In Asia Pacific, rise in public debt is hurting women’s access to social services

Joann Cesario calls for increase pay for workers in a protest action in front of the US embassy in New York (Photo by J. Ellao / Bulatlat)


NEW YORK – For minimum wage earners in the Philippines like Malou Fabella, getting sick is not an option.

As her family’s sole breadwinner, she must get up every day to work, avail of overtime pay when possible, and extend whatever remains of her salary to cover the basic needs of her family of five – all of them based in Marikina.

Her health has since taken a backseat in their budget.

Regular check ups, particularly those related to reproductive health, are not covered by the free services provided by village health centers, as per the Philippine law on universal health care. Fabella wishes that the government can allocate more funds for the basic services but this has not improved over the years.

Based on the advance unedited version of the agreed conclusions of the 68th Session of the Commission on the Status of Women in the United Nations headquarters in New York City, member states agreed to uphold, among others, women’s right to “adequate standard of living, health, and well-being of themselves and their families.”

However, in the Philippines, the government has been prioritizing infrastructure projects to supposedly spur the country’s economic growth, while turning a blind eye on the lack of “substantial and sustainable internal drivers of growth such as from developing the core productive sectors of agriculture and manufacturing,” according to Ibon Foundation.

And yet, Fabella said, that “instead of these infrastructure linking us to services we need, these are the same ones that have been siphoning budget off from basic social services” at their expense.

In the Philippines

A recent study of the Ibon International and the Asia Pacific Research Network revealed that conditionalities that are attached to loans have undermined “sovereignty, and democratic ownership of development, and harmed people’s rights.”

Last year alone, the Philippine government paid a total of P1.53 trillion ($27.6 billion) in public debt from January to November 2023. Still, the year ended with the highest sovereign debt balance amounting to P14.62 trillion ($264 billion).

Joanne Cesario, vice chairperson of the workers group Kilusang Mayo Uno, told Bulatlat in an interview that many women working in the informal sector are without social protection from the government. “While those that are covered by the government’s supposed programs suffer in terms of quality and are often ridden with corruption issues such as PhilHealth,” she said, referring to the government’s public health insurance.

Click here to read Bulatlat’s previous reports on past reported incidents of anomaly involving PhilHealth here.

Women’s group Gabriela also assailed how Filipino women have been suffering due to decades of privatization and low prioritization of public health care.

“Instead of being regarded as a universal basic right, health in the Philippines is a privilege enjoyed only by the few who can afford it. The rest of the toiling women and masses are left to fend for themselves, while the government passes over its responsibility to private, for-profit corporations,” said Cora Agovida, deputy secretary general of women’s group Gabriela.

As it stands, the group said that six out of 10 hospitals in the country are privatized, and the remaining public health facilities are “struggling to maintain operations due to low funding that result in overburdened health workers, dilapidated infrastructure, barely functional and limited equipment, among others.”

Read: #NoGoldenEra | In 2023, public health still not a priority
Read: Under a fragmented health care, Philippines is ill-equipped in combating COVID-19

“In the worst cases, women paid the ultimate price due to the weaknesses of the Philippine healthcare system, which was brought to the brink of collapse at the height of the pandemic. Several women died giving birth as multiple hospitals refused them service because they were already at full capacity,” said Agovida.

For one, at least 93 percent or $27.4 billion out of the $29.3 billion loans that were incurred during the pandemic was focused on “fostering a business-enabling environment” instead of strengthening public health systems, the research of Ibon International and the Asia Pacific Research Network revealed.

The study furthered that the “promotion of the full liberalization of renewable energy and public services drives the displacement of rural communities, along with the repression of civil-political rights and gender-based violence against women activists and their organizations, especially those involved in land and rights struggles against extractive and mega-infrastructure projects.”

Meanwhile, Gabriela said government data show how the number of annual maternal deaths steadily grew from 1,458 to 2,478 from 2019 to 2021. Last year, an average of 85 women would die during childbirth per month.

In Sri Lanka

In a side event at the 68th Session of the Commission on the Status of Women, Tharanga de Silva of Sri Lanka’s Women and Media Collective said their government has been paying interest on sovereign debt “than they do financing public services such as healthcare or education.”

“Austerity measures have been found to negatively affect women in a gender-specific and disproportionate way; and even more so, women in vulnerable and marginalized situations as it also hampers the state’s ability to carry out gender-responsive budgeting, gender responsive quality public services, critical state policies and measures,” she said during the side event at the United Nations Headquarters in New York.

As of now, Sri Lanka is still struggling and has been in debt structuring talks in the last few years as it has incurred about $10 billion debt from multilateral bodies such as the World Bank and the Asian Development Bank. Apart from this, its government also has a standing debt from bilateral creditors of about $11 billion.

A study by the United Nations Development Programme revealed how the pandemic exacerbated their already dire conditions. By 2022, Sri Lanka began using its reserves to repay its debt, which depleted their foreign exchange reserves.

On the ground, De Silva said that about 62 percent of households in Sri Lanka purchase food on credit. “They borrow money from micro credit companies at high interest rates to make their ends meet. Women are the prime target by micro credit companies.”

“As the essential services such as healthcare and education become unaffordable, women and girls are also likely to be the first to compromise on their health needs, or the first whose education will be deprioritised, further perpetuating gender inequalities,” De Silva said.

Women gather at a side event at the CSW68 fo discuss how public debts have affected their lives, rights, and welfare (Photo from APWLD)

Bearing the brunt

As of now, the advance unedited version of the agreed conclusions of the 68th Session of the Commission on Status of Women have emphasized the “special importance” for developing countries to have durable solutions to the debt crisis and “create fiscal space for addressing the challenges of women and girls living in poverty.”

Cesario, however, underscored that only the rich and powerful benefit from debts that are being incurred by the government while poor households continue to bear the brunt in the form of heavy taxes and lack of due social services.

“Instead of funding social services, agriculture, and the labor sector, the Marcos Jr.’s record (of) high public debt is only going to infrastructure efforts that will benefit big businesses and is vulnerable to corruption,” she said.

The labor leader, who is also a member of the Asia Pacific Forum on Women, Law, and Development, said the Philippine government must direct its resources to fund national industrialization and genuine agrarian reform.

“Women bear the brunt of neoliberal policies of privatization of social services and limiting state’s power and responsibility. We therefore urge all the organizations present here today to join us in asserting Filipino women’s right to health, and in calling for an end to neoliberalism especially in the Global South,” Agovida said. (RTS, RVO) (

Editor’s note: Ellao is a previous media fellow of the Asia Pacific Forum on Women, Law, and Development.

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