encompassed in its elements as enumerated in House Bill 5043.
RH and Goals 4 and 5 on maternal and child health and survival
Reproductive health also includes maternal, infant and child health and nutrition which are crucial to ensuring the health of mothers and infants and in the reduction of maternal and infant mortality.

Family planning is central to maternal and child health because the WHO states that “birth-to-pregnancy (BTP) intervals of six months or shorter are associated with elevated risks of maternal mortality” and “BTP intervals of 18 months or shorter are associated with elevated risk of infant, neonatal and perinatal mortality, low birth weight, small size for gestational age, and pre-term delivery.”

The WHO underscores that 99% of all maternal deaths happen in developing countries like the Philippines. This is why a national policy on reproductive health is crucial in order to drastically lower maternal mortality rates in the country.

The worst inequity is maternal death. The miracle of life should not result in the death of a woman. Although pregnancy is not a disease, it is ironic that 500,000 women die annually worldwide of causes related to pregnancy and childbirth. In the Philippines, 10 women die daily of such causes.

HB 5043 is also very clearly anti-abortion. Its objective is to ensure that women and couples have access to all methods of family planning in order to prevent unplanned pregnancies. According to the 2003 NDHS, 44.3% of all pregnancies in the country are unplanned principally because of the lack of information on and access to family planning services. It is for this reason that the incidence of induced abortion in this country is 500,000 annually.

Contraceptive use and abortion have an inverse correlation. The more women use effective contraception, the less likely they have unwanted pregnancies that will be terminated through abortion. Research by the Guttmacher Institute also reveals that the use of contraceptives can reduce abortion rates by 85%.

RH and Goals 2 and 3 on universal primary education and gender equality

In the Philippines, childcare is still considered primarily the role of mothers and/or older sisters. Therefore, it is not uncommon for girls to drop out of school because they are forced to care for siblings as the family continues to expand. Family planning, as an essential element of reproductive health, will help ensure gender parity in school and foreclose this inequity being foisted on girls.

Another element of RH is the elimination of violence against women which will not only promote the basic human right to live a life free of violence but is also central to achieving gender equality.

Moreover, family planning will lead to bigger investments in health and education, improved quality of childcare and more educational and employment opportunities for women. All these will go a long way in achieving Goal 2 on universal primary education and Goal 3 on promoting gender equality.

RH and Goals 6 and 7 on HIV-AIDS and the environment

Still another element of reproductive health is the prevention of HIV-AIDS and other sexually transmitted diseases. Renewed efforts to curb the spread of HIV-AIDS and other STDs as advocated in the RH bill will help government achieve part of Goal No. 6 on combating HIV-AIDS.

Slower population growth through family planning will also relieve the strain that a burgeoning population exerts on an environment increasingly threatened by human activity and will help us attain Goal No. 7 on environmental sustainability.

RH and Goal No. 1 on poverty and hunger

Guaranteeing the right of women and couples to reproductive self-determination through the family planning method of their choice will also ultimately help government achieve Goal No. 1 on the eradication of hunger and poverty.

A decline in fertility rates will help open a demographic window of economic opportunity similar to what happened in South Korea, Singapore, Malaysia and Thailand. With fewer dependent children relative to the working-age population, these countries made additional investments on health, education, food security and other basic social services which spurred economic growth and helped reduce poverty.

Clearly, by promoting and protecting the right to reproductive health, government would have a better chance of achieving the MDGs, specifically the goals pertaining to the alleviation of hunger and poverty; improved access to primary education; better health for mothers; reduction of infant deaths; holding back the spread of HIV-AIDS; and the preservation of our fragile environment.

V. RH is an Indispensable Development Tool

The empirical nexus between reproductive health and sustainable human development is consistently and clearly established.

According to the UN State of the World Population Report 2002, “family planning and reproductive health are essential to reducing poverty”. The report declares that “countries that invest in reproductive health and family planning and in women's development register slower population growth and faster economic growth”.

The annual UN Human Development Studies also show that countries with higher population growth will invariably score lower on important aspects of human development such as income, physical and emotional well-being, life expectancy, literacy and employment.

Last year, the Philippines, as the 12th most populous country, ranked No. 84 out 171 countries in the Human Development Index rankings made annually by the United Nations. This year, we are down to No. 90. Among Southeast Asian countries, the Philippines fared the worst in the latest rankings. Singapore remained in the 25th slot, Indonesia improved by 1 rank and Vietnam and Brunei each improved their position by four levels. But while Malaysia, Myanmar and Cambodia all slipped two ranks and Thailand fell down by four slots, the Philippines went down by six points.

In a recent study of poverty and its causes in the Philippines, the Asian Development Bank listed an expanding population is one of the major causes of poverty in the country.

Data from the NSO for over a decade demonstrates that there is indeed greater incidence of poverty in larger families. Large families are prone to poverty with 57.3% of Filipino families with seven children mired in poverty while only 23.8% of families having two children live below the poverty threshold.

It should be emphasized that any poverty reduction program that would be undertaken by government must include the reduction of our population growth rate for it to be effective and sensible.

A clear, comprehensive and rights-based policy on reproductive health like House Bill 5043 is just as important to the attainment of sustainable human development as good governance, the eradication of graft and corruption and the redistribution of wealth in the country.

VI. The RH Bill has overwhelming support inside
and outside the House of Representatives

Despite the intensified black propaganda launched against RH bill, it now has 113 coauthors in the House of Representatives.

Notwithstanding the all-out opposition of some members of the Catholic Church hierarchy, House Bill 5043 is now in the period of plenary debate. This is the farthest any bill of this nature has reached since similar measures were filed in 2001.

Public support for the bill is also overwhelming. Just last week the SWS released its 3rd Quarter Social Weather Survey that revealed that 71% of Filipinos support the passage of the RH bill and 76% approve of the teaching of family planning to the youth.

This survey only confirms what opinion polls for the past two decades have been telling policymakers – Filipinos approve of family planning and want an RH law to be enacted. They are also telling lawmakers that religion is not a factor in their family planning decisions because according to the SWS survey, 71% of Catholics are in favor of the bill compared to 68% of non-Catholics.

The bill has likewise received tremendous multi-sectoral support from groups as varied as scientists, professors from UP and Ateneo, and religious organizations such as the Iglesia ni Cristo and Jesus is Lord Movement to labor unions and employers’ associations, human rights groups and medical associations like the Philippine Obstetrical and Gynecological Society, and the vast NGO community.

Indeed, support for the RH bill transcends professions, social class, political orientation and religious affiliations. 

VII. The RH bill will be enacted because it is necessary, beneficial and practicable

Pills and condoms may be available in drugstores but their being physically available does not mean that they are accessible to the women and couples who want and need them most.

This is also true for those who want to utilize natural family planning methods. Women and couples who opt for NFP must be properly trained and provided with modules to help them correctly utilize their method of choice.

As healthcare providers, I am certain you fully recognize the importance of family planning to the health and wellbeing of women and children. The WHO, UNFPA and the medical journal Lancet are unanimous in asserting that correct and consistent use of contraceptives can help prevent one-third of maternal deaths. Studies conducted by the WHO also conclude that proper birth spacing reduces the risk of death for newborns and infants by 50%.

We need to institutionalize by statute a national policy on RH and population development because it will ensure that despite regular changes in national and local leadership, women and couples will always receive relevant information and have access to family planning services.

HB 5043 will benefit the millions of Filipino women who want to plan their families and meet their fertility goals. According to the 2003 National Demographic and Health Survey, the poorer the woman, the larger the gap is between her wanted and actual fertility. The poorest women still have an average of 6.5 children while the richest women consistently meet their fertility goal of 2.5.

The 2006 Family Planning Survey results also show that among the poorest women who want to avoid another pregnancy, at least 41% do not use any contraceptive method because they lack information on and access to family planning methods.

Finally, the bill is practicable because its primary beneficiaries have made it clear in surveys conducted over a period of almost 20 years that they approve of contraceptive use and want to be able to responsibly plan their families.

The support of a professional group as well respected as the PNA will be invaluable in our crusade for the enactment of the reproductive health bill. Majority of you are women and mothers and I know that in your hearts you realize that this bill is necessary and will benefit millions of women and children.

You are in a profession that is in the vocation of saving lives. Please help our legislators enact a bill that will truly be responsive to the health needs of Filipinos by taking a stand and supporting the RH bill because it is pro-poor and pro-women and because ultimately, family planning does save lives.
HB 5043: PROMOTING AND PROTECTING THE RIGHT TO HEALTH AND DEVELOPMENT
(Speech delivered by REP. EDCEL C. LAGMAN at the Interfaith Symposium
on Reproductive Health at the Sulo Hotel on 21 November 2008)

The crusade for the passage of House Bill No. 5043 or the “Reproductive Health, Responsible Parenthood and Population Development Act of 2008” has been difficult not because it lacks merit since the bill is truly meritorious as it is necessary, beneficial and practicable.

The enactment of the bill faces roadblocks not because it is deprived of popular support because survey after survey reveals that the RH bill enjoys the solid support of an overwhelming majority of Filipinos regardless of social class and religion. The latest SWS survey shows that 71% of all Filipinos endorse the passage of the reproductive health bill or even a higher 84% of those who were previously aware of the bill before the last survey.

Neither is the passage of the bill delayed because of lack of supporters in the House of Representatives. In fact, as of today, House Bill 5043 has a total of 113 coauthors, more than a majority of the requisite quorum to approve a bill.

The campaign for the enactment of the RH bill has been made difficult because of the deliberate misinformation campaign being launched against the bill by its critics and the dilatory maneuvers being contrived by its oppositors.

I am therefore thankful for this opportunity to explain the salient provisions of the measure and the chance to counter the misinformation and half-truths being peddled by those against the bill.

I am also eager to emphasize the other elements of RH which have been overlooked since the beginning of the RH debates both within and outside the Halls of Congress.

The current plenary debates in the House of Representatives on House Bill 5043 are instructive and reveal the bigotry and intolerance of its oppositors – normally reasonable and coherent human beings whose personalities turn 180 degrees when the issue being discussed is reproductive health. It is almost incredible to witness their inordinate tenacity in imposing their beliefs on the rest of the populace.

While the RH bill assures an enabling environment where women and couples have the freedom of informed choice on the mode of family planning they want to adopt based on their needs, personal convictions and religious beliefs, RH is certainly not only about contraceptives and family planning.

It is ironic that while the critics of the bill continue to condemn the use of contraceptives as “intrinsically evil”, imagine the downfall of the Filipino family and traditional Filipino values and the predict rise of a “contraceptive mentality”, they are the ones who are in fact guilty of “contraceptive mentality”. They see the RH bill as nothing but a surfeit of pills and condoms.

They are culpable of the very thing they fear – this so-called contraceptive mentality” – because they insist on delimiting, even diminishing, the issue of reproductive health to contraceptives alone when RH is much, much more than merely condoms and pills.

ELEMENTS OF RH
- The RH bill is not principally about contraceptives. It is certainly not about religion. It is about health and rights and this can be seen clearly in the coverage of reproductive health, as proposed in the bill.

Family planning is only one element of reproductive health. Equally important are the other elements of RH which include: (1) maternal, infant and child health and nutrition; (2) promotion of breast feeding; (3) prevention of abortion and management of post-abortion complications; (4) adolescent and youth health; (5) prevention and management of reproductive tract infections, HIV/AIDS and STDs; (6) elimination of violence against women; (7) counseling on sexuality and reproductive health; (8) treatment of breast and reproductive tract cancers; (9) male involvement and participation in RH; (10) prevention and treatment of infertility; and (11) RH education for the youth.

It is a pity that the debate has been confined to family planning because the other elements of RH, which will similarly protect and promote the right to health and reproductive self-determination, have been largely ignored.


STRENGTHENING OF POPCOM
- The POPCOM shall be reoriented to promote both natural and modern family planning methods. Few people know that POPCOM, which is the government agency central to the country’s family planning program, is only promoting for sometime now natural family planning even though only 29% of all women using family planning employ NFP and traditional methods compared to the 71% who use modern contraceptive methods.

MIDWIVES FOR SKILLED BIRTH ATTENDANCE
– The bill supports safe motherhood. It proposes that every city and municipality shall endeavor to employ an adequate number of midwives and other skilled attendants. Skilled attendance at birth will help prevent maternal and infant mortality which are both alarmingly high in the country. Currently, only 57% of Filipino women give birth with the assistance of a trained medical professional.

EMERGENCY OBSTETRIC CARE
- Each province and city shall endeavor to ensure the establishment and operation of hospitals with adequate and qualified personnel that provide emergency obstetric care. If we are to make headway in our commitment to the Millennium Development Goals (MDGs) to lower infant mortality and improve maternal health, it is imperative to provide emergency obstetric care to those who need them. The miracle of life should not mean death for 10 mothers daily and the importance of facilities that can provide life saving services to pregnant women cannot be overemphasized.

HOSPITAL-BASED FAMILY PLANNING - Family planning methods requiring hospital services like ligation, vasectomy and IUD placement shall be available in all government hospitals. Maternal and infant mortality and morbidity are public health concerns that government can address if effective and long-term methods such as IUDs and permanent methods like ligation and vasectomy are readily available in government hospitals – the health facilities the poor and marginalized regularly utilize.

CONTRACEPTIVES AS ESSENTIAL MEDICINES
- Reproductive health products shall be considered essential medicines and supplies and shall form part of the National Drug Formulary. The classification of contraceptives as essential medicines will help the poorest of our women, who continue to have an average of six children, avoid unplanned pregnancies and maternal death. Both the WHO and UNFPA have declared that contraceptive use can prevent 1/3 of all maternal deaths.

Our maternal mortality rate which is pegged at 162 deaths out of every 10,000 live births is both alarming and insidious. Fourteen percent of all deaths in the female population can be attributed to pregnancy and childbirth-related causes (DOH and NDHS 2003). This is unacceptable. No woman should die giving life to another human being.

It should be underscored that modern contraceptives are included in the World Health Organization Model List of Essential Medicines. Their inclusion in the National Drug Formulary will enable government to purchase contraceptives and not merely rely on unpredictable donations.

REPRODUCTIVE HEALTH EDUCATION – RH education in an age-appropriate manner shall be taught by adequately trained teachers from Grade 5 up to 4th Year High School. As proposed in the bill, core subjects include responsible parenthood; natural and modern family planning; proscription and hazards of abortion; reproductive health and sexual rights; abstinence before marriage; and responsible sexuality, among others.

Sexuality education seeks to assist young people in cultivating a positive view of sexuality; provide them with information and skills about taking care of their sexual health; and help them make sound decisions now and in the future. It has also has been shown to make adolescents more sexually responsible and adds a level of maturity to their attitudes towards sexual relations.

Formal education on RH and sexuality is necessary because of the parental default at home where conversations on sex is traditionally taboo.

Moreover, an SWS survey released only last month shows that 76% of Filipinos approve of the teaching of family planning to the youth. Family planning encompasses reproductive health and sexuality education.

IDEAL FAMILY SIZE
- The State shall encourage two children as the ideal family size. This is neither mandatory nor compulsory and no punitive action may be imposed on couples having more than two children. This also approximates the desired number of children by women and couples which is 2.5 children. This is also consistent with the desire of the youth to have only two (2) children (Youth and Adolescent Fertility Survey, 2002).

EMPLOYERS’ RESPONSIBILITIES
- Employers shall respect the reproductive health rights of all their workers. Women shall not be discriminated against in the matter of hiring, regularization of employment status or selection for retrenchment. Employers shall provide free reproductive health services and commodities to workers, whether unionized or unorganized.

These are all restatements and improvements of existing provisions of the Labor Code and prevailing Collective Bargaining Agreements (CBAs).

CAPABILITY BUILDING OF COMMUNITY-BASED VOLUNTEER WORKERS
- Community-based workers shall undergo additional and updated training on the delivery of reproductive health care services and shall receive not less than 10% increase in honoraria upon successful completion of training. This will improve the ability of our barangay health workers to deliver relevant RH information and services.

CERTIFICATE OF COMPLIANCE
- No marriage license shall be issued by the Local Civil Registrar unless the applicants present a Certificate of Compliance issued for free by the local Family Planning Office certifying that they had received adequate instructions and information on family planning, responsible parenthood, breastfeeding and infant nutrition.

PROHIBITED ACTS – The following persons, and no one else, shall be held liable for prohibited acts, as follows:

1. Public and private health care providers who:    

(a) Knowingly (with malicious intent) withhold or impede the dissemination of information about the programs and services provided for in this Act or intentionally give out incorrect information;

(b) Refuse to perform voluntary ligation and vasectomy and other legal and medically-safe reproductive health care services on any person of legal age on the ground of lack of spousal consent or authorization;

(c) Refuse to provide reproductive health care services to an abused minor and/or an abused pregnant minor, whose condition is certified to by an authorized DSWD official or personnel, even without parental consent which is not necessary when the parent concerned is the perpetrator;

(d) Fail to provide, either deliberately or through gross or inexcusable negligence, reproductive health care services as mandated under this Act; and

(e) Refuse to extend reproductive health care services and information on account of the patient’s civil status, gender or sexual orientation, age, religion, personal circumstances, and nature of work: Provided, That all conscientious objections of health care service providers based on religious grounds shall be respected: Provided, further, That the conscientious objector shall immediately refer the person seeking such care and services to another health care service provider within the same facility or one which is conveniently accessible: Provided, finally, That the patient is not in an emergency or serious case as defined in RA 8344 penalizing the refusal of hospitals and medical clinics to administer appropriate initial medical treatment and support in emergency and serious cases.

2. Any public official who prohibits or restricts personally or through a subordinate the delivery of legal and medically-safe reproductive health care services, including family planning (inaction is not culpable).

3. Any employer who shall fail to comply with his obligation under Section 17 of this Act or an employer who requires a female applicant or employee, as a condition for employment or continued employment, to involuntarily undergo sterilization, tubal ligation or any other form of contraceptive method.

4. Any person who shall falsify a certificate of compliance as required in Section 14 of this Act.

5. Any person who maliciously engages in disinformation about the intent or provisions of this Act.

Now that I have discussed the most relevant provisions of the RH bill, I would like to answer some of the misconceptions about the measure.

The bill is not anti-life. It is pro-quality life. It will ensure that children will be blessings to their parents since their births are planned and wanted. It will empower couples with the information and opportunity to plan and space their children. This will not only strengthen the family as a unit, it will optimize care for fewer children who will have more opportunities to be educated, healthy and productive.

The bill does not favor modern family planning methods over NFP. Both natural and modern family planning techniques are contraceptive methods. Their common purpose is to prevent unwanted pregnancies and the bill does not impose a bias for either method.

The bill does not legalize abortion and will not lead to its legalization. It is false and malicious to claim that the RH bill legalizes abortion. The measure repeatedly underscores that abortion is illegal, criminal and punishable, and is not part of the menu of legally permissible and medically safe family planning methods.

It is likewise misleading and inaccurate to claim that the use of contraceptives will eventually lead to the legalization of abortion. Catholic countries like Panama, Guatemala, Brazil, Chile, Columbia, Dominican Republic, El Salvador, Honduras, Nicaragua, Venezuela, Paraguay and Ireland all prohibit abortion as a family planning method even as they vigorously promote contraceptive use. Muslim and Buddhist countries like Indonesia and Laos have likewise liberalized the use of contraceptives but still continue to criminalize abortion.

Moreover, there is an inverse correlation between contraceptive use and abortion. The regular and correct use of contraceptives drastically reduces abortion rates since unplanned and unwanted pregnancies are avoided. Consequently, women do not have to resort to abortion and the State will find no need to legalize abortion.

The bill does not endorse abortifacients. Hormonal contraceptives are BFAD-approved, medically safe and legal. The primary mechanism of pills and injectables is to suppress ovulation. If no egg is released, how can there be an abortion? They also prevent the sperm from reaching the egg. If fertilization is avoided, how can there be a fetus to abort? Articles in peer-reviewed medical journals testify that IUDs do not cause abortions because they stop fertilization. A recent study revealed that not a single fertilized egg was recovered from the fallopian tubes of women using IUDs proving that they are amazingly successful in preventing fertilization.

In fact, the UNDP, UNFPA and WHO have submitted to the House of Representatives an expert opinion on the mechanisms of modern contraceptives and they state that contraceptives “cannot be labeled as abortifacients” as none of these methods have been shown to cause abortions.

The bill is truly anti-abortion. It will tremendously reduce the incidence of abortion in the country which in 2002 has been recorded to be about 470,000 and the UN estimates that it has reached 800,000 today. Data also show that it is not single women and teenagers but poor, married, Catholic women in their 20s who most often undergo abortions because they cannot afford another child.

Contraceptives do not have life threatening side-effects. Medical and scientific evidence show 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 riding a car is 1 in 5,900. 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. The probability of dying from condom use is absolutely zero. But the risk of dying from a pregnancy is 1 in 10,000.

The bill will not promote contraceptive mentality. The bill does not prohibit pregnancy. Critics are mistaken in claiming that because contraceptives would be readily accessible, people would prefer to have no children at all. Couples will not stop wanting children simply because contraceptives are available. Contraceptives are used to prevent unwanted pregnancies but not to stop pregnancies altogether. Timely pregnancies are assured.

Sexuality education will not spawn “a generation of sex maniacs” nor promote promiscuity. Age-appropriate RH education promotes correct sexual values. It will not only instill consciousness of freedom of choice but responsible exercise of one’s rights. The UN and countries which have youth sexuality education document its beneficial results like understanding of proper sexual values; initiation to sexual relations is delayed; abstinence before marriage is encouraged; multiple sex partners is avoided; and spread of sexually transmitted diseases is prevented.

Parents who do not allow their children to attend RH and sexuality education classes will not be prosecuted and jailed. The provision on Prohibited Acts does not include parents who raise objections.

The bill does not claim that family planning is the panacea to poverty. It simply recognizes the verifiable link between a huge population and poverty. Unbridled population growth stunts socio-economic development and aggravates poverty. The connection between population and development is well-documented and empirically established.

UN Human Development Reports show that countries with higher population growth invariably score lower in human development. Last year, the Philippines, as the 12th most populous country, ranked No. 84 out 171 countries in the Human Development Index rankings made annually by the United Nations. This year, we are down to No. 90. Among Southeast Asian countries, the Philippines fared the worst in the latest rankings. Singapore remained in the 25th slot, Indonesia improved by 1 rank and Vietnam and Brunei each improved their position by four levels. But while Malaysia, Myanmar and Cambodia all slipped two ranks and Thailand fell down by four slots, the Philippines went down by six points.

The Asian Development Bank in 2004 also listed a large population as one of the major causes of poverty in the country. Recent studies also show that large family size is a significant factor in keeping families poor across generations.

However, the authors of the bill do claim that the bill will help promote sustainable human development. The UN has stated that “family planning and reproductive health are essential to reducing poverty” The UNICEF also asserts that “family planning could bring more benefits to more people at less cost than any other single technology now available to the human race.”

Family planning will not lead to a demographic winter. The proposition that the use of modern family planning will wipe off the Filipino race in a catastrophic “demographic winter” is a scare tactic which fails to comprehend the dynamics of population momentum wherein the country’s population will continue to grow even if the population growth rate is increasingly reduced to below replacement levels.

Experts led by UP Economics professors have declared in a paper entitled “Population and Poverty: The Real Score” that given the excruciatingly slow decrease in our Total Fertility Rate, a so-called demographic winter will not happen in the country for “at least another 100 years”.

According to the projections of the National Statistics Coordination Board, if our TFR continues to decrease by 0.2 children every five years, replacement fertility of 2.1 children will be achieved only by 2040. However, the effects of “population momentum” or the continuous increase in population will go on for another 60 years by which time the population of the country would have reached 240 million.

An RH law will not be superfluous. It is a myopic view that since contraceptives are available in the market, there is no need to enact a law on reproductive health and family planning. This contention overlooks that availability does not mean access, particularly to those who are uninformed or could not afford to buy reproductive health supplies. Availability does not assure adequate and accurate information on family planning and reproductive health which are basic universal human rights.

There are 12.86 million currently married women of reproductive age in the country. But we have a contraceptive prevalence rate of only 49.3% (2006 Family Planning Survey).

For those who are using any form of contraception, 26.2% use supply methods like condoms, pills and IUDs; 9.5% use permanent methods like ligation and vasectomy; 13.2% use traditional methods such as withdrawal and calendar-rhythm and only 0.4% use modern natural family planning like Standard Days Method, Mucus/Billings/Ovulation Method and Lactational Amenorrhea Method.

The 2006 FPS also reveals that a staggering 2.6 million women do not want to get pregnant but are not using any form of family planning for lack of information and access. This belies the claims of the measure’s critics that the RH bill will be superfluous because contraceptives are readily available.

Moreover, when the poorest Filipino women still have an average of six children, which almost three times their desired fertility, and 44% of their pregnancies is unwanted, it is clear that the most poverty-stricken women in the country are denied their basic human right to family planning.

Family planning, as a vital component of reproductive health, does not only ensure the health of mothers and children. Family planning saves lives. The WHO and UNFPA have declared that close to 200,000 maternal deaths and 1 million infant deaths worldwide could be avoided annually if women use contraception.

We need to enact HB 5043 because it promotes and protects the right to health, the right to informed choice, the right to reproductive self-determination, the right to voluntary motherhood and the right to sustainable human development.

I have been a legislator for more than 20 years and no bill I had filed has garnered more attention and merited more invitations to speak before groups ranging from seminarians and teenagers to physicians and professors than the RH bill. This issue has truly elicited a passionate response and heartfelt reactions from both those strongly supporting and rabidly denouncing the bill.

Long before plenary debates on HB 5043 began, forums and discussions on the bill were already being held in classrooms, churches, boardrooms, in marketplaces and factories and even in cyberspace.

The Catholic Church hierarchy is on an all-out campaign against the RH bill. Consistent with its obsolete precepts, the Catholic Bishops’ Conference of the Philippines (CBCP) together with its lay proxies, has activated the archaic meaning of the word “campaign” as “war”.

In the face of the Bishops’ rampage, are we going to suffer being trampled in their warpath?

Let us all stand up and be counted. Let us fiercely and fearlessly do battle for “Choice, Women and Life”!

Let us be vigilant crusaders and join the other RH advocates in the plenary gallery of the House of Representatives every Tuesday and Wednesday afternoon until evening to express steadfast support and be part of our impending victory.
REPRODUCTIVE HEALTH IS ABOUT RIGHTS
(Speech delivered by REP. EDCEL C. LAGMAN before the
Philippine Bar Association on 15 October 2008)

I cannot recall having filed a non-controversial bill. Perhaps, bills of genuine national import are controversial ab initio or subsequently become controversial.

Among my highly controversial bills were the comprehensive agrarian reform bill, the debt cap bill which proposed to limit our foreign debt service to 15% of the country’s export receipts, the bill abolishing the death penalty and the bill which modernized the practice of optometry and dismantled the corporate practice of the profession.

Except for the debt cap bill, all of these measures were eventually enacted into law.

My advocacy for the debt cap, agrarian reform and abolition of the death penalty had an enduring partner: the Roman Catholic Church hierarchy, which is still a partner with respect to the pending extension of the land acquisition and distribution (LAD) component of the Comprehensive Agrarian Reform Law (CARL), of which I am the principal author and sponsor.

However, many Catholic bishops vilify the reproductive health bill because it challenges the orthodoxy of the Church on family life and the procreative function of marriage.

The Catholic hierarchy must abandon its antediluvian doctrines or suffer isolation from the mainstream of Philippine society. It must heed the faithful who are overwhelmingly in favor of reproductive health and family planning.

Considering that I speak before fellow lawyers, I shall underscore the relevance of reproductive health to the protection and promotion of people’s rights as well as the constitutional validity of the bill.

Reproductive health and family planning
are basic universal human rights.

Reproductive health is a fundamental human right and was affirmed as such in the Proclamation of Tehran, International Conference on Human Rights 40 years ago in 1968.

The right to reproductive health and family planning was subsequently reiterated in numerous other UN Conventions of which the Philippines is likewise a signatory.

The Philippines is also committed to achieving the Millennium Development Goals, among which are the reduction of infant mortality and the improvement of maternal health. The MDGs were recently amended to underscore that family planning is indispensable to the attainment of these two goals.

Freedom of Informed Choice

Central to the RH bill is the freedom of informed choice. An enabling environment shall be created to allow women and couples to freely choose the method of family planning from the natural to the modern that they wish to adopt consistent with their personal needs and individual consciences.

The government shall conduct a massive information campaign on the benefits of family planning without any bias for or against any method. The only limitation is that the entire menu of family planning methods must be legal and medically-safe.

The government shall afford acceptors access to the family planning supplies of their choice which shall be given free to the poor and marginalized.

A sustained information campaign shall be undertaken because freedom of choice will not be meaningful if there is no prior complete and accurate information. This includes the possible side-effects and failure rates of the various methods of family planning.

It is in this sensitive campaign of giving factual and truthful information that the misinformation being peddled by the oppositors of the bill should be exposed and rebutted, like the following:

1. It is false and malicious to claim that the RH bill legalizes abortion. It does not. The measure repeatedly provides to the point of superfluity that abortion is illegal, criminal and punishable, and is not part of the menu of legally permissible and medically safe family planning methods.

2. It is likewise misleading and inaccurate to claim that the use of contraceptives will eventually lead to the legalization of abortion. Catholic and Muslim countries which have liberalized the use of contraceptives still continue to criminalize abortion. Moreover, there is an inverse correlation between contraceptive use and abortion. The regular and correct use of contraceptives drastically reduces abortion rates since unplanned and unwanted pregnancies are avoided.

Consequently, women do not have to resort to abortion and the State will find no need to legalize abortion.

3. It is utterly unchristian and grossly inhuman to assert that medical care should not be extended to women suffering from post-abortion complications because to do so would condone and encourage abortion. Like a wounded rebel in an encounter with government forces, women in distress must not be deprived of medical help.

4. The proposition that the use of modern family planning will wipe off the Filipino race in a catastrophic “demographic winter” is a scare tactic which fails to comprehend the dynamics of population momentum wherein the country’s population will continue to grow even if the population growth rate is increasingly reduced to below replacement levels.

The importance of policymaking is that policies are never cast on stone. They are flexible and reversible. Given the experiences of countries like Singapore, South Korea and Japan where there is a thinning young population and there is need to accelerate PGR, the Philippines can anticipate well in advance these eventualities without forfeiting the vast opportunity of economic growth by currently mitigating population expansion.

5. Commending labor migration as the beneficent result of “population power” is a misplaced accolade to inordinate fertility. Dollar remittances from OFWs should not blind us to the incalculable social and economic costs of labor migration.

Moreover, the so-called “population power” has just exploded in our faces as the bleak scenario unfolds with OFWs returning home because there is a depressed market for overseas employment as a consequence of the collapse of Wall Street.

6. The issue on population is not a simple matter of “population density” but more importantly, it is a question of sustainable human development. Concededly, there are still vast unpopulated areas of the country but these are places hostile to human development because there are no infrastructures in place, no schools, no hospitals, and no visible means of livelihood and employment.

Certainly, we can place the entire world’s population of 6.5 billion people in an area the size of the State of Texas. But they would end up eating each other’s sewage!

7. It is a myopic view that since contraceptives are available in the market, there is no need to enact a law on reproductive health and family planning. This contention overlooks that availability does not mean access, particularly to those who are uninformed and could not afford to buy reproductive health supplies.

8.  It is grossly medically unfounded to allege that all contraceptives are life threatening and contraceptive use results to fatal diseases. This misinformation is negated by the data of medical authorities. For example, experts report that the risk of dying within a year (not actual death) is: one out of two hundred thousand (200,000) pill users; one out of one million (1,000,000) who have undergone vasectomy; one out of ten million (10,000,000) users of IUD; and zero (0) for condom users. This is compared to one out of 5,900 motor vehicle travelers and one out of ten thousand (10,000) non-high risk pregnancies.

The RH Bill is Constitutional

An inordinately huge population impacts negatively on all indicators of human development such as quality education, adequate medical care, food security, availability of employment, sufficient mass housing and a healthy ecology.

Invariably, all the more populous countries in the world rank low in human development. The Philippines, which is the 12th most populous country in the world with 88.4 million people is 84th in the 2006 UN-measured Human Development Index.

The salutary constitutional provisions on the right to quality education (Sec. 1, Article XIV); right to health (Sec. 15, Art. II); right to a family living wage and income (Sec. 3(2), Art. XV); right to a balanced and healthful ecology (Sec. 16, Art. II); and the right of children to proper care and nutrition and protection from all forms of neglect, abuse, cruelty, exploitation and other conditions prejudicial to their development, will all be illusory if the government is unable to promote reproductive health and family planning as indispensable tools to manage population growth and achieve sustainable human development.

The RH bill accords fealty to these constitutional rights and mandates.

House Bill No. 5043 is being faulted for being violative of the Section 12, Article II of the Constitution which reads:

“The State recognizes the sanctity of family life and shall protect and strengthen the family as a basic autonomous social institution. It shall equally protect the life of the mother and the life of the unborn from conception. The natural and primary right and duty of parents in the rearing of the youth for civic efficiency and the development of moral character shall receive the support of the Government.” (underscoring supplied).

The constitutional challenge is baseless for the following overriding reasons:

1. The RH bill does not violate or intrude on the “sanctity of family life”. On the contrary, it discharges the obligation of the State to protect and strengthen the family.

The family is more than a natural unit. It is a social institution whose well-being is impressed with public interest and concern.

Verily, it is not immune from legislation. It has to be amenable to the State’s exercise of police power for its protection and development. Hence, there are relevant laws like the Civil Code of the Philippines; Family Code of the Philippines (EO 209); the Child and Youth Welfare Code (PD 603); and the Special Protection of Filipino Children Against Child Abuse, Exploitation and Discrimination Act (RA 7610), among others.

The RH bill aims to protect the family from poverty and want by helping women and couples achieve their fertility goals.

Empirical studies consistently document that larger families are almost invariably poorer than smaller families. Moreover, large family size perpetuates poverty across generations.

According to the UN State of the World Population Report 2002, “family planning and reproductive health are essential to reducing poverty.” The report declares that “countries that invest in reproductive health and family planning and in women’s development register lower population growth and faster economic growth.”

In a recent study of poverty and its causes in the Philippines, the Asian Development Bank listed an expanding population as one of the major causes of poverty in the country.

2. The bill does not supplant the primary right of parents in the “… development of moral character” of the youth even as it proposes the mandatory teaching of age-appropriate reproductive health and sexuality education in all schools from Grade 5 to Fourth Year High School.

This is giving support, as required by the Constitution, to parents, particularly to the vast majority who have defaulted in imparting reproductive health and sexuality education to their children simply because discussing sex at home is generally taboo.

Consequently, the young get their information on sexuality from polluted and inaccurate sources – peer groups, entertainment media and the internet.

Verily, there is critical need for formal reproductive health and sexuality education in schools.

The fear that sex education would breed youthful “sex maniacs” and develop a culture of promiscuity is grossly unfounded.

Studies by the UN and progressive countries reveal the beneficent results of reproductive health and sexuality education among the young. These are:

(a)    Inculcation of correct and relevant sexual values and norms in the young which disabuses their minds of preconceived myths on sex and responsibly addresses their curiosity so much so that experimenting is foreclosed;
(b)    Initiation into sexual activity is delayed;
(c)    Multiple sexual partners are avoided;
(d)    Abstinence before marriage is encouraged; and
(e)    Spread of HIV-AIDS and sexually transmitted diseases is prevented.

3. The use of legal and medically-safe contraceptives, which are not abortifacients, and which are tested and registered by the Bureau of Food and Drugs (BFAD), does not violate the constitutional provision on the obligation of the State “to equally protect the life of the mother and the life of the unborn from conception.”

The genesis of this provision in the Constitutional Commission establishes the following:

(a) The purpose of this provision is to preempt the Congress and the Supreme Court from legalizing abortion. This bill definitely does not legalize abortion.

The anti-abortion intent of this provision is admitted both by its principal proponent, Commissioner Bernardo Villegas, and Commissioner Joaquin Bernas who initially proposed a similar provision as Section I of the Bill of Rights which read: “The right to life extends to the fertilized ovum.” (underscoring supplied).

This Bernas proposal did not materialize. Its non-adoption unmistakably manifests that the concept that life begins at fertilization was not constitutionalized for lack of concurrence from the Commissioners.

After the deletion of the Bernas proposal in the Bill of Rights, another formulation was included in Article II on the Declaration of Principles which originally read: “The State shall protect human life from the moment of conception.”

It is important to note that under the foregoing draft, it is suggested that human life begins “from the moment of conception”, not anymore from the fertilization of the ovum.

This also confirms the thinking of the Commissioners that the “fertilization of the ovum” is not the same or synonymous to “conception”. The two refer to different stages of the reproductive process.

(b) As finally adopted, it is provided that the State “… shall equally protect the life of the mother and the life of the unborn from conception.”

There were two amendments in the approved final provision: (1) the phrase “the moment of” preceding “conception” was deleted; and (2) the phrase “the life of the mother” was included. These two amendments are very significant.

The deletion of the phrase “the moment of” was the result of the Commissioners’ uncertainty as to the precise beginning of conception. Hence, they decided to defer to medical science and subsequent legislation the determination of the start of conception.

The international scientific community and numerous medical dictionaries and textbooks define the beginning of pregnancy or conception as the moment the fertilized ovum attaches itself to the lining of the uterus. Pregnancy, therefore, starts one to two weeks after fertilization.

The American College of Obstetricians and Gynecologists defines conception as “the implantation of the blastocyst. It is not synonymous with fertilization.” The National Institute of Health/Food and Drug Administration states that “Pregnancy encompasses the period of time from confirmation of implantation until expulsion or extraction of the fetus.”

Verily, the fertilized egg has no sustainable viability outside of the uterine wall. It has to implant in the uterus to have sustainable life and for gestation to progress or for pregnancy to begin.

Consequently, the International Federation of Gynecologists and Obstetrics (FIGO) defines abortion as “the termination of pregnancy after implantation and before the conceptus has become independently viable.”

It is important to note that this international medical organization expressly states that for an act to be considered an abortion, the fertilized egg must already be implanted in the uterus.

Verily, the bill does not offend the constitutional intent proscribing abortion. In fact, it repeatedly reiterates the national policy against abortion. Moreover, the RH bill is even an anti-abortion measure because it respects the option of women and couples to use legal and medically-safe contraceptives which reduces abortion rates by 85%.

In the Philippines, it has been established that majority of those who undergo induced abortion are not teenagers or single women. They are married Catholic women with ages ranging from 21 to 29 who do not want another pregnancy or could not afford another child because of poverty or lack of resources. (State of the Philippine Population Report, 2001).

(c) The proceedings of the Constitutional Commission show that there was no intention to ban contraceptives which are not abortifacient.

Contraceptives like pills and injectables which prevent a woman from ovulating are not abortifacients because in the first place, no egg is released for fertilization. Similarly, contraceptives which weaken the sperm to incapacitate it from fertilizing an egg cannot be considered abortifacient because there is no fertilized egg for implantation in the uterine wall.

In the same token, IUDs which principally slow down the sperm to prevent them from reaching the egg are also not abortifacients. The primary action of IUDs is to “release copper ions which are toxic to sperm.”

The notion that contraceptives prevent implantation has been debunked by the UNDP, UNFPA and WHO. In their joint position paper submitted to the House of Representatives, they stated unequivocally that there is “no scientific evidence supporting this possibility. Therefore contraceptives cannot be labeled as abortifacients.” (underscoring supplied).

True to its nomenclature, a contraceptive is an antidote to conception or anti-conception. Hence, contraceptive use prevents conception. In the absence of conception, there is no life of the unborn to be protected.

(d) The importance of the second amendment which included the protection of “the life of the mother” is lost because of the undue emphasis on protecting “the life of the unborn from conception.”

The Constitution mandates the equal protection of the life of the mother and the life of the unborn.

In fact, when both the lives of the mother and the unborn are imperiled, the invariable option is to save the life of the mother if both lives could not be saved. The doctor’s primary obligation is to the mother because it is she who is the patient.

Family planning, as a vital component of reproductive health, does not only ensure the health of mothers and children. Family planning saves lives. The WHO, UNFPA and the medical journal Lancet are unanimous in declaring that the use of reliable contraceptives decreases maternal mortality by one-third. Close to 200,000 maternal deaths worldwide could be avoided annually if women use contraception.

The body of a woman needs at least three years to fully recuperate from pregnancy and childbirth. The use of contraceptives prevents unremitting pregnancies which endanger the lives of mothers and infants.

It is indubitable that based on the foregoing discussion, HB 5043 is constitutional and actualizes the people’s rights related to reproductive health and family planning.

Popular support to the RH Bill


Vox populi, vox Dei (the voice of the people is the voice of God) and vox populi est suprema lex (the voice of the people is the supreme law) are truisms most relevant to the RH campaign. Consider the following popular survey results for almost two decades:

•    96% of Catholics say it is important to have the ability to control their fertility and most approve of the use of contraceptives expressly forbidden by the Church (SWS, July 1991).

•    Pulse Asia has conducted regular surveys (1995, 2001, 2004 and 2007) on family planning and the results have consistently revealed that Filipinos believe in the importance of family planning. The 2007 results reveal:

    92% of all Filipinos believe that it is important to have the ability to control one’s fertility and plan one’s family.
    93% of all Roman Catholics surveyed said that family planning is important. This is an even higher percentage than the national average of 92%.
    89% of all Filipinos support government funding for modern methods of family planning.
    90% of all Roman Catholics surveyed agreed that government should allocate funding to modern FP methods. Again, this is an even higher percentage than the national average of 89%.
    The top three ethnic groups which support public funding for contraceptives are: Bicolanos (96%), Pangasinenses (96%) and Kapangpangans (95%).
    75% of Filipinos will support candidates who are in favor of a government budget for family planning.
    76% of Filipinos consider it important that a candidate includes family planning in his or her program of action.
    77% of Roman Catholics surveyed say that it is important that family planning be included in a candidate’s program of action. Again, this is even higher than the national average of 76%.

House Bill No. 5043 or the “Reproductive Health, Responsible Parenthood and Population Management Act of 2008” has strong support inside and outside the House of Representatives. To date, 113 members of the House have coauthored the bill even as tremendous multi-sectoral support continues to increase.

This bill has the longest gestation in Congress with precursor measures dating back to the 8th Congress (1987-1992).

Now, it has irreversibly reached the period of plenary debates. Its eventual approval is almost a certainty because it is necessary, beneficial and practicable.

And, it is also rights-based and constitutional.