Philippine HIV and AIDS Policy Act

REPUBLIC ACT NO.

11166
Roots of Health (Ugat Ng Kalusugan)
Created by Sachi Kaneshiro
Contents
RA 1116 1 Overview
1. Provides terminology
4 main goals 3
for understanding the
4 main actions 4
medical, public health,
social, and legal
context 2 Articles
2. Constitutes rights of PNAC 5
PLHIV Info, Education, Communication 11
3. Dictates how Preventive Measures, Safe Practices 15
organizations,
Screening, Testing, Counseling 18
including the DOH and
Health and Support Services 21
employers, will work to
Confidentiality 26
uphold these rights and
Discriminatory Acts and Penalties 27
provide for persons
affected by HIV Final Provisions 30

3 Terminology 31
An Act Strengthening the Philippine Comprehensive
Policy on HIV and AIDS Prevention, Treatment,
Care, and Support, and, Reconstituting the PNAC,
Repealing for the Purpose Republic Act No. 8504
(The "Philippine Aids Prevention and Control Act
of 1998") and Appropriating Funds Therefore

RA11166 4 main goals

1. Establish policies and programs to prevent the spread of HIV
and deliver treatment, care, and support services to
Filipinos living with HIV
2. Adopt a multi-sectoral approach in responding to the
country's HIV and AIDS situation
3. Ensure access to HIV- and AIDS-related services by
eliminating the climate of stigma and discrimination
4. Positively address and seek to eradicate conditions that
aggravated the spread of HIV infection, which include
poverty, gender inequality, marginalization, and ignorance.

Getting to Know Each Other 4 main actions

1. Philippine National Aids Council

RA11166 reconstitutes the PNAC and establishes it's functions,

members and composition, and AMTP.

Quick facts:
First established under RA 8504 section 43 "Philippine AIDS Prevention
and Control Act of 1998"
Agency attached to DOH with a separate budget
The main function is to develop the AIDS Medium Term Plan (AMTP)
PNAC members selection is based on contribution to the AMTP and
includes Remember:
government agencies, CSOs, use
you can only and PLHIV.
a name once.
Members from NGOs are appointed by the President of the Philippines

 PNAC Functions
Develop the AIDS Medium Term Plan (AMTP)

Strengthen collaborations between government agencies, CSOs, and foreign

organizations involved in national HIV and AIDS response

Monitoring and evaluation

Mobilize funds and members

Advocate for policy reforms

Submit an annual report

Identify gaps in respons and recommend policies and programs accordingly

 PNAC Composition
Organization Department of Health Department of Education Department of Labor and
(# of members) (1) (1) Employment (1)

Department of Social Department of the

Civil Service Commission on Higher
Welfare and Development Interior and Local
Commission (1) Education (1)
(1) Government (1)

National Youth Philippine Information Department of Budget Representatives from

Commission (1) Agency (1) and Management (1) PLHIV organizations (2)

The Chairperson of the

The Chairperson of the
Committee on Health and A private organization Representatives from
Committee on Health of
Demography of the with expertise in NGOs working for the
the House of
Senate of the standard setting and welfare or identified
Representative or his
Philippines or his service delivery (1) key populations (6)
representative (1)
representative (1)
 The Role of DOH:

The National HIV and AIDS and STI Prevention and Control

Program (NASPCP) of the DOH

Composed of medical specialists and support personnel
Coordinate with PNAC on AMTP

Epidemiology Bureau will serve to:

Monitor magnitude and progression of HIV
Provide a list of high priority areas

Evaluate efficacy of programs

Process all HIV and AIDS medical reports
Adopt a coding system that ensures confidentiality
Submit quarterly and annual repots to the PNAC

 PNAC Secretariat
Serves to support the PNAC

Consists of personnel and headed by an Executive Director

Performs the following functions:

Manage day-to-day affairs
Assist in formulating, M&E of policies and the AMTP
Provide technical assistance, admin support and advisory services to the PNAC
Identify and build internal and external networks and partnerships
Serve as repository of HIV/AIDS information
Share updated, accurate, and comprehensive info about the HIV/AIDS situation
Coordinate interventions to address gaps in AMTP
AIDS
Medium
Term Includes the following:

Plan

Target and strategies to address

HIV/AIDS
A six year, national
multi-sectoral

Prevention, treatment care and

strategic plan to support of the response
prevent and control
the spread of HIV and Operationalization and identification of
AIDS

the gov. agencies implementing the

program, including the designated office

Budgetary requirements and a

corollary investment plan of each

gov. agency involved
 2. Information, Education and
Communication
"Education is part of the constitutional right to health"
and "is a health service"

Summary
Establishes the educational Prevention Program goal, purpose, and
topics
Outlines how HIV education will look in various spaces and communities
Information on Prophylactics:
Appropriate information will be attached to every prophylactic
Misinformation on HIV and AIDS
Remember:
Strictly you can only use a name once.
prohibited
Refers to any false, misleading advertising and claims in any form
of media

Prevention Program
An age appropriate, scientific evidence based program with the:
purpose of educating the public on HIV, AIDS, STIs and
goal to reduce risky behavior and vulnerabilites
and actively promote the following:

1 Safer sex practices

2 Other practices that reduce risk of HIV infection

3 Awareness and access to information, education, and treatment

4 Knowledge of health and social rights of PLHIV and their family

 Education
In Learning Institutions In the Workplace In Communities
Using info from PNAC to All public and private DILG, ULAP, LAC task
integrate instruction on workers will be regularly Implement a community-based
Causes and modes of provided with basic response on prevention tools
transmission information to stop HIV spread
Ways of preventing Topics on confidentiality Includes:
spread of HIV/AIDS and elimination of stigma Indigenous peoples
Work with DEP ed, TESDA PNAC: standardize key communities
Create learning modules messages Geographically isolated
including the DSWD DOLE: private sector and disadvantaged areas
Referral System SCS: public sector Out-of-school youth
Provide psycho-social AFP and PNP: uniformed
support and counseling service
Funds allocated to teacher
training and certification
 Education
Parents and Filipinos Going Tourists and Key Populations
Guardians Abroad Transients and Vulnerable
Communities

DepED + parent- DOLE, DFA, CFO Educational PNAC to create

teacher will prepare a materials will be peer education,
organizations seminar for all made available at support groups,
responsible for overseas workers all ports of outreach
providing to attend entry and exit, activities and
education prepared by PIA community-based
research with
guidelines from
DOH
3.Preventive Measures, Safe Practices
and Procedures

Summary:
Defines HIV preventive measures
States that the presence of prophylatic substances shall not be used
as a basis of raids
To maintain human rights values
Outlines precautions on:
Mother-to-child HIV Transmission
Remember: you can only use a name once.
Donation of Blood, Tissue, or Organ
Medical Management, Surgical, and other Related Procedures
 HIV Preventive Measures
The PNAC shall implement the following:

Create rights-based and community-led behavior modification programs that encourage HIV
risk reduction behavior

Establish and enforce rights-based mechanisms to encourage HIV+ individuals to conduct

partner notification

Establish standard precautionary measures in public and private health facilities

Accessibility of ART and management of opportunistic infections

Mobilization of PLHIV communities for public awareness campaigns and

Establish comprehensive human rights and evidence-based policies, programs, and

approaches to reduce transmission of HIV
Precautions in Medical Practice
Safe practices and
procedures

Mother-to-child Precaution on donation Guidelines on medical

transmission Tissue and organ donations require a HIV- test procedure
DOH establish a All blood will be subjected to HIV testing Protocol on
program to be Lawful consent = person freely volunteers + precautions against
integrated in donation is in accordance with RA 1710 HIV during
maternal and "Organ Donation Act of 1991" procedures involving
child health For HIV+ donations needles
services person will be deferred from donation Necessary protective
donors will be notified and referred for equipment will be
care prescribed
donations may be accepted for research Guidelines on
purposes only handling and
strict disposal requirements disposal of HIV+
Recipient has the right to demand a second test bodily material
4. Screening, testing, and counseling

Summary:
The State shall encourage voluntary HIV testing
Exceptions for compulsory HIV testing
Rape and assault cases (RA 3815 and RA 8553)
Family issues (Executive Order No. 209)
Blood dontations (RA 1710 and RA 7719)
Guidelines for HIV testing and counseling availability
Remember: you can only use a name once.

HIV
testing Follows principle of evolving capacities of the
child
for 15-18 y/o: consent shall be obtained from
Shall be made child w/o need of legal guardian
available under the below 15 y/o: those engage in high-risk behavior
following
are eligible with assistance of health worker
circumstances:
all other cases and below 15 y/o or mentally
incapacitated: conset from legal guardian

Proper counseling provided by a health care

professional

Evaluation of HIV testing standards

DOH issue guidelines for testing minors

State review and revise the HIV diagnostic
algorithm
 Mechanisms and Standards
of the DOH
Accredit
All HIV testing facilities based on capacity to deliver service
HIV and AIDS counselor training institutions
1 Competent counselors for persons with disability, including:
Translator for hearing-impaired
Braille for visually-impaired

Develop guidelines for testing and counseling to ensure

2 Informed consent, voluntary, confidential, available at all times, provided by
qualified and accredited providers

Set standards for counseling

3 Facilities shall provide free pre-test and post-test counseling

4 Ensure access to routine provider-intitated counseling and testing

5 Pre-natal medical care shall offer provided-initiated HIV testing for pregnant women
 5. Health and Support Services

Summary:
Treatment of PLHIV includes free and accessible ART and medication for
opportunistic infections
Describes care and support programs for various communities of PLHIV
Support includes economic empowerment
Constitutes the right to non-discriminatory service and protection of
service providers from harassment
Remember:
Health Insurance you can
actions only use a name once.
for PhilHealth
Monitoring and Evaluation actions for DOH
 Care and Support
How the law dictates that the DOH, DSWD, and other organizations will provide care and support for the
following communities:

Establish a program to support better

For Indigents
access

Programs with peer-led counseling, social

For PLHIV protection, welfare assistance, case
management support

Stigma-free comprehensive reintegration,

For overseas workers living with HIV care, and support program (economic,
social, medical)
 Care and Support cont.
How the law dictates that the DOH, DSWD, and other organizations will provide care and support for the
following communities:

Have comprehensive STI, HIV, AIDS

prevention and control program
In prisons and closed-setting institutions Includes HIV education and treatment
Treatment includes anti-retroviral
drugs and ensures continuity-of-care

Counseling to prevent HIV-related

discrimination within a family
Educational assistance for children with
For affected families, intimate partners, HIV and children orphaned by HIV and AIDS
significant others and children of PLHIV Management of opportunistic infections
for minors living with HIV who are not
eligible under the Outpatient HIV and
AIDS Treatment Package of PhilHealth
Health
Insurance
Develop a benefit package for PLHIV with
The Philippines Health coverage for in-patient and out-patient medical
and diagnostic service
Insurance Corporation
(PhilHealth) shall:

Develop a benefit package for the unborn and

newborn child from infected mothers

Set a preference price for HIV services in gov.

hospitals

Conduct programs to educate the human resource

units of companies on the PhilHealth package on

HIV and AIDS

The Insurance Commission

Develop a mechanism for orphans living with HIV

(IC) shall ensure to access HIV benefit package
confidentiality in
provision Ensure no person is denied insurance claims if

they die of HIV or AIDS under a valid policy

 HIV and AIDS
DOH shall maintain a M&E program to:
Determine and monitor the magnitude
and progression of HIV and AIDS
Monitoring and Evaluate the efficacy of HIV
prevention and treatment programs
Evaluation Collate and evaluate all HIV and AIDS
related medical reports from all
medical centers
Submit an annual report to the PNAC
containing the findings
 6. Right to Confidentiality
Violations Exceptions Disclosure

Non-consensual When complying with Persons who test

disclosing of reportorial HIV+ are stongly
information that a requirements of the encouraged to
person has AIDS, HIV- national active notify sexual
related treatment, or passive surveillance partner(s).
HIV exposure system of the DOH
Non-consensual media When informing other
disclosure of the health workers
name, picture, or any involved in the
identifying info of a treatment of a PLHIV
PLHIV or confidential When responding to a
info subpoena
7. DISCRIMINATORY ACTS AND
PRACTICES AND CORRESPONDING
PENALTIES
 Discriminatory Acts and Practices
Workplace: unfair
Travel: refusal of Learning institutions:
policies in hiring or
entry, deportation, or denial or services of
provision of
quarantine student
employment

Denial of health
Denial of burial Restrictions on housing
services or unfair high
services or lodging
fee charges

Exclusion from credit Prohibition from seeking

Bullying in all forms
and insurance services or holding public office
Summary of Penalties are given for the following actions:

Penalties Misinformation
Unwarranted police operations
Negligent HIV infection of another person
For complete details, see
HIV testing centers failing to maintain safe
Section 50, Article 7
practices
---
Harassment of HIV service providers
Violation of health insurance provisions
Breaching confidentiality
Acts of discrimination

Penalties depend on the case but will involve*:

A fine (P50,000-P500,000)
Penalties collected are put into a PNAC fund
Imprisonment (6 months-12 years)

*Additional penalties
Corporations may be suspended or revoked license

Aliens may face deportation

Employees may face disqualification from office
 8. Final Provisions
The section involves legal functions of the Act such as
Appropriations for initial funding
Implementation of the Act
Act will take effect 15 days after its publication
PNAC will implement the rules and regulations 90 days after the Act is
effected
A separability clause to maintain parts of
the Act if others are declared
unconstitutional
 Terminology Health
ACQUIRED IMMUNE DEFICIENCY SYNDROME A health condition resulting from HIV. Individuals have a weakened
(AIDS)

immune system susceptible to opportunistic infections

Treatment that slows viral replication and infection of retroviruses

ANTI-RETROVIRAL THERAPY (ART)
including HIV

Study taken in community settings, involving community members in

COMMUNITY-BASED RESEARCH
design and implementation of projects.

COMPREHENSIVE HEALTH INTERVENTION Evidence-based policies, programs, and approaches that aim to
FOR KEY POPULATIONS reduce HIV transmission and its harmful consequences.

A retrovirus that infects cells of the immune system, leading to

HUMAN IMMUNODEFICIENCY VIRUS (HIV)
deterioration and deficiency of the immune system.
 Terminology Health
Refers to at high risk or affected populations whose behavior make them likely to
KEY AFFECTED POPULATIONS
be exposed to HIV or to transmit the virus;

Illnesses caused by various organism, many of which do not cause diseases in

OPPORTUNITSTIC INFECTIONS
persons with healthy immune system

The process by which the "index client", "source", or "patient" who has a STI
PARTNER NOTIFICATION including HIV, is given support in order to notify and advise the partners that have
been exposed

The use of prescription drugs as a strategy for the prevention of HIV infection by
PRE-EXPOSURE PROPHYLAXIS
people who do not have the HIV and AIDS. It is an optional treatment,

A preventive medical treatment started immediately after exposure to pathogen

POST-EXPOSURE PROPHYLAXIS (HIV) in order to prevent infection by the pathogen and the development of the
disease
 Terminology Health
PROPHYLACTIC Refers to any agent or device used to prevent the transmission of an infection;

Choices made and behaviors adopted by a person to reduce or minimize the risk of
SAFER SEX PRACTICES HIV transmission; including postponing sexual debut, non-penetrative sex, correct and
consistent use of condoms, and reducing the number of sexual partners

SEXUALLY TRANSMITTED Infections that are spread through the transfer of organisms from one person to
INFECTIONS (STI) another as a result of sexual contact

Private and public hospitals or medical establishments accredited by the DOH to have
TREATMENT HUBS the capacity and facility to provide treatment and care services to PLHIV

Communities and groups suffering from vulnerabilities of social economic, cultural

VULNERABLE COMMUNITIES and political conditions making them more susceptible to HIV infection and to
developing AIDS
 Terminology HIV
COMPULSORY HIV TESTING HIV testing characterized by lack of consent, informed choice, use of force, or use of
testing as a prerequisite for employment.
Communication between a client and trained counselor, whose objective is to
HIV COUNSELING resolve difficulties, encourage the client to explore options and skills to stay HIV-
negative and plan for the future
Any individual trained by an institution or organization accredited by the DOH to
HIV AND AIDS COUNSELOR provide counseling services on HIV and AIDS with emphasis on behavior
modification

The documentation and analysis of the number of HIV and AIDS infections and the
HIV AND AIDS MONITORING
pattern of its spread

HIV AND AIDS PREVENTION Measures aimed at protecting non-infected persons from contracting HIV and
AND CONTROL minimizing the impact of the condition on PLHIV
 Terminology HIV
Facility-based, mobile medical procedure, or community-based screening modalities
HIV TESTING
that are conducted to determine the presence or absence of HIV in a person's body.

Laboratory testing or procedure done or an individual in relation to a person's HIV

HIV-RELATED TESTING
condition

The transfer of HIV from one infected person to an uninfected individual, through
unprotected sexual intercourse, blood transfusion, sharing of contaminated
HIV TRANSMISSION
intravenous needles, or which may occur during pregnancy, delivery, and
breastfeeding

PERSON LIVING WITH HIV

Any individual diagnosed to be infected with HIV
(PLHIV)

The process of providing an individual with information and emotional support

PRE-TEST COUNSELING
before the individual is subjected to the test
 Terminology HIV
The process of providing risk-reduction information and emotional support to a person
POST-TEST COUNSELING
who submitted to HIV testing at the time the result is released;

A health care provider initiating HIV testing to a person practicing high-risk behavior or
PROVIDER-INITIATED
vulnerable to HIV after conducting HIV pre-test counseling. A person may elect to
COUNSELING AND TESTING
decline or defer testing

HIV testing done on an individual who, after having undergone pre-test counseling
VOLUNTARY HIV TESTING
willingly submits to such test

A person's involvement in certain activities that increase the risk of transmitting or

HIGH RISK BEHAVIOR
acquiring HIV

Any DOH accredited on-site or mobile testing center, hospital, clinic, laboratory, and
HIV TESTING FACILITY
other facility that has the capacity to conduct HIV counseling and HIV testing
 Terminology Legal
Repeated action of any form directed at a person that causes fear of harm or damage
BULLYING
and creates a hostile environment; infringing on rights of another person

Unfair treatment that shows preferences based on any ground such as sex gender, age,
sexual orientation, gender identity and expression, economic status, disability, ethnicity,
DISCRIMINATION
and HIV status, and which has the effect of impairing the exercise by all persons similarly
situated, of their rights

Article 5 of the Convention on the Rights of the Child recognizing the developmental
EVOLVING CAPACITIES
changes and self-determination capacity of children as they grow, thus requiring
FOR THE CHILD
guardians to include children in autonomous decision-making

The voluntary agreement of a person to undergo or be subjected to a procedure based

INFORMED CONSENT
on full information, whether such permission is written or conveyed verbally
 Terminology Legal
The legal principle that recognizes the capacity of some minors to consent
independently to medical procedures, if they have been assessed by qualified health
MATURE MINOR DOCTRINE
professionals to understand the nature of procedures and their consequences to
make a decision on their own

The core duty of medical practice where the information provided by the patient to
MEDICAL CONFIDENTIALITY health practitioner and his/her health status is kept private and is not divulged to
third parties.

REDRESS An act of compensation for unfairness, grievance, and reparation

Set of policies and programs designed to reduce poverty and vulnerability by

promoting efficient labor markets, diminishing people's exposure to risks, and
SOCIAL PROTECTION
enhancing their capacity to protect themselves against hazards, and interruptions
on, or loss of income
 Terminology Legal
Dynamic devaluation and dehumanization of an individual in the eyes of others, which may be based on
STIGMA attributes that are arbitrarily defined by others as discreditable or unworthy, and which results in
discrimination when acted upon

Office, premise or work site where workers are habitually employed and shall include the office or place
WORKPLACE where workers, with no fixed or definite work site, regularly report for assignment in the course of their
employment
 Terminology Other
Groups of nongovernmental and noncommercial entities engaged in
CIVIL SOCIETY ORGANIZATIONS
collective action around shared interests.

Juridical entities legally organized to provide for the provision of designated

HEALTH MAINTENANCE
health care services to its enrolled members for a fixed pre-paid fee for a
ORGANIZATIONS specified period of time

The way a person communicates gender identity to others through behavior,

GENDER EXPRESSION
clothing, hairstyles, communication or speech pattern, or body characteristics;

The personal sense of identity as characterized, among others, by manner of

GENDER IDENTITY clothing, inclinations, and behavior in relation to masculine or feminine
conventions.

The direction of a person's emotional, sexual attraction, or conduct towards

SEXUAL ORIENTATION people