“We will focus on treatment!” This is the reassurance HIV advocates say they have received from the Government of the Philippines in the aftermath of United States funding cuts to the Philippines HIV response. 

These commitments are critical to scale up treatment access for the 60% of people living with HIV in the Philippines who are not currently receiving antiretroviral therapy. But far more is needed to achieve epidemic control in a country that has seen a six-fold increase in new infections since 2010. 

In 2024, three to four people were infected with HIV every hour in the Philippines. Of particular concern is that almost half of them are young people aged 15–24 years. Programmes to reach young key populations, especially young gay men and other men who have sex with men, are urgently needed. 

“We are seeing a trend where younger and younger people are getting infected,” says Russell Elloso of Network Plus Philippines, the umbrella organization of people living with HIV. “And we are not seeing a plateau—the number of cases is still increasing. That means the current approaches are not working.” 

Through PEPFAR, the United States invested primarily in supporting HIV prevention strategies and community-led work to ensure services reached people most in need. 

One of the programmes that has been cancelled as a consequence of the funding cuts is the EpiC-supported Free to be YOUTH HUB. This innovative think tank developed culturally resonant HIV prevention and treatment support approaches specifically for young people. It ran 12 projects, including an academy for social media influencers, an innovative approach to HIV education, and a peer-led project to re-enrol youth who had stopped HIV treatment. 

“We have a progressive HIV policy in the Philippines and a comprehensive sexual and reproductive health policy, but they are not youth-focused and youth centred,” explains Aaron James Villapando, Co-chair of Free to be YOUTH. “The value of this initiative was having an advisory board focused on promoting a youth-led response. Young people can lead, and we need to be at the frontlines of the HIV response for it to be effective.” 

In the aftermath of the funding freeze, the organization has ramped up efforts to engage the private sector and foundations. A key priority has been to work with local government and local youth councils to secure more decentralized and sustainable funding for HIV programmes in the respective provinces. But activists are finding it particularly difficult to secure support for interventions for young key populations. 

“Our Secretary of Health has assured the public that they will scale their current initiatives with a goal of not being so dependent on international funding. But the reality is that some of the community-led projects that are most needed are not priorities,” Mr Villapando says. 

Stakeholders are lobbying the Department of Health to expand modern prevention methods and community-led service delivery, which were traditionally funded by external donors. These donor investments specifically addressed critical programmatic gaps, including youth programming and increasing access to modern testing and prevention options. 

Despite the Government procuring almost all HIV commodities, including PrEP, challenges remain around funding and systems for community-led responses, and the introduction of novel interventions such as long-acting PrEP, the dapivirine vaginal ring and selftesting. Advocates are lobbying policy-makers to develop and implement a social contracting mechanism so the community can continue to provide services without support from the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and PEPFAR.