Medicine Cabinet

The National Institute of Allergy and Infectious Diseases (NIAID)/Flickr 

May 15 marked the start of the country’s week-long observance of the International AIDS Candlelight Memorial. This annual event is an opportune time to remember the many lives lost to AIDS (acquired immunodeficiency syndrome) and honor those who dedicated their lives to helping people living with and affected by HIV (human immunodeficiency virus). 

The Philippines had the fastest growing HIV epidemic in the Asia-Pacific region with the highest percent increase (174%) of new HIV infections between 2010 and 2017, according to the Joint United Nations Programme on HIV/AIDS (UNAIDS). 

Unfortunately, the coronavirus disease 2019 (COVID-19) pandemic has worsened the HIV epidemic in the country. In “The Philippine HIV crisis and the COVID-19 pandemic: a worsening crisis” published in November 2021 in Public Health, Dr. Rowalt Alibudbud cited Department of Health (DoH) data showing that HIV testing decreased by 61% and treatment initiation dipped by 28% in 2020. Moreover, only 70% of the estimated 111,400 Filipinos living with HIV in 2020 are aware of their status, while only 61% are on life-saving antiretroviral therapy (ART). 

Dr. Alibudbud identified lower accessibility, delivery, and financing of HIV-related health services and programs in the community as factors during the pandemic that contributed to the country’s state of HIV.  

Accessibility to a testing center and delivery of HIV-related health services were hindered by travel restrictions and limited mass transportation; and financing of HIV-related programs were limited by the re-appropriation and re-alignment of the government’s budget to pandemic control measures. 

Decreased HIV testing and treatment could result in an increase of full-blown AIDS cases in the country, warned Dr. Alibudbud. He also pointed out the HIV/AIDS & ART Registry report that 105 pregnant women were diagnosed with HIV in 2020, the first time in the past decade that this statistic reached more than a hundred. If left unchecked, the country’s HIV crisis may shift from its concentration in MSM (men who have sex with men) into the general population, he said. 

In “HIV crisis in the Philippines: urgent actions needed” published in February 2019 in The Lancet, HIV researcher Dr. Louie Mar Gangcuangco outlined six interventions to curb the country’s HIV epidemic. 

First, reduce the stigma by integrating sexual health and gender-sensitivity education in school curriculums. Second, increase HIV awareness among healthcare professionals by emphasizing the importance of early HIV detection and enhancing knowledge in HIV management in medical and nursing curriculums. 

Third, distribute pre-exposure prophylaxis (PrEP) on a national scale as part of comprehensive HIV prevention programs. Fourth, use integrase inhibitors. Fifth, empower primary care physicians to provide HIV care. Lastly, with injecting drug users accounting for 4% of HIV cases in the country, address substance abuse and promote mental health. 

Two decades after the country’s first HIV/AIDS legislation was passed, Republic Act 11166 or the Philippine HIV and AIDS Policy Act, was enacted in 2018. It lowers the age of a person to avail of free HIV testing without parents’ consent to 15 from 18 years old; provides free and accessible anti-retroviral treatment and medication for opportunistic infections to all people living with HIV (PLHIVs) enrolled in the program; mandates the development of a benefit package for PLHIVs that includes coverage for in-patient and out-patient medical and diagnostic services, including medication and treatment; development of a benefit package for the unborn and the newborn child from infected mothers; sets a reference price for HIV services in government hospitals; and mandates the development of a mechanism for orphans living with HIV to access the HIV benefit package. 

The research-based biopharmaceutical industry is actively engaged in a number of initiatives to improve screening, timely diagnosis and access to treatment for HIV, awareness raising and education to halt transmission and reduce stigma, and research and development (R&D) of new medicines and vaccines to combat this disease.  

Our industry is developing 44 medicines and vaccines for HIV infection, focusing on improved treatment regimens, more effective therapies, and preventative vaccines. These include a first-in-class medicine intended to prevent HIV from breaking through the cell membrane, and a cell therapy that modifies a patient’s own cells in an attempt to make them resistant to HIV. 

Over the past 35 years, HIV/AIDS has gone from being a death sentence to a chronic, manageable disease thanks in large part to advances in biopharmaceutical research that has developed more than 20 antiretroviral therapies. R&D for new treatments and vaccines will provide long-term benefits to help halt the global AIDS epidemic. 

  

Teodoro B. Padilla is the executive director of Pharmaceutical and Healthcare Association of the Philippines (PHAP), which represents the biopharmaceutical medicines and vaccines industry in the country. Its members are at the forefront of research and development efforts for COVID-19 and other diseases that affect Filipinos.