Abstract Aim This paper examines the interplay between political actors in different levels of government (i.e. from local to national) during the COVID-19 pandemic, using the framework of medical populism. Subjects and methods Three case studies illustrate how subnational political actors in the Philippines deployed medical-populist tactics to assert their leadership and challenge national policies: (1) Cebu Governor Gwendolyn Garcia’s promotion of “tuob” or steam inhalation during the early months of the pandemic; (2) two congressmen’s endorsement of ivermectin in Metro Manila during the country’s worst COVID surge; and (3) Former Manila Mayor Isko Moreno’s opposition to the national face shield mandate in the period leading up to the 2022 presidential elections. Results By spectacularizing the crisis, forwarding knowledge claims, and forging divisions between ordinary people and the so-called elite establishments of government and health authorities, these actors were able to either speak over scientific evidence or help contradict policies that were not backed by solid evidence to begin with. Conclusion This paper highlights the plural manifestations of medical populism in a given country, beyond just national leaders, as well as the evolving dynamics between national and local governments (and political actors) amidst health crises.

Throughout the COVID-19 pandemic, political leaders and public health institutions alike invoked "science" and "evidence" in their responses, and knowledge translation throughout the health crisis has been a vibrant field of scholarship. But how did specific bits of scientific knowledge (e.g., journal articles) find their way to policy and public discourses, traversing different geographic, political, and epistemic registers in the process? Drawing inspiration from STS insights on the performativity of scientific evidence and the nature of expertise, this paper tackles this question by making case studies out of three Lancet articles invoked by various actors in the Philippines to justify-or criticize-government responses to the pandemic. Taken together, the case studies on face shield mandates, pandemic response evaluations, and debates over airborne transmission illuminate how the articles shaped-and were shaped by-the country's realities, and how their meanings and implications were mediated by local health experts, journalists, and government officials. By reflecting upon the relationship between science and authoritarian and populist statecraft, this analysis illuminates the stakes involved in what counts as "evidence" and "expertise" amid crisis and in postcolonial contexts, underscoring the urgency not only of decolonizing global health knowledge but deconstructing its myriad (and unexpected) circulations.

This article advances understanding of the barriers to evidence-informed policymaking on illicit drugs in Southeast Asia. By doing so, it aims both to broaden the range of cases that are used to inform theory on evidence use in policymaking and to assist in the collective process of creating more effective and humane drug policies in Southeast Asia. The study is informed by the policy constellations approach and uses case studies from Indonesia, Malaysia, The Philippines and at the intergovernmental level of drug policymaking in Southeast Asia, with a particular focus on involuntary treatment, decriminalisation of drug use/possession, and the use of the death penalty for drug offences. These case studies use three scoping reviews of 83 documents containing the available research evidence on these policy issues, combined with analysis of 200 policy documents and 54 in-depth interviews with evidence producers, users and intermediaries. Critical realist abductive and retroductive analysis reveals that barriers to evidence use include the security focus of drug policymaking, dissensus on the nature of useful evidence, institutionally structured blockages to evidence use, and political pressures and backlash against evidence use. These barriers are supported by material and vested interests, and by the ethico-political base of patriarchal paternalism that underlies drug policymaking in Southeast Asia. These are not absolute blockages to evidence use to inform policy, but they do shape the use of evidence to by the most powerful policy actors to promote continued support for the ‘drug-free’ ideal.

This article critically examines the effects of punitive drug policies on children and young people in the Philippines. Drawing from ethnography, policy analysis, and a narrative review of the literature, this article argues that drug policies have had a profound and multifaceted impacts on Filipino youth, from actual violence to the structural violence that they reflect and reinforce. In the first place, anti-drug campaigns-most recently and significantly Duterte administration's "war on drugs" (2016-2022)-have led to direct harms, such as extrajudicial killings, incarceration, and psychological trauma, as well as indirect effects related to family disruption, community fear, and the erosion of trust in institutions. Beyond such violent campaigns, however, young people have been subjected to surveillance through drug testing. Meanwhile, young people who use substances like shabu (methamphetamine) and solvents (rugby) face stigma, discrimination, and ever-increasing threats of further criminalization, including proposals to lower the age of criminal responsibility even as socioeconomic contexts of their use of these substances are not addressed. Ultimately, it calls for a shift from a punitive to health- and rights-based approaches that center the welfare, dignity, and agency of young people.

Discourse, policy, and research on early childhood care and development have largely focused on parents-their roles, knowledge, and practices. Yet raising a child is inherently collective and intergenerational. Historical and evolving sociocultural contexts highlight the growing involvement of diverse "significant others" in nurturing young children. This study explores the childcare experiences of Filipino parents during their children's early years, from infancy to preschool (0-4 years old). Drawing from 17 key informant interviews with Filipino parents, the study emphasizes the vital contributions of multiple caregivers-including siblings, grandparents, other relatives, yayas or kasambahays (domestic helpers), and community members such as daycare teachers and health workers-in shaping parenting practices and ensuring young children's well-being. Using an inductive approach, the analysis interrogates institutionalized, parent-centric assumptions that dominate early childhood care and development discourse. The findings underscore the indispensable roles of these significant others in children's early development and in everyday parenting practices.

With lives, livelihoods, and entire societies at stake, immunisation was as a matter of immense political and social importance throughout the global health crisis. Using the framework of medical populism, this paper articulates the emergence of vaccines for COVID-19 as a populist trope by using three countries with diverse contexts and distinct vaccine responses - Brazil, the Philippines, and the United States - as case studies, drawing on the discourses and actions of their heads of states from March 2020 to December 2021. In the Philippines, President Rodrigo Duterte engaged in 'vaccine messianism', offering the promise of future vaccines as a simplistic solution to the pandemic. In the US, President Donald Trump dramatised his vaccine project and tied it to his 'America First' politics in what has been called 'vaccine nationalism'. Meanwhile, in Brazil, Jair Bolsonaro's 'vaccine skepticism' helped forge divisions between his constituencies and global elites as well as political opponents. Overall, the case studies show how medical populist performances evolved during the pandemic, and how the use of vaccine as a populist trope was linked to immunological, and often exclusionary, notions of nationalism.

In medical anthropology and public health, there has been a longstanding scholarly focus on the different forms of traditional medicine (TM); how they can collaborate with biomedical health systems; and how people actually embrace both as part of their medical pluralism. However, less attention has been paid on the temporal relationships between TM and biomedicine within individual patient pathways. This paper charts the roles that TM play within the therapeutic itineraries of Filipino patients. In unearthing these connections, we draw from an extensive, multi-sited qualitative study featuring over 30 FGDs involving various demographics and geographic settings in the Philippines. We find that TM figures in people's therapeutic itineraries before, alongside, and after treatment; and that even before consulting traditional healers, people engage in traditional practices on their own. Some diseases are perceived as not warranting biomedical help, while others are seen as deserving a 'trial' of TM before biomedical consult; there are also conditions that are seen to be benefit from both - and traditional medicine is also considered a 'last resort' if biomedical treatments fail. By identifying the ways in which the temporalities of TM interact with biomedicine, our findings can inform health communications and other public health efforts, while providing a contemporary picture of TM in the country.

"Kuwento ni Rosario" (Story of Rosario) is a case study that has been widely used in the Philippine health sector to discuss the socioeconomic realities that influence health in the country. Drawing on oral histories, archival research, and auto-ethnographic reflections, this essay traces the genesis of this case study from the early 1980s and follows its iterations and figurations in health discourse until the Covid-19 pandemic. Through this metanarrative, I also unearth intersections between local and global movements, and offer insights as to the role of the "case study" or "case method" in public health and social medicine.

Background Throughout the COVID-19 pandemic, various substances were promoted and used as preventive measures, cures, and treatments for COVID-19, from repurposed drugs to traditional medicines and herbal remedies. Scholars have described the politicized promotion of these substances as ‘pharmaceutical messianism’. In this article we show the broad range of these substances, drawing from a wide range of data sources including the use of emergent and generative AI. Methods We conducted a scoping review of major academic databases and public health websites to create a global database of unproven, alternative, and unorthodox substances used for COVID-19. We further supplemented our search with treatments discussed in grey literature, and we employed AI tools to identify personalities promoting their use and countries where these therapeutics have been reported. Findings We identified over 1,000 different substances globally, the most widespread being repurposed drugs such as ivermectin and chloroquine/hydroxychloroquine, and various nutraceuticals in different formulations. Many of the substances were used in multiple countries, indicating a robust transnational circulation of products and ideas. To a lesser extent, chemicals, disinfectants, and illicit drugs have also been used for COVID-19. Despite the diversity of substances, there were familiar patterns, including the preponderance of products with pre-existing medical uses, as well as the prominence of medical and religious actors alongside politicians as endorsers of the substances. Conclusion By charting and characterizing the extent of the use of various substances for COVID-19, our findings can inform pharmacovigilance, regulations surrounding unproven and alternative treatments, health communications, and health literacy and other public health initiatives. Our novel scientific contributions employing advancements in methodologies can inspire further work to catalog various substances not just for COVID-19, but for other medical conditions of global significance.

Our article provides the first qualitative inquiry into the use of alkyl nitrites or poppers in the Philippines. Drawing from thematic analysis of 13 semi-structured interviews, we illuminate the role of poppers in the lives of men who have sex with men (MSM) in the country, arguing that the popularity of these substances is embedded within multiple, occasionally conflicting sexual and chemical ideologies. More than their multifunctionality as drugs that fulfill many roles and are used in various sexual settings, it is their ideological acceptability that largely explains their popularity. In the contexts of the ongoing Philippine drug war and of Philippine society's long history of stigmatizing people who use drugs, poppers are widely regarded as biomedically, sociopolitically, and legally 'harmless' and 'acceptable', especially relative to other substances used for chemsex. In constructing poppers as chemsex drugs, we depart from definitions of chemsex established mainly by the Global North and provide a glimpse into how MSM who use poppers situate themselves in a particularly hostile sociopolitical milieu. We consider the implications of our findings against the country's drug paradigm, reflecting on the nature of poppers as substances located in the gray area of legality, and what they mean for sexuality, drug use, and the localized, cultural taboos of our time.

Background: This paper reconstructs and analyses the "official drug narratives" in Singapore and the Philippines as recounted by its drug enforcement agencies and government officials. Drawing inspiration from narrative analyses and works that have explored official and institutional narratives, it defines such narratives as government accounts of how drugs figured in its country's history and how it responded to the challenges posed by drugs to society. It then identifies common elements in these narratives, namely plot, settings, characters, and moral of the story. Methods: Documents and other material from drug-policy and-enforcement related institutions, primarily the Central Narcotics Bureau (CNB) and the Ministry of Home Affairs (MHA) for Singapore, and the Dangerous Drugs Board (DDB) and Philippine Drug Enforcement Agency (PDEA) for the Philippines, from 2015 to 2024, with particularly attention to drug policy-related anniversaries and official commemorations. Findings: In both countries, official drug narratives highlight the national(list) character of their drug policies and cast their longstanding campaigns in existential terms, relying on the language of statistics and expertise, as well as a curation of the past, to legitimise the righteousness of their initiatives. While people involved with drugs were the expected 'villains' and the citizenry, especially the youth, the expected victims, notable was the characterisation of drug enforcers as underdogs pit against powerful enemies. Conclusion: Analysing official drug narratives offers a way to examine a country's policy trajectories and overall paradigms and call attention to aspects that may be overlooked because they are not directly related to policy. By reconstructing the narrative content and structure of governments' discourses on drugs, official drug narratives can contribute towards a better understanding not just of the making of national drug policies, but on the stories on which they stand.

Background: This paper examines the political constructions of people who use drugs in the Philippines throughout the presidency of Rodrigo Duterte (2016-2022), during which the government engaged in a 'war on drugs' and promoted a punitive drug regime. Methods: Building on and drawing inspiration from the global drug policy scholarship that has looked at the ways in which drugs are framed and problematised in various domains, this study used qualitative content analysis to review 96 documents from national government agencies - including strategic action plans, directives, memorandums, guidelines, annual reports, and legislative measures. Results: Foremost, the study finds that various terms were interchangeably used to refer to 'drug users' dependent, offender, personality, abuser - and all of them contributed to the problematisation of people who use drugs as a societal "menace". As "drug dependents", they were likewise portrayed as necessitating treatment or rehabilitation. Moreover, presented as victims or passive subjects, their agency and subjectivity are not acknowledged in the documents, even as counter-discourses, mainly from opposition lawmakers, challenge these portrayals and call for people-centered, harm reduction approaches. Conclusion: Overall, these overlapping framings cast people who use drugs simultaneously as victims, criminals, deviants, and sick individuals to the detriment of their security, health, and well-being - and to the retrogression of drug policy in the country.

Since 1984, when the first HIV case was reported in the Philippines, the viral infection has been the subject of popular, political, and public health concern. In the 1980s HIV/AIDS was mostly perceived as a foreign threat, mobilized against US military presence in the country. Then, in the early 1990s, HIV/AIDS evolved into a moral issue, figuring into the reproductive politics emerging from long-standing church- state tensions in the country. Taking these points together, this article illustrates how HIV and AIDS influenced larger political and social issues in the Philippines, and conversely, how these issues informed how HIV/AIDS was framed and responded to.

As part of their populist performances during disease outbreaks, public officials and politicians tend to offer 'miracle cures' or 'wonder drugs' that can supposedly treat or prevent the disease in question. This article analyzes contemporary instances of what we call 'pharmaceutical messianism' and proposes four characteristics for this phenomenon, namely, that it: (1) emerges during times of extraordinary health crisis; (2) builds on preexisting knowledge, practices, and sentiments; (3) borrows from medical, often heterodox, authority; and (4) involves accessible, affordable, and/or familiar substances. Demonstrating the analytic value of our framework, we present three case studies, constructed using academic and journalistic sources, during the COVID-19 pandemic: hydroxychloroquine in France, ivermectin in the Philippines, and Covid-Organics in Madagascar. We conclude by identifying some implications of our findings on public health and avenues for future research.

Objectives:While the chronically overburdened state of public school teachers in the Philippines is well-established, little is known about how they specifically provide 'care' and attend to their students' health in the workplace. This article addresses that knowledge gap by illustrating the many forms of 'health work' undertaken by public school teachers on a daily basis, and analyzing the concrete challenges they face in doing such work. In so doing, this article provides a qualitative construction of school teachers as 'health workers' in the country. Methods:This article draws from two focus group discussions conducted in Southern Luzon and Eastern Visayas between November 2018 to May 2019, as part of a multi-sited study on the health-related challenges faced by low- and middle-income Filipinos. A total of 19 teachers participated in those two discussions. We used the principles of thematic analysis to code and analyze the discussion transcripts. Results:Teachers regularly fulfill various tasks that can be considered health work, including measuring students' anthropometrics; supervising and administering government programs like deworming, feeding programs, and vaccinations; providing first-aid and various forms of immediate medical attention; addressing students' mental and psychological health concerns; and working with students' families in ways that resemble social work. However, the study participants largely considered themselves unqualified to do health work, often sacrificed their own personal health and interpersonal relationships to take on the additional burden of health work, and felt they received insufficient institutional support. Conclusion:Doing health work not only takes away from actual teaching time, but also comes at the expense of teachers' own health. Hiring the appropriate personnel to conduct health work and improving legal safeguards are possible solutions to ameliorating the present working conditions of teachers. Yet, the larger and more long-term conversation demands the prioritiziation of teachers' well-being and overall quality of life, and recognizing the cruciality of a healthy work-life balance for them. Future studies should involve more diverse geographic sites and teacher populations, and utilize more focused forms of analysis (e.g., comparative, policy-driven).

Pantawid-gutom literally means “to bridge hunger” and refers to a range of food and non-food products and practices in the Philippines that allow people to survive in between “serious meals.” What does its existence as a liminal category between food/non-food or serious/non-serious meal signify, particularly for millions of Filipino families who regularly experience hunger? Drawing on fieldwork in low-income urban communities on Luzon Island, and from a review of the scholarly and popular literature, we use local conceptions of pantawid-gutom—hitherto overlooked in the scholarship—as a starting point for exploring the lived reality of food insecurity in the country. The efficacy of pantawid-gutom, we argue, is both material and symbolic, providing temporary relief from the feeling of hunger and allowing people to suspend their ideas of what is good to eat while maintaining the hope that their socioeconomic predicament is something bridgeable. BUOD Sa Pilipinas, ang tambalang salitang “pantawid-gutom” ay tumutukoy sa mga pagkain at iba pang bagay o gawain na ginagamit o ginagawa ng mga tao upang “maitawid” ang kanilang gutom sa gitna ng kahirapan o mahirap na sitwasyon. Ano ang maaari nating matutunan sa pagsasabuhay ng mga tao sa konseptong ito, at sa relasyon nito sa pagkain, lalo na sa milyon-milyong pamilyang Pilipino na araw-araw nakararanas ng gutom? Hango sa˛ isang etnographiya (pakikiag-usap, pakikipagkwentuhan, at pagmamasid) sa˛ iba’t ibang mga komunidad sa Timog Luzon, at sa pagsasaliksik ng mga nauna nang naisulat tungkol sa naturang paksa, ginamit namin ang mga lokal na pag-unawa sa “pantawid-gutom” (isang paksang sa pagkakaalam namin ay hindi pa napagtutuunang-pansin sa antropolohiya) upang simulan ang isang malalim na pagtanaw sa karanasan ng pagkagutom at kakulangan ng pagkain sa bansa. Mula sa aming pagsusuri, ang bisa ng pantawid-gutom ay nakaugat sa silbi nito bilang isang bagay na sadyang nakakapawid ng gutom at sa pagiging simbolo nito ng pag-asa: pag-asa na may mas ‘tunay’ na pagkain na nakaabang sa kanila, at, gaya ng gutom, maging ang kanilang mga suliranin sa buhay ay maaari ring ‘maitawid’.

Pantawid-gutom literally means "to bridge hunger" and refers to a range of food and non -food products and practices in the Philippines that allow people to survive in between "serious meals." What does its existence as a liminal category between food/non-food or serious/non-serious meal signify, particularly for millions of Filipino families who regularly experience hunger? Drawing on fieldwork in low-income urban communities on Luzon Island, and from a review of the scholarly and popular literature, we use local conceptions of pantawid-gutom -hitherto overlooked in the scholarship-as a starting point for exploring the lived reality of food insecurity in the country. The efficacy of pantawid-gutom , we argue, is both material and symbolic, providing temporary relief from the feeling of hunger and allowing people to suspend their ideas of what is good to eat while maintaining the hope that their socioeconomic predicament is something bridgeable.