The Aklan PAC brief history

The Aklan Provincial AIDS Council (PAC) is a multi-agency body organized to spearhead the HIV/AIDS Prevention and Control Program of the Province of Aklan. It is composed mostly of major government agencies and non-government organizations. The composition reflects representation from major areas such as health, education, media, government, and civic group.


Basis for forming the PAC

The Provincial AIDS Council was officially organized in May 2000 under the UNFPA 5th Country Programme of Assistance. It was initially formed in response to a program need since UNFPA had required that certain structures be put up to hasten RH campaigns and advocacy in the province. The impetus for organizing PAC was therefore program-driven and not needs (client)-based from the very start. However, there was another major contributing factor which inspired Aklan to organize the PAC. This was the Observation Study Tour in Manila, Cagayan, and Cebu participated in by Aklan delegates in 2000 facilitated by Positive Action Foundation Inc. The delegates observed that a big component behind the success of VAWC and STD programs in the sites they visited were the presence of advocacy support groups that complemented the efforts of main program implementers. They saw how AIDS Councils were contributing to smoother implementation of the Reproductive Health (RH) program. The delegates were convinced that a multi-sectoral body such as the AIDS Council would be helpful in giving the HIV/AIDS program in Aklan a truly multi-sectoral character. They had seen the evidence and result of complementation of efforts in the OST sites they had visited and were impressed by the partnership of the health sector with the local government, civil society groups, and NGO in regulating or curbing the spread of sexually-transmitted diseases in their provinces. Convinced that this was the vital component needed to make the Aklan’s own RH program successful, the delegates united on the idea of adopting the practice once they return to Aklan. Thus the Aklan Provincial AIDS Council was essentially a replication project.


Taking the First Step

The plan to organize the PAC came mainly from members of the delegates who represented the health sector – Social Hygiene Clinic and the Provincial Health office – with support from other member delegates, notably the DILG. Thus the delegates themselves took the initiative of giving concrete form to the idea of organizing the Aklan Provincial AIDS Council.

After the OST, the delegates had a meeting with the Provincial Project Management Unit (PPMU) of UNFPA-Aklan for feedbacking and sharing of insights. One of the agenda during this meeting was the discussion and possible adoption of program practices that they believe would work for Aklan. The formation of an AIDS Council was proposed and unanimously approved. The Provincial Health Officer, Dr. Landelino Meñez, who was also a member of the PPMU endorsed the idea and moved for its immediate implementation. The Secretariat was tasked to schedule the first meeting to gather the delegates once more, invite members from other government agencies, with the objective of forming the Provincial AIDS Council of Aklan.
The Composition of the PAC

On May 17, 2000, the Provincial AIDS Council was officially organized. The Council officers represented the following agencies: DSWD, PIA, PNP, DILG, PHO, PPDO, and DepEd. The composition was limited to those government agencies that participated in the OST and few others that attended that first meeting. However, the composition though limited was considered ideal because it represented a close knit of agency representatives who also belonged to the provincial RH Speakers’ Pool, an informal group which serves as an on-call resource center whenever there is an RH training in Aklan. Then too, they were a group who has had quite a long exposure to the program. Most of them have been around since the UNFPA 4th Country Program of Assistance, had worked closely with one another, had attended the same seminars, participated in OST, orientations, etc., and in their own words “have achieved a level of working relationship marked by ease and familiarity with one another.” In other words the Provincial AIDS Council of Aklan was a tight knit of active RH movers.


Difficulties

The Provincial AIDS Council was clear on its mandate of advancing a specific cause, i.e., STI/HIV and AIDS. In actual implementation, however, PAC members admitted that it had been a different matter. The plethora of Reproductive Health issues and concerns and the demand for integrated delivery of RH services proved to be a source of confusion for the PAC. Under the UNFPA 5th Country Program, the program focus was on the four core elements of Reproductive Health. These were Family Planning (FP), Adolescent Sexuality and Reproductive Health (ASRH), Maternal and Child Health and Nutrition (MCHN), and STI/HIV and AIDS. According to Provincial Sanitary Engineer Lou Santamaria, PAC member, the Council embraced all RH issues during the 5th CP and therefore failed to focus on its STI/HIV and AIDS work. Two reasons were cited for this: First, the Council as a body failed to have a distinct program of action focusing on HIV/AIDS alone; Second, HIV/AIDS was not seen a major issue and concern in Aklan.

During the period 2000–2002, there was no known or monitored case of HIV infection in the province. The first HIV case surfaced and was monitored in Aklan only in 2003; at present, there are 4 cases of HIV positive in the province. The other reason, the failure of coming up with a separate program plan for STI/HIV and AIDS was rooted to organizational/structural dilemma. The PAC members were themselves members of the Provincial RH Core Team, a loose group composed mainly of Health Program Coordinators within the Provincial Health Office who sit down with the PPMU of UNFPA-Aklan in its planning sessions. The PAC and the RH Team invariably end up crafting one integrated RH Plan for the province because, structurally, they are just one body. This problem was evident in activities of the PAC from 2000 to 2002 which almost always reflected joint implementation with UNFPA. PAC was actively involved in such activities as World AIDS Day Celebration, World Population Day, School-Based Orientation on ARH, Safe Sex Strategies, etc. However, while these activities involved the PAC, they were not initiated nor conducted primarily by the Council. The PAC members had been active, but largely on a supporting role. They were tapped as speakers on symposia, or presenters of HIV/AIDS statistics during school-based orientations.




Finding Focus

The attainment of PAC’s program focus came gradually and became evident in 2003. This corresponded with thrust towards sustainability which was the program call during this period. 2003 was the midterm phase of the UNFPA 5th CP when all program sites were finally required to show proof that it had installed mechanisms that would ensure the continuity of the program even after the 5th Country Programme of Assistance. This was the program exigency which provided the impetus for PAC to re-gain focus. It also helped that PAC was finally able to identify an issue on which it could work on its own: RA 8504 or the Philippine AIDS Law. In 2003, PAC conducted a series of orientations on RA 8504 among teachers, media, the police, health service providers, and program stakeholders. This came about when the MIATs (Municipal Information and Advocacy Teams) organized by the RH Advocacy Subprogramme intensified its HIV/AIDS campaign in the municipalities, monitoring the presence of sex establishments especially in towns near the resort island of Boracay and in Boracay itself. The campaign to popularize RA 8504 gained momentum during this period (2003). The requests from MIATs poured into the UNFPA-PPMU office and were referred to PAC, which responded accordingly by conducting orientations on RA 8504 in these municipalities.

Another development which strengthened the PAC was the expansion of the Council. In 2003, the Council adopted an organizational structure patterned after the Philippine National AIDS Council (PNAC) which included a wider multi-sectoral representation. All major government agencies were invited and new members were recruited. This was regarded by even by the original PAC members as a welcome development, for the new members brought new ideas and reinvigorated the Council. According to Provincial STD Coordinator Debbie Villaflor, the overload of tasks and the doubling of functions had taken its toll on the old Council members. The tightly-knit group of original RH movers had grown too fit for comfort. There was a need for fresh blood, so to speak.

The restructuring of PAC and its conduct of successive activities were just two of the measures that helped to strengthen it. The third was the marked regularity in the conduct of organizational meetings in 2004. Documentation showed that the meetings were distinctly PAC’s and not of any other RH body. This was taken as a reflection of PAC’s eventual coming of age. It was not anymore subsumed under other RH bodies, but had become a distinct organization.


Linking Up

PAC gained further focus in its work for HIV/AIDS when it teamed up with Butterfly Brigade. Butterfly Brigade is a gay group UNFPA program partner in its HIV/AIDS Program, focusing primarily on vulnerable sectors such as the gays themselves, commercial sex workers, and the People Living with HIV/AIDS (PLWHAS).

In 2003 when Butterfly Brigade was invited into the Council, the latter experienced a more vigorous initiative in its STD/HIV and AIDS campaign. The coming in of the Butterfly Brigade freed the PAC from doing IEC ground working and enabled it to reach out to a wider sector, which included gay, adolescents, and commercial sex workers. It also gave the PAC the opportunity to assume other tasks and functions which it had not focused on before. Thus, lobbying and legislative work was finally given attention during this period. The DILG and the DOJ teamed up for this task. The concrete output of this legislative work was Executive Order No. 16. While this EO granted the PAC a belated official status, its major service to the PAC was the granting of a budget allocation for PAC operations.

Another major achievement in the legislative/advocacy arena was the inclusion of RH agenda in the Sangguniang Kabataan Program Plan. The Provincial AIDS Council, through its DILG representative, worked for the restructuring of the SK Budget to include allocations for RH projects, as stipulated in the Constitution. Thus another source of funding for RH activities, including HIV/AIDS campaign projects, had been opened up though the initiative of the PAC.


Gaining Sustainability

In the second quarter of 2004, the Provincial RH Sustainability Planning was conducted in preparation for the pull out of the 5th CPA. The PAC as a component organization of the Aklan RH machinery took part in the planning. In its Sustainability Plan, the PAC outlined its major projects for 2005 and beyond, but more importantly it identified the immediate and major task of seeking legislative support and funding for its projects.

Thus on August 11, 2004 during its official meeting, the PAC resolved to lobby for funding from the Aklan Provincial Council. There was no conscious plan to conduct the lobbying during the election period (May 2004 national and local elections), but the move proved propitious. The new Governor was receptive to the program, and after several meetings and dialogue with members of the PAC and UNFPA, the Governor eventually signed Executive Order No. 16 on March 22, 2006. This document officially identified the composition of the (restructured) HIV/AIDS Council, its Technical Working Groups, and their tasks and functions. More importantly, EO No. 16 stipulated a budget allocation for PAC operations, taken from the Provincial GAD Fund. This was considered a landmark in the sustainability not only of the PAC operations, but of the entire RH Program in Aklan.


Establishing Records

When the 5th Country Programme of Assistance ended in Aklan in 2004, PAC had already proven its capability as a program implementer of the STI/HIV and AIDS Prevention and Control Program. It had a shaky start as all organizations have, but eventually found its strength.

In the 5th CPA, PAC had functioned primarily as an IEC/advocacy body, conducting awareness-building activities on HIV/AIDS and RA 8504. As early as 2000, the PAC had identified other tasks for itself , such as case monitoring of HIV/AIDS and sex establishments, as well as the enforcement of laws pertaining to their operations. These tasks–case monitoring, checking of known/suspected sex establishments, and enforcement of regulatory measures–had taken a backseat to the IEC/ advocacy work of the PAC.

The groundwork for HIV/AIDS prevention and control had been laid down by the PAC through its IEC work in schools, communities and among sectors, and agencies. But IEC is only a portion of the larger task at hand. It was time for PAC to go beyond building awareness and start building capabilities and installing services. This was a task it set out to do under the UNFPA 6th Country Program of Assistance.

Aklan was included in the 6th CPA as a special project because of its achievement in HIV/AIDS Prevention and Control and ARH Programming. Thus, it became a recipient of funding grant for these two projects which were deemed its showcase or “best practices.” PAC’s achievement under the 6th CPA was establishment of the first community-based HIV/AIDS services which provides full package of services such as condom provision, voluntary testing, counseling, care and support, and ARV treatment. The latter was initially funded by UNFPA and now being continued by the Global Fund.

The upgrading of the technical capability of service providers in HIV/AIDS treatment, care, and prevention has also been started, and is continuing. In 2005, the PAC in coordination with the PHO spearheaded the formation of the HIV AIDS Core Team (HACTeam) and the subsequent conduct of the following trainings: HACT Training on ARV Literacy and Counseling, Training of Sanitary Health Inspectors and Embalmers on RA 8504 and Universal Precautionary Measures for Infectious Diseases, and Proficiency Training for Medical Technologists. PAC and UNFPA organized and facilitated the training activities, tapping technical experts from RITM/SACCL and other national agencies who served as speakers or resource persons.

Another concrete achievement in this area is the completion of Guidelines and Procedures on the Admission and Hospital Care of People Living with HIV/AIDS. This document was finalized by the Aklan HIV/AIDS Core Team (HACT) on June 2006. The PAC members sat down in the making of this module and were largely instrumental in pushing for the realization of this output. It must also be mentioned that PAC was instrumental in the formation of the HACT.

In joint effort with other program partners, the PAC worked for the establishment of a Satellite Social Hygiene Clinic in Boracay, making access easier and speedier for vulnerable groups in this resort island.


Extending the Reach

The PAC has extended its HIV/AIDS assistance even to PHAS in other provinces of Region 6, particularly those in Negros Occidental which does not have a voluntary testing center yet. This reflects the PAC principle and practice of “inclusive” services, without regard to gender, economic status, or geographic identification.

In June 2006, Aklan hosted a Regional Consultative Planning and Network Building Initiative on HIV/AIDS in Region 6. The activity gathered 26 major program planners and implementers from all the six provinces of Western Visayas, namely Antique, Aklan, Capiz, Iloilo, Guimaras, and Negros Occidental. The objective is to create a region-wide network of care and support for PHAS as well as to launch a region-wide initiative against HIV/AIDS. Aklan was chosen to host this regional conference in recognition of its leading work in HIV/AIDS Programming.


Summing Up the Strengths, Difficulties, and Lessons Learned

Despite having established a record of good practices, the Provincial AIDS Council of Aklan is still considered by its own members as an organization in progress. There are still many things to improve in it, not so much on the activities it has conducted, but in the way it has functioned as a body.

The multi-sectoral composition is both a source of strength and difficulty. The diversity of membership has resulted to a richer infusion of ideas which has invigorated the operations. But the new structure (patterned after PNAC) is too big to manage. Only three out of the five Technical Working Groups are active: Health Services, Legislative lobbying/Advocacy, and Media. To make the structure manageable, the PAC has formed a core group composed of five people. This worked in the beginning, but proved to be a weakness in the end because the core group ended up assuming the tasks of the non-active members.

A good number in government agencies view their membership in the Council as extraneous or secondary to their main function in their respective agencies, and therefore not worth the effort. Members from non-health agencies tend to regard the health sector as the primary implementer, and so relegate the main tasks to or rely on the health sector representative in the PAC.

Program planning remains a major challenge to the PAC. Initiatives are varied and numerous, but they are often individual rather than group effort. There is a need to build a holistic view of the program so that the efforts will be more concentrated and effective.