The eight Millennium Development Goals (MDGs) and the Philippines

     The eight Millennium Development Goals (MDGs) – which range from halving extreme poverty to halting the spread of HIV/AIDS and providing universal primary education, all by the target date of 2015 – form a blueprint agreed to by all the world’s countries and all the world’s leading development institutions. They have galvanized unprecedented efforts to meet the needs of the world’s poorest.

      In September 2000, building upon a decade of major United Nations conferences and summits, world leaders came together at United Nations Headquarters in New York to adopt the United Nations Millennium Declaration, committing their nations to a new global partnership to reduce extreme poverty and setting out a series of time-bound targets - with a deadline of 2015 - that have become known as the Millennium Development Goals.
     The Millennium Project was commissioned by the United Nations Secretary-General in 2002 to develop a concrete action plan for the world to achieve the Millennium Development Goals and to reverse the grinding poverty, hunger and disease affecting billions of people. In 2005, the independent advisory body headed by Professor Jeffrey Sachs, presented its final recommendations to the Secretary-General in a synthesis volume “Investing in Development: A Practical Plan to Achieve the Millennium Development Goals.” 
     The United Nations Millennium Campaign, started in 2002, supports and inspires people from around the world to take action in support of the Millennium Development Goals. Watch the videos by the Millennium Campaign on poverty, education, women’s empowerment, maternal health and the environment and discover how the lives of ten ordinary people around the world are impacted in profound ways by the level of progress their countries have made towards achieving the Goals. 
     "Eradicating extreme poverty continues to be one of the main challenges of our time, and is a major concern of the international community. Ending this scourge will require the combined efforts of all, governments, civil society organizations and the private sector, in the context of a stronger and more effective global partnership for development. The Millennium Development Goals set timebound targets, by which progress in reducing income poverty, hunger, disease, lack of adequate shelter and exclusion — while promoting gender equality, health, education and environmental sustainability — can be measured. They also embody basic human rights — the rights of each person on the planet to health, education, shelter and security. The Goals are ambitious but feasible and, together with the comprehensive United Nations development agenda, set the course for the world’s efforts to alleviate extreme poverty by 2015. "
United Nations Secretary-General BAN Ki-moon

The 8 MDGs at the National Progress Level: An Overview to the Philippines

     To reach these targets, each country needs to ensure that the MDGs are prioritized and integrated into their respective development plans with efficient monitoring, localization, and advocacy systems put in place; crucial financing secured; multisectoral support mobilized; and an enabling environment created with an MDG-responsive policy framework and legislation. In partnership with international and country-based organizations, the Philippines has made encouraging strides to achieve the MDGs, particularly in the alleviation of extreme poverty; child mortality; incidences of HIV/AIDS, tuberculosis, and malaria; gender equality in education; household dietary intake; and access to safe drinking water.
     Underpinning these gains are two facts. First, the MDGs have been integrated into the Medium-Term Philippine Development Plan (MTPDP) 2004-2010, thus allowing government strategies, policies, and action plans to simultaneously address MDG targets. Second, the government has closely monitored its own rate of progress with MDG indicators, and has used this information to fine-tune planning and implementation processes, particularly at the local level.
     Nevertheless, serious challenges and threats remain with regard to targets on maternal health, access to reproductive health services, nutrition, primary education, and environmental sustainability. Moreover, glaring disparities across regions persist, as do severe funding constraints.
     The probability of attaining the targets depends largely on the confluence of several factors. Among them are the scaling up of current efforts on all target areas; more efficient synchronization and allocation of available limited resources; and stronger advocacy as well as the enhanced capability of MDG implementation at the local level.
  Goal 1: Eradicate extreme poverty and hunger

Pace of progress of the Philippines in terms of attaining the target
Targets and Indicators Pace of progress Probability of attaining the target
Target 1.A: Halve, between 1990 and 2015, the proportion of people whose income is less than one dollar a day
Proportion of population below poverty threshold 0.88 Medium
Proportion of population below food threshold 1.28 High
Target 1.C: Halve, between 1990 and 2015, the proportion of people who suffer from hunger
Prevalence of underweight children under-five years of age 0.67 Medium
Proportion of households with per capita intake below 100 percent dietary energy requirement 0.79 Medium
Based on the 2010 Philippines Progress report on the Millennium Developments Goals (MDGs)

     Extreme poverty refers to the proportion of population or families living below the subsistence or food threshold. As of 2003, the proportion of people with incomes below the subsistence threshold was 13.5 percent (10.2 %of all Filipino families), down from the baseline figure of 24.3 percent (20.4 % of all Filipino families) in 1991. This represents a decline of 0.90 percentage point each year. At this annual rate of decline, the Philippines is on track in meeting its target of halving the proportion of people below the food threshold. The MTPDP 2004-2010 has set a higher target in terms of proportion of families below subsistence threshold at 8.98 percent in 2010.
     However, there is a cause for concern if one looks at subsistence incidence rates of population by region. In 2003, 11 of the country’s 17 regions had subsistence incidence rates that exceeded the national average. This was led by Zamboanga Peninsula (Region 9) in Mindanao with an incidence rate of 32.7 percent, followed by CARAGA, also in Mindanao, with 30.9 percent, and Region 5 with 26.6 percent. Only four regions [the NCR, Cagayan Valley (Region 2), Central Luzon (Region 3), CALABARZON (Region 4-A)] had subsistence incidence rates in the single digit range, from 0.7 percent for the NCR and 7.6 percent for Region 2. The five regions effectively pulled down the national average with their low incidence rates.
     The overall poverty incidence rate for households and the population and movements in the national average also indicate good prospects in meeting Goal 1. In 2003, the poverty incidence rates were 24.4 percent and 30 percent for households and the population, respectively, compared to the baseline 1991 figures of 39.9 percent and 45.3 percent. The poverty incidence rates for households and the population had declined each year by about 1.2 percent. At such a rate of decline, these poverty incidence rates would have been reduced by half in 2006.
     Looking however at poverty incidence rates by region, the imbalance is again very noticeable. Only three (3) regions, namely, Central Luzon, CALABARZON and the NCR had household poverty rates that were less than the national average. The remaining 14 regions had poverty rates that exceeded national figures, with CARAGA, ARMM (Autonomous Region of Muslim Mindanao) and Region 9 topping the chart at 47.1 percent, 45.4 percent, and 44 percent, respectively. This regional imbalance suggests that efforts to reduce poverty must reach all regions of the country indicating progressive instead of regressive measures. This means that to overcome the problem, regions with poverty incidence rates above the national average must receive more than a proportionate share of resources.
     The proportion of households with food intake per person that is less than hundred-percent dietary energy requirement was 69.4 percent in 1993. This figure decreased to 56.9 percent in 2003, representing a decline of 1.25 percent each year. The target is to bring down this indicator to 34.7 percent in 2015. This requires an annual decline of 1.85 percent from 2003 forward. To achieve this, the progressive approach must be applied to the regions exceeding 56.9 percent of which, there are eight, namely, CALABARZON, Bicol Region (Region 5), Central Visayas (Region 7), Eastern Visayas (Region 8), Zamboanga Peninsula, Northern Mindanao (Region 10), SOCSARGEN (Region 12), and the ARMM.
  Concerning the prevalence of underweight preschoolers, the National Nutrition Survey (NNS) conducted by the Food and Nutrition Research Institute (FNRI) showed a decline from 30.6 percent in 2001 to 26.9 percent in 2003. This declined further to 24.6 percent in 2005. The target by 2015 is 17.25 percent, which requires an annual decline of 0.74 percent. If the rate of decline between 2001 and 2005 of 1.5 percent each year can be maintained, the likelihood of meeting the 2015 target is high. To accelerate the decline, a progressive approach must be applied to the 10 regions with proportion of underweight children exceeding the national average, e.g., Ilocos Region, MIMAROPA (Region 4-B), Bicol Region, Western Visayas (Region 6), Central Visayas, Eastern Visayas, Zamboanga Peninsula, Northern Mindanao (Region 10), SOCSARGEN, and ARMM.
     Consistent with gender equality, proper nutrition is critical for women during pregnancy and lactation, both for their own health and for their children to have the best possible start. It is estimated that 28.4 percent of pregnant women were nutritionally at-risk in 2005, based on the weight-for-height index. In addition, about 40 percent of pregnant women were anemic, with even higher levels of 50 percent and over in some provinces in Mindanao in 2006.
     The diet of pregnant women was also found to be grossly inadequate, with 78.4 percent adequacy level for calories and low micronutrient levels. These conditions increase the risk of both maternal mortality and the delivery of low-birth weight infants. The latter, in turn, are also at risk of dying within their first year or of becoming undernourished in their pre-school years. 

Goal 2: Achieve universal primary education
Pace of progress of the Philippines in terms of attaining the target
Targets and Indicators Pace of progress Probability of attaining the target
Target 2.A: Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling
Elementary education net enrolment rate .00 Low
Elementary education cohort survival rate 0.30 Low
Elementary education completion rate 0.29 Low
Based on the 2010 Philippines Progress report on the Millennium Developments Goals (MDGs)

     The figure shows that in SY 2002-2003, the NER or participation rate in primary or elementary education3, both public and private, of the school-age population 6 to 11 years was 90.29 percent. The most recent figure for SY 2005-2006 indicated a decline in the participation rate at 84.44 percent with a huge decline noted in the urban areas. By region, CALABARZON accounted for the highest NER of 92.87 percent, with the lowest in CARAGA at 74.8 percent.
     Cohort survival rate (CSR) at elementary level exhibited an erratic trend from 2000 to 2005 and was 69.9 percent as of 2005, indicating that the retention ability of schools calls for improvement. Meanwhile, dropout rates at the elementary level showed an increasing trend from 2001 to 2005. More learners dropped from the system but the number decreased as they reached higher grades.
     In terms of completion rate (CR) the trend tended to decrease from 2002 to 2005 and was 67.99 percent in 2005. The weak ability of the government to provide complete basic education services in more than 7,000 barangays in the country may be one of the reasons for the low completion rate in 2005. Of the 37,496 elementary schools established in 2005, some 7,766 or about 21 percent had incomplete grade-level offerings. Overall, the country is lagging behind in achieving the MDG target of achieving universal access to primary education as measured by NER, CSR and CR.
     There was less disparity across regions in terms of NER for both public and private schools in 2005, ranging from a high of 92.87 percent (CALABARZON) to a low of 74.8 percent (CARAGA). In terms of enrolment, there was almost parity between children in urban and rural areas but was slightly in favor of children in rural areas.
     With regard to CSR, there was wide disparity across regions, ranging from a high of 86.83 percent (Region 1) to a low of 36.2 percent (ARMM). The regional disparity in terms of completion rate was also wide during the same year ranging from a high of 85.48 percent (Region 1) to a low of 34.76 percent (ARMM). The ARMM showed a relatively high NER, but it ranked the lowest in terms of efficiency as shown by its low cohort survival and completion rates.
     In terms of efficiency of the elementary school system, more children in the rural areas were disadvantaged than in urban areas. Among the reasons for the urban-biased elementary completion rate are the high number of incomplete school buildings in rural/remote areas, much higher malnutrition rates and incidence of child labor in rural areas compared with the urban areas (in 2001 for example, 7 out of 10 working children in the 5-17 age group resided in the rural areas).
     It is interesting to note that participation rates in primary education by region is inversely correlated with the incidence rates for food and overall poverty. The regions with highest participation rates showed the lowest poverty incidence rates, namely, the NCR, Ilocos Region, Cagayan Valley, Central Luzon, and CALABARZON. Accordingly, these five regions had the highest cohort survival rates and lowest dropout rates. The observed correlations among these variables suggest that investment in primary education is promising for poverty reduction. The above correlations support the importance of adopting progressive approaches in fighting poverty and investing in primary education. Such an approach raises the likelihood of accelerating the realization of MDG targets.
Goal 3: Promote Gender Equality
Pace of progress of the Philippines in terms of attaining the target
Targets and Indicators Pace of progress Probability of attaining the target
Target 3.A: Promote gender equality and empower women
Ratio of girls to boys in elementary education participation rate - High
Ratio of girls to boys in secondary education participation rate - High
Ratio of girls to boys in elementary education cohort survival rate - High
Ratio of girls to boys in secondary education cohort survival rate - High
Ratio of girls to boys in elementary education completion rate - High
Ratio of girls to boys in secondary education completion rate - High
Based on the 2010 Philippines Progress report on the Millennium Developments Goals (MDGs)

     The participation rate of females in elementary education was better than that of males. For example, in SY 2001-2002, female participation rate was 90.91 percent, compared to 89.33 percent of males. In SY 2005-2006, female participation rate was 85.35 percent against 83.56 percent for males. The school leaver rate for females (6%) was lower than that of males (8.62%) in SY 2005-2006.
     In addition, female cohort survival rate exceeded that of males. Consequently, female participation rate in high school also exceeded that of males (63.53% vs. 53.65%). There was also a gender gap in achievement levels in favor of girls as shown by the performance of a cohort of children in the National Achievement Test (NAT). Test results, disaggregated by sex, show that the female advantage widened as the children moved up to higher grades in primary school.
     These figures suggest equal status between males and females in terms of access to basic education. The disturbing part is the decline in the school participation rates over the six-year period. The only regions with participation rates in elementary education equal or above the national average in SY 2005-2006 were the NCR, Ilocos Region, Central Luzon, CALABARZON, Bicol Region, and the ARMM. The rest fell below the national average.
     In technical-vocational education and training (TVET), the total number of enrollees for AY 2004-2005 indicated an almost equal distribution between females (50.7%) and males (49.2%). Higher education remained femaledominated with women comprising 53.8 percent of total enrolment in AY 2004-2005.
     The government recognizes that gender equality has many dimensions, extending beyond education participation rates of men and women. A number of indicators have been added and discussed below.
Male-to-female population ratio is 101 to 100. Filipino women live longer than men, with a life expectancy of 72.5 years compared to 67.2 years for men. Women also have a slight edge over men in simple literacy rates (94.3% vs. 92.6%) and functional literacy rates (86.3% vs. 81.9%). The country’s Gender Development Index (GDI), based on the 2006 Human Development Report, depicts an improvement from 0.751 in 2002 to 0.761 in 2004. Likewise, the Gender Empowerment Measure (GEM) increased from 0.48 in 1999 to 0.542 in 2004. These gains, however, do not necessarily translate into positive measurable changes in the roles and status of women.
     On gender-based violence (GBV), a recent national survey estimated that around 2.2 million Filipino women or nine percent of all women ages 18 years and above, experienced violence inflicted by their partners. In the past two years, around 70 percent of child-abuse victims were girls and about 40 percent of cases were sexual abuse and exploitation.
     The Philippines is also recognized as a source, transit, and destination country for cross-border trafficking of women and children for sexual exploitation and forced labor. It is estimated that between 60,000 to 100,000 children and over 100,000 women are trafficked (internally and externally) annually. Since the passage of the Anti-Trafficking in Persons Act of 2003, the number of cases filed for investigation and prosecution by the Department of Justice (DOJ) had steadily increased from 12 in 2003 to 114 cases in 2005. There had been eight (8) convictions since 2003.
     On access to income and productive resources, the last decade had seen an increase in the number of women in the labor force with 50 percent of all women working compared to 80 percent of men. In terms of quality of work, 64 percent of those in higher wage-and-salary jobs and 67 percent of own-account workers were men. Among the employed women, 50 percent were wage-and-salary workers, 33 percent were own-account workers and 17 percent, unpaid family workers.
     Women had a large presence in the growing informal economy and had limited benefits and protection, such as social security and health care. Moreover, their economic contribution was largely invisible. As a country with the highest number of Overseas Filipino Workers (OFWs) worldwide, women and men were almost equal in number. The national economy and a quarter of the country’s families were highly dependent on OFW remittances.
     However, the average cash remittances of women were only 60 percent that of men. This is indicative of the status of women OFWs in lesser skilled and often unprotected lower paying jobs. This renders women vulnerable to exploitation, trafficking and abuse. Of particular concern is that 72 percent of newly-hired OFWs in 2005 were women, indicating lack of opportunities locally for decent work and livelihood to provide for themselves and their families.
     On civil and political rights of women, the Philippine Constitution upholds the right of women to sectoral participation in national and local legislative bodies. The Philippines is one of the few countries with a woman President. Four out of 24 senators are women. Women dominate the civil service at the technical level (74%) but are still largely outnumbered by men in decision-making positions (35%). Women account for only 20 percent of total positions in the judiciary. In the 2004 elections, mean participation rate of women was 18.2 percent at the national and local levels of both executive and legislative bodies.

Goal 4: Reduce child mortality 

Pace of progress of the Philippines in terms of attaining the target
Targets and Indicators Pace of progress Probability of attaining the target
Target 4.A: Reduce by two-thirds, between 1990 to 2015, the under-five mortality rate
Infant mortality rate 1.17 High
Under-five mortality rate 1.20 High
Based on the 2010 Philippines Progress report on the Millennium Developments Goals (MDGs)

     Based on data from the Technical Working Group on Maternal and Child Mortality, under-five mortality rate (U5MR) was 80 deaths per 1,000 live births for 1990. This rate declined to 48 in 1998 and to 42 in 2003. In 2006, using results of the Family Planning Survey (FPS) of NSO, the rate fell down further to 32 deaths per 1,000 live births. For the period 1990-2006, the decline was about 60 percent. This suggests a high likelihood of meeting the target of 26.7 deaths per 1,000 live births by 2015.
    Infant mortality rate (IMR) has also been decreasing from 57 deaths per 1,000 live births in 1990, to 35 in 1998, to 30 in 2003 and in 2006, it declined further to 24 deaths. The decline from 1990 to 2006 in infant mortality rate was about 58 percent. Similarly, the likelihood of attaining the MDG target for IMR is high. It should be further noted that the MTPDP 2004-2010 aims to reduce the IMR to 17 per 1,000 live births by 2010, a much greater decline than the 2015 MDG target.
    Still, there were regions that in 2006 had infant mortality rates exceeding the national average of 24 deaths per 1,000 live births. These were Cordillera (29), MIMAROPA (32), Bicol (26), Eastern Visayas (29), Zamboanga (38), Davao (28), CARAGA (28), and the ARMM (31). 

Goal 5: Improve maternal health 

Pace of progress of the Philippines in terms of attaining the target
Targets and Indicators Pace of progress Probability of attaining the target
Target 5.A: Reduce by three quarters, between 1990 to 2015, the maternal mortality ratio
Maternal mortality ratio 0.47 Low
Target 5.B: Achieve, by 2015, universal access to reproductive health
Contraceptive prevalence rate 0.27 Low
Based on the 2010 Philippines Progress report on the Millennium Developments Goals (MDGs)

     MMR is defined as the number of maternal deaths per 100,000 live births. The indicator on maternal health status is disturbing. Based on data from the 1993 and 1998 National Demographic and Health Survey (NDHS), MMR went down to 172 deaths from a 1993 baseline figure of 209 deaths. In 2006, based on the FPS, it declined to only 162 deaths. Though the decline continued, it was at a sharply diminishing rate.
     The target reduction in MMR is 52 deaths per 100,00 live births in 2015. In view of the fact that the decline has slowed down considerably and appears to have stalled, this goal has been identified as the least likely to be achieved for the Philippines.
     Out of three (3) million pregnancies that occur every year, half were unplanned and one-third of these end in abortions, according to a 2006 report of the Allan Guttmacher Institute conducted in the Philippines. Induced abortion was the fourth leading cause of maternal deaths. Young women accounted for 17 percent of induced abortions. Over half of births occurred at home and one-third of them were assisted by traditional birth attendants (TBAs). Around 75 percent of the poorest quintile did not have access to skilled birth attendants (SBAs) compared to only 20 percent of the richest quintile. There is, therefore, a need to improve prenatal and postnatal services and special competencies of SBAs to reduce neonatal mortality.
     Universal access to sexual and reproductive health education, information, and services improves health, saves lives and reduces poverty. The slow decline in MMR may be traced to inadequate access to integrated reproductive health services by women, including poor adolescents and men.
     The country’s total fertility rate (TFR) based on the 2006 FPS was 3.2 births per woman. This is a slight decline from the 2003 TFR of 3.5 children per woman. Among the regions, Region 4-B posted the highest TFR (4.1), while NCR, the lowest.
     On the contraceptive prevalence rate (CPR), the percentage of currently married women ages 15-49 years using contraceptives slightly changed from 49 percent in 2001 to 50.6 percent in 2006 based on the FPS for the same years. Among the regions, Central Luzon had the highest CPR at 58.9 percent, followed by Cagayan Valley (58.6%) and Southern Mindanao (57.2%). The lowest CPR was in ARMM (20%).
     The unmet need for family planning was 15.7 percent in 2006, representing a decline from the 1998 figure of 19.8 percent. The ARMM showed the highest unmet need (29.7%) while Cagayan Valley, the lowest at 9.7 percent.
     These trends indicate the need to actively promote family planning and responsible parenthood most especially, for low-income households. Without access to FP techniques, the actual number of children of poor families generally exceeds desired family size.
     Survey findings, however, revealed that Filipino women across all socio-economic classes desire fewer children and would like to use modern contraceptives. Yet only about half of women of reproductive age practice family planning (FP). Even when FP services are available, it has been observed that the decision to seek health services is often determined by gender norms in the family and community, as well as cultural and religious beliefs and practices.
     Concerning the young, data from the Young Adult Fertility and Sexuality Survey (YAFSS) for the period 1994-2002 indicated that the overall prevalence of pre-marital sexual activity increased from 18 percent to 23 percent. It is likewise observed that twice as many females than males experienced reproductive health (RH) problems. The higher levels of RH problems observed in females can be attributed to their higher experience of less serious RH problems. It is however noted that there was an increase in serious RH problems among females as compared to males due to the increasing proportion of females engaging in sexual risk behaviors and the low level of contraceptive use. The 2006 FPS results also showed that 6.3 percent of women 15-19 years old had begun childbearing and majority of them were poor and from the rural areas. Other studies show that teenage pregnancies accounted for 17 percent of induced abortion cases. 
Goal 6: Combat HIV and AIDS, malaria and other diseases

Pace of progress of the Philippines in terms of attaining the target
Targets and Indicators Pace of progress Probability of attaining the target
Target 6.A: Have halted by 2015 and begun to reverse the spread of HIV and AIDS
HIV prevalence among 15 years and over 0.02 Low
Proportion of population aged 15-24 with comprehensive correct knowledge of HIV and AIDS 0.03 Low
Target 6.B: Achieve, by 2010, universal access to treatment for HIV and AIDS for all those who need it
Proportion of population with advance HIV infection with access to antiretroviral drugs 0.72 Medium
Target 6.C: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases
Malaria morbidity rate 2.01 High
Malaria mortality rate 2.37 High
Tuberculosis case detection rate 3.82 High
Tuberculosis cure rate 2.53 High
Based on the 2010 Philippines Progress report on the Millennium Developments Goals (MDGs)

     Since the first official report of HIV and AIDS case in 1984, the Department of Health (DOH) through the National Epidemiology Center has been tracking HIV and AIDS cases in the country. Based on the DOH’s AIDS Registry, the total number of reported HIV Antibody seropositive and AIDS cases from January 1984 to December 2006 was 2,719. Of this number, 72 percent were asymptomatic, while the remaining 28 percent were full-blown AIDS cases. From 2004 to 2006, the DOH noted an increase in the number of reported cases ranging from 200 to 300 annually. This is a 20 percent increase that has raised concerns, as it suggests spreading, rather than a reversal of the number of seropositive cases. In addition, the cumulative death toll from AIDS had already reached 298.
     There seems to be an underreporting of HIV and AIDS cases in the country; the DOH estimated the HIV and AIDS cases to be about 11,200 as of 2005. The social stigma of disclosing to the public one’s infection in a predominantly Catholic population may be one of the reasons for the underreporting. While the numbers had not caused much alarm in the past, what is worrisome is the increasing number of new reported HIV cases. In 2006, for instance, six Filipinos were reported infected with HIV every week. One in every three cases was an OFW, mostly seafarers and domestic workers who reportedly had unprotected sexual contact. Cases among OFWs are easily detected because they are mandated to undergo HIV-testing by their prospective employers.
     Recent figures on HIV and AIDS cases suggest the infection has spread, not reversed. However, in spite of these new cases, the national target of keeping the prevalence rate at less than one percent of the population remains within target.
     Sexual transmission continues to be the main cause of HIV infection. However, injection by drug users, which is the strongest driver of HIV infection in Asia, may raise cases of HIV and AIDS given the observed increase in the level of needle sharing among drug users. The high prevalence of risky behavior such as unprotected sex and having multiple sex-partners among high-risk groups, combined with the rise in needle sharing among drug users is a cause for concern. HIV and AIDS awareness level across population groups, especially, among the youth, leaves much room for improvement. Misconceptions on basic facts about the disease must be dispelled. Preventive measures, on the other hand, must be advocated.
     Malaria is the eighth leading cause of morbidity in the Philippines. Based on program data, malaria morbidity rate indicated a decrease from 72 cases per 100,000 population in 1998 to 47 cases in 2002. However, there was an increase in the rate to 55 cases in 2005. The mortality rate due to malaria, likewise, decreased from 0.8 deaths per 100,000 population in 1998 to 0.1 death in 2002. This slightly went up to 0.17 deaths in 2005. The geographical distribution of malaria cases based on a five-year average (2001-2005) is as follows: Luzon (55%); Visayas (1%); and Mindanao (44%). In 2005, the top ten (10) provinces in terms of the number of malaria cases were: Palawan, Tawi-tawi, Sulo, Sarangani, Isabela, Cagayan, Sultan Kudarat, Agusan del Norte, Surigao del Sur and Zambales.
     Similarly, tuberculosis (TB) remains a major public health problem in the country, being the sixth leading cause of morbidity and the sixth leading cause of mortality in 2003. Data indicate that the mortality rate due to TB decreased from 38.7 deaths per 100,000 population in 1999 to 33 in 2003. In 2005, the case detection rate was posted at 71 percent while the cure rate was 82 percent.

Goal 7: Ensure environmental sustainability 

Pace of progress of the Philippines in terms of attaining the target
Targets and Indicators Pace of progress Probability of attaining the target
Target 7.A: Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation
Proportion of population with access to safe water 0.82 Medium
Proportion of population with access to sanitary toilet facilities 1.68 High
Based on the 2010 Philippines Progress report on the Millennium Developments Goals (MDGs)

    Philippine Agenda 21 continues to be the guiding document for the country’s strategy for sustainable development. The action agenda for protecting the ecosystem, for example is comprehensive, with targets for the following: forest and upland, coastal and marine, urban ecosystem, freshwater, lowland and agricultural, minerals and biodiversity.

Forest cover statistics was generated in early 2004 using satellite imageries taken in 2002 and 2003. Results of this undertaking show that the remaining forest cover was about 7.2 million hectares or 24 percent of the total land area of the country. This is 0.71 million hectares or 11 percent higher than the 1998 actual forest resource inventory record of 6.5 million hectares.
The number of proclaimed Protected Areas (PAs) under NIPAS has been continuously expanding. From 83 proclaimed PAs in 2000, the number of proclaimed PAs in 2006 increased to 103. There was also a significant increase in confiscated flora from 58 pieces in 2002 to 600 pieces in 2005. The number of confiscated fauna also increased from 175 heads in 2002 to 2,944 heads in 2004.
The Philippines’ productive coastal ecosystems and habitats include at least 25,000kms. of coral reefs, sea grass and algal beds; 289,890 hectares of mangroves; a variety of productive fisheries that provide more than 50 percent of the animal protein consumed in the country; and beaches and various coastlines of value for tourism and other development.
Pollution, however, remains a problem in the country’s major urban centers. It is projected that the volume of air pollutants will continue to increase due to greater industrial activity, heavy traffic and the large number of vehicles plying the streets, many of which are smoke-belching public utility vehicles.
An average Filipino generates 0.3 and 0.5 kg. of garbage daily in rural and urban areas.
This means that every person living in the metropolis generates a half kilo of waste per day. With an estimated population of 10.5 million, the total waste generated in Metro Manila alone could run up to 5,250 metric tons per day.

Data from surveys conducted by NSO suggest that access to safe drinking water and access to sanitary toilet facilities had slightly improved over the years. Based on the 2004 Annual Poverty Indicators Survey (APIS), access to safe drinking water slightly increased from 80.0 percent in 2002 to 80.2 percent in 2004. The proportion was lower for those belonging to the lowest 30 percent (65.4%) compared to families belonging to the highest 70 percent income group (86.5%). The latest survey also showed that the percentage of those using sealed water and closed pit type of toilet facility was 86.2 percent. This is slightly higher than the proportion in 2002 (86.1%).
The MDG target for 2015 is to ensure that 86.8 percent of the population will have access to safe water and 83.8 percent will have access to a sanitary toilet facility. Given the current trend, there is a high probability that the targets will be achieved. Based on the 2004 APIS, the target for access to sanitary toilet facility, which is at 83.8 percent, has been achieved. The MTPDP 2004-2010 has actually set a target higher than the 2015 MDG targets. These are 92 percent to 96 percent for safe drinking water and 86 percent to 91 percent for sanitary toilet facilities.

The government estimated that in 2002, there were more than 588,853 families in the country regarded as informal settlers with majority in the major urban centers like the NCR. In 2004, the government estimated that there were 675,000 informal settler families or squatter households nationwide. This is 14.6 percent higher than the 2002 figure. More than half of the informal settlers or 51.8 percent were in the NCR, Region 6, CALABARZON, and Region 5. The regions with the least number of informal settlers were Region 1, CAR and MIMAROPA.
In pursuit of the global MDG target, the
national government and the private sector had provided security of tenure or shelter security units (e.g., house and lot, house only or lot only) to 710,203 households from 2000 to 2006.

Goal 8: Develop a global partnership for development 

     In 1994, the Philippines acceded to the WTO, the successor to the General Agreement on Tariffs and Trade (GATT). The WTO is a multilateral body dedicated to rules and non-discriminatory trade. It is anchored on the “most-favored-nation” principle that any trade privilege granted to one member country cannot be withheld from another.

In line with the principles espoused by the WTO, the Philippines has unilaterally pursued since early 1980, trade liberalization anchored on import liberalization and tariff reduction. Under this liberalization program, the average tariff protection has gone down significantly. In addition, quantitative restrictions (QRs) on almost all imports have been lifted. However, rice is the only commodity still subject to a QR.

      In Southeast Asia, the Philippines is an active participant in the ASEAN Free Trade Area (AFTA) anchored on the Common Effective Preferential Tariff (CEPT) scheme. The applied tariff scheme for imports in the ASEAN ranges between zero and five percent, with few requested exceptions that may be subject to compensation. At this point, 60 percent of products in the inclusion list are subject to zero duty.

     In addition, the Philippines is a founding member of the Asia-Pacific Economic Cooperation (APEC), an informal grouping that is committed to “open regionalism.” APEC seeks open and free trade and investment in the region by 2010 for industrialized economies and by 2020 for the developing economies. Commitments though are voluntary.

     The Philippines continues to participate in multilateral trade negotiations under the WTO
in an effort to conclude the Doha Development Round. However, disagreements over agricultural trade prompted the government to intensify its efforts at forging regional and bilateral trading improve partnerships, like the following: (a) Japan-Philippines Economic Partnership Agreement (JPEPA); (b) Memorandum of Understanding on Bilateral Trade and Investment Cooperation with the Kingdom of Saudi Arabia; and (c) Agreement on Trade in Goods under the ASEAN-Korea Framework Agreement on Comprehensive Economic Cooperation. The country also continues to participate in negotiations for the ASEAN-Australia-New Zealand Free Trade Area (FTA) and has begun implementation of the Early Harvest Program and the first package of tariff concessions under the Normal Track of the ASEAN-China FTA.

     The Government is aware that good governance is needed under increasing internationalization of trade, investment and finance. In this connection, a new Government Procurement Act (GPA) was enacted based on competitive bidding and transparency. It is also stepping up the fight against corruption and supports the ongoing judicial reform program.

     The commitment of the government to poverty eradication is embodied under the MTPDP. The Plan upholds creating high-wage, high-skill jobs through increased investments in education and training, while providing industries and firms of all sizes including micro, small, and medium enterprises (MSMEs) equal access to low-cost raw materials, spare parts, components and technologies available in world markets. 

     The drawbacks from having a large public debt were realized in the Philippines in 1983 when the government declared a moratorium on foreign-debt servicing. A liquidity crisis forced the government to seek a standby credit arrangement from the International Monetary Fund (IMF). The IMF program meant strict observance of austerity measures. In 1984-85, the Philippine real gross domestic product (GDP) contracted by about 11 percent.

     The Philippines then sought debt relief from its Paris Club creditors, following the restoration of democratic political institutions in 1986. The Country obtained some debt reduction Program under the Brady bond scheme. At the same time, the Philippine government implemented consistent fiscal, monetary, and exchange rate policies aimed at stable growth. In addition, it pursued long-term industrial restructuring designed to enhance the international competitiveness of industries through import liberalization and tariff reduction.

     The government’s fiscal policy since 1986 aims to balance the budget. This is through a comprehensive tax reform package to widen the tax base and prudent government spending. Institutional changes have also been introduced at the Bureau of Internal Revenue (BIR) and the Bureau of Customs (BOC). These changes enabled the national government to post a surplus in 1994-1997. However, the government budget was at a deficit in 1998, the financing of which caused the ballooning of public debt. In 2005, the outstanding debt of the national government stood at PhP 4.47 trillion or about 76 percent of the gross national product (GNP), according to the Philippine Statistical Yearbook. As a result, debt service has been absorbing about one-third of the national government budget.

     In 2005, President Gloria Macapagal-Arroyo succeeded in having the Reformed Value Added Tax (RVAT) enacted, which expanded coverage along with a hike in the rate from 10 percent to 12 percent. This has had good effects on debt management. In addition, emerging fiscal reforms are proposing forward budgeting with a medium-term expenditure framework aimed at strengthening the links between planning and budgeting. 

     Meanwhile, the policy reforms that contribute to large increases in exports, whether of goods or factor services, have meant improvements in the ratio of debt service to export earnings. In addition, low inflation and declining interest rates have led to significant declines in interest payments on the public debt.

   Official Development Assistance (ODA) donors have welcomed the fiscal reforms. Government efforts to mobilize domestic resources have prompted multilateral financing agencies like the Asian Development Bank (ADB) and the World Bank (WB) to extend program loans that support government budget.In 2005, the government also began advocating for a debt-for-MDGs conversion scheme either through equity or ‘swaps’ to respond to the financing gap of the MDGs. A study commissioned by UNDP on financing the MDGs shows that investment requirements of critical MDGs such as poverty reduction, health, education and water alone show a financing gap amounting to anywhere between US$12.2 B to US$15.7 B.

     The debt-for-MDGs proposal envisions the involvement of 102 of the world’s poorest and proportionately most heavily-indebted countries, with the target of reducing global poverty by 50 percent by the year 2015. Under the proposal, given creditor approval, such borrowers may deploy up to half of their debt service payments to fund reforestation, pollution control, mass housing, information technology, health care, clean water or other MDG projects. With the impact of climate change now being felt globally, large-scale debt-for-equity programmes could be channeled for reforestation, clean water, irrigation and food production.

At the recent ASEAN Summit in 2007 January, member-nations endorsed the proposal and issued a call for a creative and responsible international debt management in the context of the MDGs and for the Paris Club of international lenders to receive and consider the proposal In the wake of constraints it faces in the international financial system, especially in the Paris Club rules and IMF debt sustainability assessment.

     According to the World Medicines Situation, a 2004 publication of the World Health Organization (WHO), only 66 percent of the country’s population had access to essential medicines. Access is measured based on the estimated percentage of the population with access to at least 20 essential medicines. Access to essential lifesaving drugs depends on the availability and affordability of such, especially in areas of high morbidity and mortality. Moreover, other factors also influence and have direct or indirect effects to access to essential drugs namely, rational selection and use of medicines, tailored procurement, sustainable financing and reliable health and supply systems.

     In 2000, the DOH initiated the Parallel Drug Importation Program (PDIP) as an innovative strategy to reduce the costs of essential medicines. This was expanded to the Gamot na Mabisa at Abot-Kaya (GMA 50) Program to ensure that affordable, high quality, safe and effective drugs and medicines are always available, especially to the poor.

     The MTPDP targets to reduce the prices of essential medicines to half of their 2001 prices. According to the Pharmaceutical Management Unit of the DOH, GMA 50 parallel drug imports achieved an estimated average of 60.9 percent price reduction in 2004, a figure above the 50 percent target by the year 2010. In 2006, the prices of essential medicines in the PDIP decreased by an average of 41 percent, the same price reduction in 2005. Low priced medicines were available in all 72 DOH-managed hospitals and three (3) local LGU hospitals located in the ARMM (two in Maguindanao and one in Lanao del Sur).

     The following interventions have been prioritized to achieve the envisioned goal of better health outcomes through provision of essential drugs, especially for the poor:

     On the objective of creating a regulatory environment that promotes a level playing field and fair competition among the various players in the pharmaceutical industries, the DOH National Drug Policy-Pharmaceutical Management Unit (NDP-PMU), in cooperation with the Bureau of Food and Drugs (BFAD), has crafted and implemented various policy instruments that intend to break the trends of imperfect market practices and monopolies/oligopolies in the pharmaceutical sector.

     Policies have been promulgated to promote generic drugs such as: a) Administrative Order (AO) 2005 – 0031 also known as “Guidelines and Procedures for the Issuance of the Principal Certificate of Product Registration and the Listing of Identical Drug Products based on the Identity of Manufacturer and Pharmaceutical Formulation”; b) AO 2005 – 0001 also known as the “Revised Policies and Guidelines Governing Patent and Trade Secret Rights in relation to the registration of pharmaceutical product”; c) Product
      Services Division (PSD) Memo 03 – 2005 also called as the “Facilitation of Applications for Product Registration”; d) The Generics Act of 1988 (RA 6675), “An Act to Promote, Require and Ensure the Production of an Adequate Supply, Distribution, Use and Acceptance of Drugs and Medicines Identified by their Generic Names”; and e) AO 2004 – 169 which sets the guidelines for the exclusive use of generic names or generic terminology in prescriptions and orders in all DOH facilities without the corresponding brand names, sustain the institutionalization of promoting generic names and to provide a system of monitoring compliance to generic prescription.

     To achieve the objective of enhancing availability and access to low-priced quality essential medicines frequently bought by the poor, the intent is to saturate the market with low – cost essential drugs through the following:

a. Establishment of Botika ng Barangay (BnBs)

     The BnB Program seeks to make quality essential medicines more affordable and available to the people down to the barangay level particularly to the poorest of the poor. Regulatory requirements for establishing BnBs were streamlined and seed capital investments were provided by the DOH to assist LGUs in pushing for and realizing the objectives of the Program. As a result, around 30 to 50 essential drugs were made readily available and affordable even in the remotest part of the country.

     In 2006, the BnBs sold 18 types of over-thecounter (OTC) drugs and nine types of prescription medicines. Nationwide, the number of BnBs rose to 7,437 (or 67 percent of the 11,000 target) from 4,738 in 2005. This is composed of 6,102 BnBs managed by or based in DOH-Centers for Health Development (CHD), 986 Botika Binhi of the Kabalikat ng Botika Binhi, Inc., and 349 Health Plus outlets of the National Pharmaceutical Foundation. Compared to private outlets, drugs in the BnBs are 63 percent cheaper based on current prices.

b. Botika ng Bayan (BNB)

     The DOH together with the Philippine International Trading Corporation (PITC) launched in December 2004 the BnB project to set up a nationwide network of privately-owned and operated accredited pharmacies that shall sell low–priced PDI or generic drugs in competition with commercially priced medicines in the market.

     The distribution network of the BnB expanded from 1,016 outlets in 2005 to 1,283 outlets in 2006. The DOH issued AO 2006-0033 entitled “Guidelines for the DOH-PITC Expanded Drug Access Pilot Program using convenience stores as BNB Express Outlets.” The objectives of this AO are: (a) to identify areas of collaboration between the DOH and PITC in relation to the Expanded Drug  Access Pilot Program; (b) to identify procedures for the operation of selected Botika ng Bayan as distribution network as well as accreditation of convenience stores under the Botika ng Bayan identified by PITC; and (c) to provide clear definition of roles and responsibilities among stakeholder entities.

     The use of generic products by DOH facilities and institutions is also being encouraged by requiring these entities to use only generic terminologies in procuring, prescribing, dispensing and administering medicines. The same institutions are also asked to promote the Generics Law to enhance the public’s awareness of its objectives as well as to establish GMA 50 Help Desks to assist the public in gaining access to low-cost medicines and provide information on rational drug use.

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