Five years later, Inez Feria still remembers the line snaking around the block outside the clinic in Cebu City. Men and women were smiling and laughing as they queued for clean hypodermic needles. For Feria, an advocate for the rights of drug users, it felt like a hopeful moment.
The needle exchange — part of an international push to slow the region’s skyrocketing HIV transmission rate — was the largest of its kind in the Philippines. When it started in 2014, about half the city’s drug-using population (approximately 6,000 people) was HIV-positive, and three-quarters of those people contracted the virus after sharing contaminated needles. By almost every metric, the pilot program exceeded its targets: fewer drug users reported sharing needles, more were being tested for HIV and all could access basic medical services.
But only months after the clinic was up and running, the Cebu City Anti-Drug Abuse Council filed an official letter demanding that it be shut down. In April 2015, five months into the planned two-year program, the clinic’s syringe distribution was suspended due to “political pressure,” according to the American medical non-profit Population Services International (PSI), which started the program.
A few weeks later, Philippine Senator Vicente Sotto gave a speech condemning the service. “Harm reduction strategy is, in reality, a pro-illegal drugs strategy,” he declared. “This nonsense must stop.” Needle distribution at the clinic permanently halted, and, according to a PSI review, “multiple clients were lost to follow up,” while new referrals slowed to a trickle.
“It was really sad,” Feria said. “It wasn’t just about providing syringes. It had a bunch of different services, HIV testing, counseling. People got connected to all these services that they otherwise wouldn’t have. It showed that people do want to take care of themselves.”