Lila Ramos Shahani is assistant secretary of the National Anti-Poverty Commission (NAPC). She is also adjunct faculty of the Center for Development Management at the Asian Institute of Management (AIM) and a doctoral candidate at Oxford University. This piece was published in the September 19, 2011 edition of the BusinessWorld, pages S1/4 to S1/5.


Here in Asia’s “oldest” democracy, traditional power blocs steadfastly oppose one another, often with breathtaking virulence. Tragically, it is the poor who tend to suffer most — unwilling pawns in power plays that affect their personal future and that of the entire country. For well over a decade, the struggle to pass an effective reproductive health (RH) bill has remained a source of bitter legislative contention.

The Catholic Bishops Conference of the Philippines’ (CBCP) hold over the Senate and the House cannot be underestimated, considering that 2013 and 2016 already loom brightly in our not-too-distant political future. Still, some opponents of the RH bill appear to have dispensed with empiricism altogether, opting instead for legalistic (the RH bill is redundant), demographic (“winter” is well-nigh imminent), and moralistic (contraception is murder) hairsplitting. But in terms of our national well-being and the needless suffering of the poor, it is useful to examine what experts say.

Dr. Esperanza Cabral observes that over 3,700 women die every year (over 10 daily) from complications of pregnancy and childbirth, as do over 33,000 children under one month of age. Combined, maternal mortality and neo-natal mortality rates produce a death toll of over 100 lives a day. How anyone purporting to be “pro-life” could reasonably oppose the desire to lower such disturbing figures remains unclear.

Nine thousand Filipinos are now HIV-positive, while another million contract various sexually transmitted diseases (STDs) yearly. Worse, there are nearly two million unintended pregnancies annually, over 90% of which happen to women who use “traditional” or no methods of contraception.

Tellingly, Social Weather Stations (SWS) surveys indicate that the poor actively seek reproductive health interventions from the government, while the RH bill is opposed mainly by those living in luxury and comfort — our bishops and legislators among them. In the last SWS polls, 70% of respondents from all classes gave pro-RH responses.

Indeed, the lack of RH legislation weighs most heavily on the poor. Dr. Ernesto Pernia and Dr. Corazon Raymundo independently estimate that the birth rate of the poorest 20% of the population is roughly double that of the national average. (We have the highest birth rate in Asia and the worst poverty situation in the entire ASEAN 4 region, and the dubious distinction of being the 12th most populous country in the world. Alarmingly, the National Statistics Office projects that our population will be 103 million by 2015, and we lack the environmental resources to contain much more without facing worrisome levels of scarcity.) The National Demographic and Health Survey further reports that poorer households have a higher number of “unwanted” children and that women in the poorest 20%, unlike their wealthier counterparts, have the shortest birth intervals. Pernia attributes the 2.1% rise in poverty incidence from 2003 to 2009 to the high fertility rates in this demographic group. Thus the inescapable inference that the lack of an RH bill will significantly increase the number of this nation’s poor.

Our population growth outstrips economic growth, and this can only lead to increased under- and un-employment (and therefore hunger), greater demand on the education system and poorer health care. These factors make it difficult to understand how anyone desiring poverty reduction in this country (except, of course, for those guided solely by religion or ambition) could reasonably oppose the RH bill.

The current administration, elected on a pro-poor platform, is committed to RH as a responsible parenthood bill: a national policy to implement responsible parenthood, family planning, and reproductive health care for all Filipinos, rich or poor. Critically, the bill promotes informed choice, especially for the three million couples now without access to such services.

So how could the RH bill be “redundant” despite the Magna Carta for Women, when the latter does not specify how and where women might avail themselves of reproductive health services? And, since no one is advocating zero growth, why should the “demographic winter” currently being experienced by countries like China be a source of concern, when this will not affect us for at least 60 years? Furthermore, opposition to contraception appears to be a predominantly Catholic issue. Virtually every other religious group in the nation — whether Christian or Muslim — appears to publicly support the RH bill. In fact, the bill itself in no way restricts the CBCP’s right to oppose contraception. Instead, the bill simply provides a legal mandate for family planning choices (already being taken advantage of by the elite) to be made available to the poorer members of our population.

And finally, to the deeper philosophical issues: Is it more ethical to use family planning at the stage of inception or to bring children into this world that one cannot afford to feed, clothe, educate, and ultimately sustain? What quality of life will these children have if they are forced into under-employment at best and crime or prostitution at worst? Is it even fair to consign an under-educated majority to the mind-numbing gridlock of poverty, generation after generation?

The Philippines, after all, is a democracy, not a theocracy, so the need to separate Church and State is obvious. The economic future of the nation — and the welfare of the most neglected among our population — cannot be held hostage by a group of bishops who fear their power is in decline, nor by a political elite made up of men wealthy enough to raise and educate several families anytime — while millions of their countrymen and women grimly fight a losing battle for mere survival.