The Reproductive Health Story

Yellow Pad

One of the most difficult pieces of legislation that the Philippine Congress has tackled is Reproductive Health (RH). The book titled The RH Bill Story: Contentions and Compromises, authored by Marilen J. Dañguilan (Ateneo de Manila University Press, 2018) narrates and explains how it is so. And more importantly, the book shows how to overcome such adversity in making the RH Bill a law.

The difficulty is partly explained by knowing what RH really is. Different people or entities have different meanings for RH.

What exactly is RH? Family planning? Population control? Artificial contraceptives? Abortion? Poverty alleviation? Development strategy? Choice? Empowerment? Dañguilan surfaces these questions and answers them not on the basis of what she thinks but by way of documenting the debate and controversies surrounding the bill and how these were resolved (though not completely) through legislation.

According to the International Conference on Population and Development Programme of Action, RH is “a state of complete physical, mental and social well being and not merely the absence of disease or infirmity, in all matters relating reproductive system and to its functions and processes.” For a lay reader and even the politician, this definition is abstract and high-falutin.

That RH as an idea is a complex one already makes it a challenging advocacy. But the real difficulty, the main impediment, in having it passed is the most resolute, most relentless opposition from a particularistic interest, the Roman Catholic Church.

The literature on collective action explicates the puzzle of how a highly organized minority, in this case, the Catholic Church, can influence policy making. In gist, the minority — very organized, highly dedicated and motivated, and endowed with huge resources — has much to lose in the passage of RH. (The Church as an institution is, in this specific context, the minority. The majority of the population and the majority of Catholics favor RH.)

The public has much to gain from RH in terms of empowering women, reducing maternal deaths and promoting health, alleviating poverty, and the like. RH is thus public interest. But one individual citizen, the poor especially, cannot immediately calculate the greater public benefit. The cost to her of joining the RH advocacy (for example, the cost of forfeiting work to engage in mass action and lobby) can be arguably bigger than the future personal benefit she might be able to get from RH. Or she can enjoy the future benefits without being organizationally involved and by freeloading. After all, RH is a public good.

The common politician, or the traditional politician, on the other hand, makes calculations based on whether his position on the issue translates into votes. He will listen to public opinion, and here public opinion supports RH. But he also has an understanding that public opinion on the issue does not necessarily translate into votes. The majority of those who favor RH do not cast votes solely on the basis of the RH issue. To illustrate, Senator Koko Pimentel was against the RH bill, but many pro-RH voters still voted for him because of other reasons — his overall record, his support for sin taxes, his support for local governments, his being a bar topnotcher, his being the son of Nene Pimentel, etc.

The wise traditional politician likewise knows that while there is no “Catholic vote,” there still is a solid number of Catholics who will vote purely on the basis of his stand on RH. This solid RH bloc, even though a minority, still constitutes a big number of votes.

In this light, Dañguilan’s RH Bill Story is an essential read not only for the health practitioners but also for all those who pursue or follow public policy and advocacy. This is a story that provides key insights and lessons for politicians and policy makers, technocrats and social scientists, civil society organizations, reformists and revolutionaries, journalists, and opinion makers.

The lessons are drawn not only from the collective experience of RH advocacy but also from Dañguilan’s own experiences. She is a veteran in the crafting of public health legislation or policies, but the RH episode is the toughest one.

Dañguilan reminds advocates to be focused on a singular objective, to be aware of the pitfalls of having a too comprehensive bill, to communicate clear and simple ideas, to accept compromises without sacrificing the essentials, to seriously listen to adversaries and respect them.

On the latter, note how Dañguilan portrays the late Rep. Roilo Golez in her story. She depicted Golez, a staunch if not stubborn RH oppositionist, as an articulate, intelligent opponent. Dañguilan’s evenhandedness also shows in her treatment of Rep. Edcel Lagman, the RH Bill principal sponsor in the Lower House. Dañguilan points out the compelling pro-RH arguments raised by Lagman when he debated with the likes of Golez. But she also narrates how Lagman unreasonably thumbed down valid arguments of the opposition. (For example, Lagman questioned the integrity of the data presented by Golez, despite the fact that Golez cited a reliable source.)

But no doubt about it, through Dañguilan’s narration, we can agree that Lagman, for his persistence, persuasion and bullheadedness, was most instrumental in having the RH Bill passed.

Most admired was the role of the late Sen. Miriam Defensor Santiago in the passage of RH. Dañguilan highlights Defensor Santiago’s sponsorship speech for the RH Bill. What made Defensor Santiago’s sponsorship most distinctive, most compelling, and most edifying was her use of Vatican documents to muster support for RH!

The victory of the RH struggle cannot be attributed solely to the heroics of politicians like Defensor-Santiago and Lagman and for that matter former President Noynoy Aquino. Dañguilan also makes an accounting of how nongovernment actors like the Reproductive Health Advocacy Network, Likhaan Center for Women’s Health, and other health or public-interest groups contributed to the success of the advocacy.

The book is comprehensive and detailed. It documents the post-dictatorship history of the development of RH, culminating in its legislation. Culmination might not even be the exact term, for the law continues to face threats and challenges.

Despite its comprehensiveness and richness in details, much still has to be said about the RH legislation. More stories have to be told by many others who participated in this great struggle.

The RH epic has a cast of thousands of protagonists. And their stories likewise have to be told. I remember how the doctors in the sin tax advocacy shifted their focus on the RH Bill after the sin tax was won. I remember how Rep. Sid Ungab, then chair of the ways and means committee, made skillful political negotiations to ensure victories for both the sin tax and RH legislation. I remember how the late Rep. Dina Abad, without publicity, worked for the additional RH votes, engaging politicians and civil society advocates alike, even as she was busy championing other worthwhile issues.

Dañguilan’s RH Bill Story has unleashed such remembering. And my hope is that her book will lead to more storytelling about how RH was won.

But Dañguilan’s book is not just for posterity. It is a reference for continuing and future struggles. The RH is essentially about being pro-women; hence, it also rejects misogynism and sexism. To quote Dañguilan, sadly, “the misogynism and sexism continue to run deep.”

 

Filomeno S. Sta. Ana III coordinates the Action for Economic Reforms.

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