For advocates of the bill, there is no longer any question that most politicians have seen the light and acknowledge that the voice of the people who are clamoring for access to reproductive health information and services count for more than the views of a benighted minority of Talibanic extremists.

The next big question is where the Senate of the Philippines stands on the issue. The three lady senators presumably see the issue as being an integral part of a women's rights package and are likely to be in favor of most provisions. It is however still uncertain that, on this politically charged subject, any of the senators will publicly promote open and frank discussions that can lead to consolidating and clearing the two Senate proposals (the Biazon and Lacson bills) on record. Population and women's rights advocates need to focus pressure on the silent senators on this issue.

***

Greed, politics, religious extremism, unseemly pride, and plain bullheadedness are all erecting almost insurmountable barriers to the alleviation of the misery of the majority of individuals, families and communities in the Autonomous Region of Muslim Mindanao.

Health status indicators in the region are the worst in the country and among the worst in the world. From the viewpoint of health, if, as is feared by many, the peace process ends up with a new country, it will most certainly be ranked in the least developed category.

Although the discussions regarding the situation in Southern Philippines rightly concentrate on issues of violence and cessation of hostilities, it may serve to soften positions on either side if the social development concerns are made more prominent. The leadership of the health sector on both sides is almost certain to be in agreement if they discuss issues from the perspective of the high maternal and infant mortality rates and the unavailability of basic health services.

***

Commercial kidney transplantation in the context of a high poverty rate is grossly unethical and simply amounts to exploitation of the already suffering poor majority of Filipinos. For as long as the poor do not have an equal chance of availing of modern interventions as rich Filipinos and foreigners, buying one of their kidneys is an inequitable transaction - even if the price paid to the donor is equivalent to the professional fees of the transplant surgeons and the hospitals.

The present efforts to re-establish renal transplants from paid unrelated living donors are doomed to failure because loopholes and incentives for abuse will be almost impossible to identify. This is especially likely if the mechanisms regulating the sale of kidneys are designed mainly by those who profit from the commercialization of this modern medical intervention.

***

Last January, infectious disease experts were already commenting on the unusually high number of dengue cases for that month. This should have been taken as a warning that this year's dengue season would be worse than the last few years. True enough, the monthly numbers for the dry season have turned out to be more than in previous dry seasons.

As the dengue season started in June, the numbers of cases have kept rising. There are signs that this will be the worst season since 1998 when record numbers were reported at the peaks in October and November. It is worth noting that the DOH approaches were developed during the record 1998 season.

However, the health research community should be concerned that, in 10 years, no new approaches to dengue prevention and control have been developed for a problem that has confronted the health community year in and year out for decades.

***

At a recent health meeting, a representative of the pharmaceutical industry pointed out that prices of drugs and medicines have not risen despite rising costs of all inputs. It is certainly to the credit of the industry that it has, in these difficult times, been able to "moderate its greed." On the other hand, this may also be tacit admission that the profits of these companies have been so high in the past that it is not a problem for them to absorb added costs resulting from rising oil and other commodity prices.

***

Fragmentation and lack of coordination of basic health services probably accounts for most of the deaths of women and children related to the reproductive process. Even as the poor are unable to pay for specialist care, resources continue to be focused on specialist-led interventions with little or no participation by non-medical health professions.

It is curious that in this country, midwives seem to have taken over the reproductive health care of the poor. Many physicians, especially those who work closely with midwives at community level, are still involved in this area of health. Nevertheless, it seems that the medical profession for the most part and certainly the nursing profession have basically abandoned their roles in the reproductive process especially among the poor.