Taking the Rights Path: The key to ending AIDS in the Philippines

The world has made enormous progress in reducing the impact of HIV over the last 15 years. Globally, 30.7 million people – 77 percent of those living with HIV – were on treatment in 2023, up from just 7.7 million in 2010. This has resulted in a dramatic decline in AIDS-related deaths, down by 51 percent over the same period. These advances align with the UNAIDS 95-95-95 target, which aims for 95 percent of people living with HIV (PLHIV) to know their status, 95 percent of those diagnosed to be on sustained treatment and 95 percent of those treated to achieve viral suppression by 2030.

Yet despite the development of effective treatment and prevention tools, the world is not on track to end AIDS as a global health threat by 2030. Global progress remains too slow, and in at least 28 countries, new HIV infections are actually rising – including in the Philippines.

The Philippines continues to face significant challenges in its HIV response. While many countries are seeing declining HIV rates, the Philippines has emerged as one of the countries with the fastest-growing HIV epidemics in Asia and the Pacific. From 2010 to 2023, new HIV infections in the country increased by 550 percent. There are 26,700 estimated new HIV infections in 2023, with a significant concentration on key populations such as men who have sex with men (MSM), transgender women, female sex workers, people who inject drugs (PWID) and young key populations. Of these, only 61 percent have been tested and diagnosed. While improving, the country’s treatment coverage remains below the global average at 67 percent of PLHIV and only 44 percent of PLHIV on treatment were tested for viral load.

So how do we protect the gains already made against HIV and make further progress towards that vital 2030 goal?

A new UNAIDS report released ahead of World AIDS Day, called “Take the Rights Path,” shows that upholding rights is the pathway to an HIV response that is robust and sustainable. The world can end AIDS as a public health threat, but only if the human rights of all people living with and at risk of HIV are protected. Upholding the rights of PLHIV, key populations and other vulnerable groups is central to ending the AIDS pandemic.

Stigma and discrimination remain among the biggest barriers faced by PLHIV and key populations. According to the Philippine PLHIV Stigma Index 2.0, PLHIV continue to experience discrimination when accessing both HIV and non-HIV health services. This discrimination is compounded by intersectional biases against LGBTQI+ individuals, female sex workers and people who inject drugs. Such barriers lead to delayed or foregone care and mistrust in the health care system, further increasing their risk of HIV and AIDS while impeding the achievement of the 95-95-95 targets. This underscores the urgent need for legal protections for key populations.

The lack of access to education and information puts people at significant risk. The 2022 Integrated Hematological and Behavioral Surveillance Survey reveals that only less than half of key populations possess comprehensive knowledge about HIV transmission and prevention. Among these groups, only 36 percent of MSM, 39 percent of transgender women, 24 percent of female sex workers and 18 percent of PWID demonstrate comprehensive understanding. There is an urgent need to ensure the provision of HIV education and comprehensive sexuality education to key populations – a critical component of HIV prevention – and address discrimination in the education sector that limits access to life-saving HIV information.

Gender-based violence also increases vulnerability to HIV. According to the 2022 National Demographic and Health Survey, 18 percent of cisgender women aged 15-49 have experienced physical, sexual or emotional violence by their current or most recent intimate partner. While systematic data collection on violence against LGBTQI+ Filipinos remains limited, numerous reports document its persistence, including multiple deaths within the community. This highlights the urgent need to address gender-based violence as part of the HIV response.

The anti-rights backlash threatening to undo progress in the global HIV and AIDS response must be challenged head-on. To protect everyone’s health, we must protect everyone’s rights.

There is hope. Across the world, many divisive laws that impede the delivery of public health services to vulnerable groups have been removed. Two-thirds of countries now do not criminalize LGBTQ people, including the Philippines. While the Philippine HIV and AIDS Policy Act of 2018 (RA 11166) explicitly prohibits discrimination against PLHIV and key affected populations within HIV spaces, the country still lacks legislation protecting them from discrimination while accessing non-HIV services. This gap drives many away from HIV treatment and prevention, increasing their risk. This reality emphasizes the importance of passing the Sexual Orientation, Gender Identity, Expression and Sex Characteristics (SOGIESC) Equality Bill to protect LGBTQI+ Filipinos across all sectors, including health, education and employment.

The implementation of the Philippine HIV and AIDS Policy Act and the Responsible Parenthood and Reproductive Health Law represent positive steps, allowing young key populations aged 15-18 to access HIV testing without parental consent and mandating age-appropriate comprehensive sexuality education. However, challenges persist in their full implementation, and young people still face barriers in accessing HIV prevention, testing and treatment services.

The Department of Health reports that 32 percent of new HIV infections in 2022 were among young people aged 15-24, emphasizing the urgent need to include HIV prevention and treatment services in the legal framework of RA 11166 and enhance youth-focused interventions.

As UNAIDS’ new report emphasizes, taking the rights path is crucial to ending AIDS. For the Philippines, this means not only strengthening rights-based approaches and addressing stigma and discrimination but also ensuring concrete action through policy implementation to leave no one behind in our national HIV response. The time for comprehensive reform is now – our future depends on it.

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Louie Ocampo is the UNAIDS Philippines Country Director.