YELLOW PAD
By Viviane Apostol and Carlos Jacinto
“There is no tool for development more effective than the empowerment of women,” according to Kofi Annan, former UN Secretary-General.
By breaking barriers in fields that were exclusive to men such as education and science, the pioneering efforts of women all over the world have led to groundbreaking changes in the course of history.
In the Philippines, we dedicate the month of March to celebrate the vital role of women in our society. Since 1988, the National Women’s Month has been part of Filipino tradition, and it forms part of the worldwide observance of International Women’s Day held on March 8.
The key to empowering women is the realization of rights and their role as change makers in all aspects of society. By doing so, we are able to inch closer to reaching the sustainable development goal of gender equality.
One of the landmark reforms that helped advance women’s rights in the country is the Responsible Parenthood and Reproductive Health (RPRH) Law. The RPRH Law has strengthened the prioritization of women’s health. But in this regard, the sin tax law of 2012 was crucial in augmenting the funds for the effective implementation of the RPRH services.
The enactment of the sin tax law resulted in a threefold increase in the budget of the Department of Health (DoH). The revenue from this law led to the birth of numerous health programs. The funds generated continue to nurture and develop these programs further. In many ways, it is fitting to brand sin tax as the mother of health programs.
Among the programs that have benefited from the expansion of the health budget are the programs for Family Health and Responsible Planning. By 2017, services for RPRH constituted almost 40% of the DoH budget.
The utilization of RPRH services has been increasing. About a fifth (21%) of the total PhilHealth benefit claims are from RPRH services, the bulk of which is for Maternal Neonatal and Child Health Services,
All told, however, the Philippines is still far from achieving its target health outcomes for women. Data from the DoH’s 4th RPRH Annual report states that maternal mortality ratio in the Philippines remains high at 114 per 100,000 live births. The unmet need for family planning (FP) in the Philippines is still 49% among unmarried, sexually active women and 17% among married women. And while FP services are provided at no cost to the public by government health facilities and PhilHealth-accredited institutions, gaps in coverage, especially among the poor, still remain.
Given the effectiveness of the sin tax law in augmenting the budget for women’s health, another significant increase in sin taxes should provide a viable source of funding to help our country reach its RPRH targets.
Furthermore, a substantial increase in tobacco taxes is needed to safeguard the health of women because, alarmingly, female smoking prevalence in the Philippines has remained among the highest in the ASEAN region.
According to the Southeast Asia Tobacco Control Alliance (SEATCA), the Philippines has the fourth highest smoking prevalence among female adults in the ASEAN region. Among the female youth, the picture is even more disturbing. Female youth smoking prevalence in ASEAN is highest in the Philippines at 9.1%. This figure is almost four percent higher than Thailand, which is second with 5.2%.
Calculations show that if we do not pass a high tobacco tax increase, we will be powerless to stop at least one million Filipinos from starting to smoke by 2022. To put it more specifically, non-passage of the tax increase means that we will be unable to stop women smokers (adult and youth alike) from potentially facing the health consequences brought about by tobacco use.
According to the Philippine Cancer Society, the four leading cancer cases for women include cancers of the breast, cervix, colon, and the lung. Multiple studies show that the risk of contracting these cancers increases when exposed to cigarette smoke, whether firsthand or secondhand.
Moreover, exposure to cigarette smoke has a marked effect on the reproductive health of women. The World Health Organization states that female smokers are more likely to suffer from infertility. For those who are able to conceive, they are more susceptible to stillbirth, and neonatal death compared to non-smokers. Cigarette smoking affects not only the health of the mother, but of the baby as well.
Earlier this year, President Rodrigo Duterte certified the tobacco tax increase as an urgent measure. The Senate Committee on Ways and Means chair Senator Sonny Angara has stated that an agreement has been made in principle to pass a tobacco tax increase that will significantly reduce smoking prevalence among the youth. Should this reform be passed, it will shoot two birds with one stone. It will not only discourage women from smoking, but will also ensure that programs that put women’s health at the forefront are well-funded.
The signing of the Universal Health Care Law in February 2019 will definitely improve the health and well-being of our people. We do hope that before the Seventeenth Congress ends in June, we can add another increase in sin taxes to the growing list of health laws that further empower the lives of Filipinos, especially women.
Viviane Apostol and Carlos Jacinto are researchers of Action for Economic Reforms’ health financing team.