Two years into the Supreme Court’s temporary restraining order (TRO) on the distribution of contraceptives and pregnancy-control devices, the Department of Health (DOH) continues to keep faith with the justices’ “respect for the rights of women.”
“We’re positive that the [Supreme Court] will issue a decision in our favor,” said Dr. Eric Tayag, spokesperson for the DOH.
“[But] it’s up to them when to decide. We cannot force them, but we know that they are studying the matter thoroughly. We are confident that the Supreme Court will respect the rights of Filipino women,” Tayag said, referring to the TRO that also restrains the Food and Drug Administration (FDA) from granting any and all pending applications for the registration or recertification of contraceptives.
With the country’s supply of contraceptives reduced by the 2015 TRO, women have switched from pills and implants—among those covered by the court ruling—to cheaper and more readily available alternatives like condoms. Some are even considering more permanent options like vasectomy and tubal ligation.
Civil society organizations (CSOs), women’s groups and nongovernmental organizations (NGOs) have joined their voices to the clamor for the lifting of the TRO, which the Supreme Court imposed on contraceptives after a probirth group had claimed that these induced abortion.
Aside from Purple Ribbon Movement for Reproductive Health, which started an online petition to urge the Supreme Court to lift the TRO, CSOs like Likhaan Center for Women’s Health have assumed part of the government’s responsibility for the reproductive rights of its citizens.
The group provides direct health care services to women in marginalized communities, said one of the group’s founder and director, Dr. Junice Demeterio Melgar.
As the CSOs’ representative in the National Implementation Team of the country’s Reproductive Health law, Likhaan supports the DOH and its allied agencies like the FDA, PhilHealth and Commission on Population (Popcom) in its policies on family planning, Melgar said.
“Likhaan has tried to respond to this looming contraceptive crisis by educating women in poor communities, providing family planning services, and supporting government agencies in their actions to lift the TRO,” she said.
Despite the TRO, Likhaan continues to provide contraceptives in poor areas like Malabon, Port Area in Manila, Pasay, Bulacan, Quezon City, and Eastern Samar, where its staff also do organizing work.
“Luckily for us at this time, the contraceptives that poor women use still have viable registrations and we are able to access supplies from the DOH and the UN Population Agency and mobilize the supplies to remote areas where the demand is high. So the contraceptives are used before their registration expires,” Melgar said.
The groups’ proactive stance on the issue was a response to the TRO, which, according to Melgar, “is terribly inconsiderate of women’s specific needs and downright discriminatory. It is a gross violation of women’s human rights by the Supreme Court, which makes seeking accountability extremely difficult.”
Health Secretary Paulyn Ubial, who remained optimistic that the Supreme Court would eventually heed the DOH appeal to lift the TRO, said the department continued to coordinate closely with its partner NGOs.
“The TRO was [directed] at the DOH so the private sector, the NGOs, can still provide these contraceptives,” Ubial said, adding that the DOH continues to distribute supplies not covered by the Supreme Court order.
Even with the TRO still in effect, there are other contraceptive products and services accessible and available to women, she said, including injectables, pills, condoms, IUDs, sterilization and vasectomy for men, and tubal ligation for women.
“If eventually the [Supreme Court] decides not to lift the TRO, we’d be left with condoms and sterilization,” Ubial said.
She said the DOH hoped a decision would be reached soon, as the hormonal contraceptives Implanon and Implanon NXT in their storage would expire in 2018.
As a last resort, should the TRO stay, the supplies could be donated to another country before their expiration date, she said.
“What we’re trying to negotiate right now is for the Philippines to donate these commodities to other countries that can use them instead of wasting P300 million worth of subdermal implants,” Ubial said.
Out of stock
There are still adequate supplies of public commodities, but the more expensive brands of pills, including those used for PCOs (polycystic ovary syndrome), have gone out of stock, Melgar said.
“Yet it is not easy to counsel women with PCOS to shift brands because brands have different contents and effects on people,” she said.
“It is ironic that the crisis in FDA registration is affecting affluent women more, meaning those who need the pills not for contraception but to treat an ovarian problem that is preventing them from getting pregnant. Perhaps the Supreme Court justices would be moved to act if the capacity to get pregnant by rich women was most affected?” Melgar said.
For Tayag, the more pressing issue is not the availability of contraceptives, which are produced regularly, but their registration.
“Even if, let’s say, there are donated contraceptives, they cannot be used unless they are registered,” he said.
“The issue is not about running out of supply. The issue is before you can use them, there has to be certification, registration with the FDA,” he added.
According to Tayag, the DOH is currently conducting an inventory of contraceptives, particularly the implants that can no longer be used because of the TRO.
“Except for the implants, we have already distributed the other contraceptives to the health centers. Anyway, these are not covered by the TRO,” Tayag said.
Worst case scenario
According to Executive Order (EO) No. 12, signed in January by President Duterte and which calls for the full implementation of the Reproductive Health Law, some 6 million Filipino women have unmet needs for modern family planning methods.
Of this number, a third—or 2 million—have been identified as poor women who should be given access to contraceptives by 2018 and thereafter, according to the EO.
The TRO, however, contradicts the executive order’s avowed goal.
Tayag said the DOH was also preparing for the worst case scenario should the TRO stay: an increase in population that could endanger the health of women, and possibly increase the number of maternal deaths and of abortion.
With contraceptive supplies thinning out, the country’s population could balloon to 106 million this year, Popcom Executive Director Juan Antonio Perez III said in an earlier interview.
Tayag said the DOH would soon release a list of contraceptives affected by the TRO and the expiration dates of their certificates of product registration for reference.
Ubial said the DOH submitted a motion for reconsideration to the Supreme Court last year, and made a follow-up in March.
“But we have yet to receive a reply,” she said.