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Philippines

 

The following is an excerpt from an ANCD report:

The link between amphetamine-type stimulant use and the transmission of HIV and other blood-borne viruses in the Southeast Asia region.

The Philippines is a republic with a population of 92.3 million. The capital is Manila with a population of 1.66 million. The Philippines is a signatory to the IDADIN.

Amphetamine-type stimulant use

The primary drug of concern in the Philippines is crystal methamphetamine referred to as ‘shabu’ and typically smoked (United Nations Office on Drugs and Crime, 2010b). The Global SMART Program report suggests that the drug is also snorted. In 2008, the estimated number of drug users was 1.7 million, although this figure is markedly less than the 6.7 million estimated in 2004. An estimated 62 per cent of drug use involves ATS (United Nations Office on Drugs and Crime, 2010b). Polydrug use is common in the Philippines.

Manufacture, trafficking and seizures

During 2009, 149kg of crystal methamphetamine and 832 litres of liquid meth/amphetamine were seized (United Nations Office on Drugs and Crime, 2010b). Law enforcement efforts in 2006 and 2007 appear to have had an effect on crystal methamphetamine production with laboratories moving from urban to rural areas to avoid detection. However, in 2008 and 2009 manufacturing was again detected in urban areas. There has also been a move from large manufacturing units to smaller ones which are easier to conceal. Since 1997, 32 ATS laboratories have been closed down and 2057kg of shabu seized (United Nations Office on Drugs and Crime, 2010b). Precursor chemicals such as ephedrine and pseudoephedrine are trafficked into the Philippines from China and India, and East Asian drug syndicates are known to be involved (United Nations Office on Drugs and Crime, 2010b).

Injecting drug use

The estimated number of PWID in Philippines is between 7000 and 14 500 (Devaney, Reid & Baldwin, 2006). No details of the number of PWID injecting ATS were available (Devaney, Reid & Baldwin, 2006).

Drug-related arrests

In 2009, there were 9052 drug-related arrests, 73 per cent for crystal methamphetamine (United Nations Office on Drugs and Crime, 2010b).

Drug treatment

More than half of all treatment admissions (n=2863) in 2009 (59%) were for crystal methamphetamine (United Nations Office on Drugs and Crime, 2010b). This pattern of drug arrests for ATS has been constant over the past five years, although the number of those arrested in 2009 is significantly lower than the almost 5000 ATS-related arrests in 2005. Data from treatment centres indicate that most clients used multiple illicit drugs and the vast majority (90%) were male (United Nations Office on Drugs and Crime, 2010b). No details of specific ATS treatment programs were available.

HIV in the community and among injecting drug users

Population prevalence of HIV in the Philippines is less than 0.1 per cent (UNAIDS, 2010a). Data on HIV among PWID are scarce but estimated to be 0–7 per cent (United Nations Office on Drugs and Crime, 2010b). Between 1984 and 2009, 4424 individuals were reported to the Philippine HIV and AIDS Registry (Philippine National AIDS Council, 2010). One-third (31%) of all new infections in the country were detected in 2008 to 2009 (UNAIDS, 2010a). Of cumulative HIV cases reported between 1984 and 2009, the vast majority (90%) were reportedly due to unsafe sex (MSM 29%; heterosexuals 55%; bisexuals 15%). Around onefifth were attributed to PWID (Philippine National AIDS Council, 2010).

HIV testing

HIV testing facilities are available across the Philippines, although none targets PWID in particular. Only 1.5 per cent of PWID reported being tested for HIV and knowing the result of the test in 2009 (UNAIDS, 2010a). Testing was more common, but still low, for female sex workers (19%) and MSM (7%).

HIV anti-retroviral treatment

No information on the availability of ART for high-risk groups was available.

Prevention education

A 2009 behavioural survey indicated that 55 per cent of female sex workers, 29 per cent of MSM and 11.5 per cent of PWID had been reached with HIV prevention education (Philippine National AIDS Council, 2010). No prevention education targeting PWID was reported.

Harm reduction

Possession of needles and syringes is illegal in the Philippines. Needles and syringes are available from pharmacies and a small number of non-government organisations working in the outreach area. These organisations distributed an estimated 50 000 units in 2009, an average of three needles and syringes per PWID per year. Although non-government organisations are encouraged to be involved in harm reduction activities, workers within these organisations are vulnerable to arrest because of the laws governing the possession of drug-injecting equipment. Only medical officers are legally allowed to be in possession of injecting equipment. The 2009 national behavioural survey indicated that 85 per cent of PWID surveyed (n=958) used sterile equipment during the last injecting event.

Concerns

Involvement of crime syndicates in the manufacturing of ATS in the Philippines is a concern. Additionally a lack of support for harm reduction in the Philippines hampers HIV prevention among high-risk groups.