Population and health

By mid-2015, says the Population Commission, Filipinos will number 101.4 million, just a few months after we observed the birth of the

100 millionth Filipino.

This is the result of our total fertility rate of 3 percent, the highest in Southeast Asia, such that while neighbors like Singapore and Japan are struggling with what has been called their “graying” populations, the Philippines is faced with quite another problem: a rapidly growing population made up mostly of young people of nonproductive age.

The more alarming development is that many of these births are from dependents themselves, with the number of pregnancies among teens increasing. This means that the burden of providing food, shelter, healthcare and education for the new arrivals will fall on those currently productive: young adults, the middle-aged and even the seniors who must somehow extend their income-earning years to provide for grandchildren and even great-grandchildren.

Rising pregnancy rates among adolescents also mean that many young people are losing the opportunity to complete their education, thus compromising their ability to earn a living or even provide a future for their progeny.

In a news report, Popcom’s executive director Juan Antonio Perez III was quoted as saying that their efforts, together with the Department of Health’s, will be centered on the implementation of the Responsible Parenthood and Reproductive Health (RH) Law. More specifically, they will aim at improving the “dependency ratio,” that is, reducing the number of dependent Filipinos (those too young to be earning a living) and easing the burden on the currently productive population.

This will principally consist of trying to bring down the average number of births per woman, from the current average of three to two, which Perez describes as the “replacement rate” (two children to replace their parents). True, the national birth rate is falling, conceded Perez, but this decline is taking place much too slowly.

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Part of the DOH-Popcom program to address the need to speed up population decline and thus hasten the creation of what’s known as the “demographic dividend,” is the introduction of new and effective methods of contraception while promoting long-term and permanent methods such as tubal ligation and vasectomy.

Still, it must be emphasized that the “demographic dividend,” a swift upswing in development as the birth rates fall and a young, productive population takes advantage of advances in education and employment, will not take place without the commensurate improvements in the educational system, health system, labor market, and in economic policy.

In its “State of the World’s Population” Report for 2014, the UN Population Fund says that “with a large working population and fewer dependents, a country has a one-time opportunity for rapid economic growth and stability.” This is the “push” that Thailand enjoyed in the 1970s and 1980s, and Singapore even earlier. Experts suggest the Philippines was on the “verge” of benefiting from this dividend as early as the 1970s, but missed the opportunity repeatedly. We face such a threshold again. Will we miss it anew? With the lives of 101.4 million Filipinos at stake, let’s hope we clinch the challenge this time.

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We tend to raise alarms in the face of sudden catastrophic events: tsunamis, typhoons, massive floods, even New Year’s revelry turned deadly.

But all around us, health emergencies are taking place almost without us noticing it. Another front-page item shakes us out of our post-New Year hangover. This is about how 500 new cases of HIV infections were recorded from November last year alone, with the majority of the cases traced to individuals aged 15 to 24, with sexual contact the primary mode of infection.

Most of the cases are those of “men having sex with men,” the sector seen as primarily driving the alarming increase in HIV cases in the country.

Again, this is truly alarming as worldwide, the trend has been toward the reduction if not elimination of HIV/AIDS. The Philippines, though, is one of the few countries where the number of new infections has been rising.

Save for a few bulletins and warnings, the persistence and growth of this epidemic have been largely ignored, at least if we compare it to the panic raised by the possibility, just the possibility, that we would soon be beset by Ebola from West Africa.

If you will recall, the entire nation was in an uproar about the reports that Filipino peacekeepers who were repatriated home from their assignment in Liberia, one of the “hotspots” of the Ebola scare, were to be housed in an Army outpost in Tarlac. So loud were the protests that the returnees had to be transferred to an island in Luzon, if only to allay these fears. This even if the peacekeepers had tested negative for Ebola before their departure, and even if Ebola is not transferred through air.

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But even while in quarantine, the public fears would not be quelled. When Acting Health Secretary Janette Garin and AFP Chief of Staff Gen. Gregorio Catapang visited the peacekeepers, they were slammed for risking infection by not wearing protective clothing on the visit.

We have yet to hear or see such outrage or alarm about HIV and AIDS in the country, even if the situation has only grown “worser and worser” in the last few years. True, there are many more health emergencies to face in this and coming years. But ignoring the threat of HIV, especially the need for more public awareness on the disease, could lead to an epidemic that threatens our entire health system.