Shifting tides that unbind

F

ree HIV testing and treatments. Oral pre-exposure prophylaxis (PrEP). Tuberculosis screenings. These are just some of the programs designed to address critical gaps in healthcare for a marginalized sector in a conservative environment – the LGBTQ+ – in the Philippines.   

Philippine community-based organization LoveYourself had been providing these health and empowerment services for this sector since 2011. Founder and executive director Dr. Ronivin Pagtakhan came up with the idea of such a group while volunteering for an LGBTQ+ youth center in San Francisco, U.S.A.

“At the time,” he said, “I felt there was a real problem with the way we were handling HIV prevention among the gay community in the Philippines… It was all about fear. I wanted something more optimistic and encouraging,” he said. And so the group operated for over a decade, in large part with the help of the United States’ foreign assistance.

But when U.S. President Donald Trump suddenly announced a 90-day freeze on all such aid on Jan. 20, the group was forced to close down 10 of its partner clinics that were fully reliant on the U.S. Agency for International Development (USAID). 

Thanks to its self-sustaining model and other partnerships, LoveYourself survived the sudden cuts. It still offers basic services for free – with funding from the Philippine government and The Global Fund. Its USAID-supported free deliveries of free HIV testing kits and PrEP to its clients had to stop, though.  

The free deliveries were intended to reach those “who are afraid and not ready” to disclose their status – a strategy considered an “innovation,” said Pagtakhan. For now, these clients have to pick up the kits directly from the clinics. “We are more determined than ever to find solutions, care for our community, and move forward with hope and resilience,” he said. 

LoveYourself’s predicament illustrates the adverse consequences of USAID’s dismantling under the Trump administration. 

These cuts, attributed to massive shifts in U.S. foreign policy, have left a gaping hole in the country’s development landscape, impacting everything from disaster resilience to healthcare access and environmental protection. The impacts of these cuts are acutely felt by groups pursuing DEI (diversity, equity, and inclusivity) initiatives, once a cornerstone of U.S. democracy but now examples of “radical and wasteful” programs.

Sources: TIME, U.S. State Government, U.S. Embassy in the Philippines, U.S. State Department Office of the Historian, National Commission for Culture and the Arts, Philippine History, The American Presidency Project – U.C. Santa Barbara, Philippine Supreme Court E-Library

For LGBTQI+ groups that work in health care, such impacts are compounded. In a forum last February, Louie Ocampo, the country director for U.N. AIDS, estimated that more than 550,000 individuals were affected by the U.S. freeze order. The said funding went partly to efforts to curb HIV cases in the country. 

Since 2020, USAID has contributed over $34.7 million to bolster the Philippines’ HIV response through its U.S. President’s Emergency Plan for AIDS Relief.

These funds have helped fill the gap left by the government even as the Philippines faced one of the world’s fastest-growing HIV epidemics: between 2010 and 2022 alone, HIV deaths in the country surged by a whopping 538% while infections rose to 418%.

Ocampo warned that the decrease in HIV services once provided by UNAIDS “could have a long and serious consequence which could make the transmission much faster … More people will be infected and … will die of AIDS because of late diagnosis and treatment.” 

Another impact, Ocampo said, is the “loss of safe spaces of HIV key populations – transpeople, people who inject drugs, men who have sex with men, and young key populations.”

One such safe space, the Transmasculine Philippines, whose USAID-funded Tanggap Trans Hub – the first-ever transgender community center in the Philippines, was told to cease operations shortly after the freeze order was announced.

The hub was a place for transgender Filipinos to socialize and access relevant resources and services. Now it has suspended all operations until further notice, and the complete termination of funding placed under review.  

Beyond funding challenges, Transmasculine PH executive director Dean Mathias Alea feared the ripple effects would be felt most severely by the communities that rely on these organizations for essential services.

“We believe the suspension endangers efforts to provide accessible services to community members, as well as individuals relying on such projects for their well-being,” he said. “As always, it was never about the money—only the work that unites our community and honors our queer siblings that came before us.” 

Geopolitical reordering 

For almost 65 years, since 1961, the USAID had invested nearly P290 billion pesos ($5 billion) in Philippine development initiatives. Most of these focused on health, education, and environment. 

Partially reported data for fiscal year 2024 show that USAID provided $180 million of the $740 million in disbursed aid to the Philippines. The funds supported various priority programs such as health ($46 million), environment ($35 million), governance ($24 million), and education ($23 million).

Other sectors receiving assistance were maternal and child health, family planning ($19.27 million), emergency response ($12.59), basic education ($18.23 million), and energy ($7.44 million).

But the Philippine government said the United States has not been a major source of aid for the Philippines. 

In 2023, Japan held the largest share of official development assistance in the country at 32%, followed by the Asian Development Bank and World Bank.

“Their aid is their decision to make. Nothing needs to be done on our end,” said Congressional representative Joey Salceda, an economist and chair of the House of Representatives’ ways and means committee. “Our most important foreign relationships are, in this order, our relationship with Japan, our ASEAN community, and our strategic multilateralism.” 

ASEAN is the 10-member Association of Southeast Asian Nations regional bloc, of which the Philippines was one of the founding members. 

Nevertheless, Salceda warned, if the United States neglected its relationship with the Philippines, its oldest treaty ally in Asia, the country might have no other choice but to “balance that out with China.” 

“We are not blind to the fact that they [the U.S.] will look after their interests first. We just want them to be fair, and I think they will be. Because the farther the U.S. goes from us, the closer they force us to [turn to] their adversaries.”

The Philippines is considered a critical keystone in America’s Indo-Pacific strategy, where China has sought to exert dominance, such as in the context of its territorial row with the Southeast Asian country in the South China Sea. 

Experts have cautioned against the geopolitical risks inherent in the Trump administration’s efforts to curtail USAID and foreign aid, fearing that this would allow China to solidify its influence in developing countries through its extensive Belt and Road Initiative, which has already disbursed billions in infrastructure loans.

Last month, China’s aid agency announced new funding for literacy and nutrition programs that were recently terminated by the U.S. in Cambodia. 

Projects in limbo

Still and all, the loss of U.S. support for crucial programs is bound to be felt in the long term. At least 37 USAID-funded development projects worth nearly P4 billion ($54 million) would be left in limbo. Publicly available data shows that environmental projects would be taking the largest hit – nine projects worth $20 billion – followed by basic education projects, valued at $13 billion.

The project with the largest allocation for fiscal year 2024 was The Inspire Project by the Gerry Roxas Foundation – one of the oldest social development foundations in the Philippines – which received $7.97 million in obligations.

The project, slated to end in 2026, aims to improve local conservation and climate change mitigation efforts through broader civil society participation.

Also affected are at least four basic education projects worth $13 million, all aimed at improving literacy and providing special education programs.  

Education Secretary Sonny Angara said the department would “exhaust all means to sustain these programs, ensuring that the education of our learners is not disrupted. DepEd will maximize its existing budget, engage with existing and new partners, and absorb key components of these projects.” 

Beyond fund cuts 

Since the cuts were announced, NGOs – and government agencies alike – have been forced to adapt, seeking alternative funding sources and streamlining their operations. Some have turned to local philanthropies and private sector partnerships, while others have explored innovative fundraising strategies. 

But what’s clear for them is that the cuts have also highlighted the need for greater local ownership and sustainability in development initiatives. 

“This is why an independent foreign policy is important. We cannot place our hopes on the U.S. for all our needs, including national security and economic development,” Bayan president Renato Reyes said in a statement.

Alea of Transmasculine PH admitted that relying solely on foreign grants is not ideal, but “it’s often the only way to keep life-saving services free or affordable for the people who need them most.” However, it’s the volunteers who are “the true backbone of community-based organizations, even more so than funding.”

“It’s the dedication, passion, and tireless efforts of volunteers that keep these initiatives alive. Even when funding runs out, these organizations continue to exist because of the people who show up.” 

Then, too, it’s the Philippine government’s moment “to step up and partner with civil society organizations,” said Pagtakhan of LoveYourself.

The Philippine government has promised to provide funding for some projects affected by the cuts, said Rose Edillon, undersecretary for the National Economic and Development Authority, the country’s socioeconomic planning body. 

One of the government agencies that responded to the USAID cuts was the Department of Health, which said it was identifying domestic financing sources for HIV and AIDS as well as other diseases like tuberculosis and malaria. 

It’s time the Philippines started “owning the HIV response,” said Ocampo of UNAIDS. That is, by “providing all the sources needed including full funding support to implement all the necessary interventions to halt the epidemic,” ◉