The Mayor of Manila, Philippines, issued an executive order on the provision of sexual and reproductive health rights, services, and commodities. The order, which was based on the sanctity of life and the protection of the life of the mother and the unborn, established that Manila would uphold natural family planning “not just as a method but as a form of self-awareness in promoting the culture of life.” The enforcement of the order discouraged the use of modern contraceptives and had a negative impact on the sexual and reproductive rights of women.
The CEDAW Committee carried out an inquiry as provided under Article 8 of the Optional Protocol to the CEDAW Convention, finding grave and systematic violations of the sexual and reproductive rights of women in Manila under Articles 12 and 16 of the Convention.
The CEDAW Committee received a joint communication from three NGOs requesting an inquiry into the Philippines regarding the consequences of the enforcement of Executive Order No. 003, issued by the former Mayor of Manila, José L. Atienza. While the order did not expressly prohibit the use of modern contraceptives, it severely limited women’s access to sexual and reproductive health services in practice.
Twenty petitioners from Manila had repeatedly challenged the constitutionality of the order and sought redress before the Court of Appeals, the Supreme Court, and the Regional Trial Court (the Osil case). These efforts were unsuccessful.
Based on these facts, the CEDAW Committee launched an inquiry into whether the Philippines failed to comply with its obligations under the CEDAW and was internationally responsible for the events in Manila.
The Committee indicated that, while the order did not explicitly ban modern contraceptives, its implementation resulted in the removal of all supplies of modern contraceptives from healthcare facilities and the refusal to provide women with family planning information and counselling other than on “natural family planning.” Cases of misinformation were documented as well. This had a negative impact on women’s health and lives.
It went on to note that although the order was a local policy document, it was attributable to the State Party, given that municipal offices are state organs, and the State Party is responsible for ensuring compliance with the standards of the Convention by all its organs, including local governments to which powers have been granted.
The Committee therefore considered that the State Party failed to ensure that the local government refrained from engaging in any act or practice of discrimination against women. It further failed to take all measures necessary to modify or abolish existing laws, customs, and practices that constituted discrimination. The Committee cited, for example, the tacit acceptance by the central government of the policies of the Manila government, as well as the insufficient and inadequate measures taken to address the flaws of the Manila healthcare system.
Recalling its general recommendation No. 24, the Committee noted that it is discriminatory for a State Party to refuse to legally provide for the performance of certain reproductive health services for women, and that the differences between men and women as regards certain health issues, such as women’s reproductive functions, must be taken into consideration. The Committee further considered that the principle of substantive equality required States Parties to attend to risk factors that predominantly affect women. Given that only women can become pregnant, lack of access to contraceptives is bound to affect their health disproportionately.
The Committee observed that the lives and health of many women were put at risk during the years when the order was in effect, as they were compelled to have more children than they wanted or than their health permitted them to have. The order led to an increase in unplanned pregnancies, unsafe abortions, unnecessary and preventable maternal deaths, and increased exposure to HIV/AIDS and other sexually transmitted diseases.
In the Committee’s view, the ban particularly harmed disadvantaged groups of women, including poor women, adolescent girls, and women in abusive relationships. The State Party failed to eliminate economic and social barriers to reproductive health services so that all women, irrespective of age and income level, would have equal access to these services. It recalled that access to sexual and reproductive health services presupposes the availability and affordability of adequate and sustainable services and commodities.
Access was also limited by the failure to provide complete and accurate information to women. In some cases, women received misinformation that did not allow them to make informed decisions, which in turn deprived them of their ability and autonomy to make fundamental and intimate decisions affecting their bodies and lives.
The rights of women to family planning and to exercise their freedom of choice and independence in making decisions with regard to the number and spacing of their children were also violated, exacerbating inequalities between men and women in marriage and family relations.
The policy reinforced discriminatory and prejudicial gender stereotypes about women that their primary role was as child bearers and child rearers, which in turn further contributed to the belief that it was acceptable to deny women access to modern methods of contraception based on of their role as mothers.
Based on all the above, the Committee found that these were not isolated cases, and that the systematic nature of the violations was evident from the prevalent pattern of violations that occurred as a result of official policies disproportionately affecting women and discriminating against them by placing a certain ideology above their well-being.
Based on all the above, the Committee found violations of the following articles:
1. Articles 2 d), 2 f), and 12: When the executive order was issued, the State Party failed to ensure that the local government refrained from engaging in any act or practice of discrimination against women. It further failed to take all measures necessary to modify or abolish existing laws, regulations, customs, and practices that constituted discrimination against women.
2. Articles 12 and 10 h): The State Party failed to ensure access to the full range of sexual and reproductive health services and commodities, including information and counseling on modern methods of family planning.
3. Article 16 1) e): The State Party undermined the right of women to decide freely and responsibly on the number and spacing of their children.
4. Articles 5 and 12: Gender stereotypes prejudicial to women were reinforced, given that the orders incorporated and conveyed stereotyped images of women’s primary role as child bearers and child rearers.
5. Articles 2 c) and 12: The State Party failed to put in place a system to ensure effective judicial protection and to provide effective judicial remedies for human rights violations experienced by women in Manila as a result of Executive Order No. 003.
Based on the above, the Committee made recommendations to the State Party, including the following:
a) To guarantee universal access to the full range of reproductive health services and information for women, including the reintroduction of emergency contraception in the State Party;
b) To ensure that systematic training on sexual and reproductive health rights, services, and commodities is provided to health-care professionals;
c) To ensure that Executive Orders Nos. 003 and 030 are officially revoked, and that women are informed of such revocation;
d) To legalize abortion in cases of rape, incest, threats to the life or health of the mother, or serious malformation of the fetus;
e) To ensure that local government units put in place effective legal remedies for women seeking redress for violations of their right of access to sexual and reproductive health services;
f) To ensure that state policies and legislation give priority to the protection of women’s health rights over any religious postulates;
g) To ensure that training on sexual and reproductive health rights, services, and commodities is provided to healthcare professionals.