One morning in 2015, I woke up with aching joints in my fingers. I waited several days before going to a doctor who diagnosed me with Rheumatoid Arthritis (RA), a chronic, auto-immune condition. I did not know how to react, but it dug a hole in my heart. I stopped the tears from flowing. I knew that my life would change moving forward but like many patients I tried to portray a normal life. It was not difficult to hide the diagnosis because the disease is invisible at the onset and I was good at hiding my fear and uncertainty.

I went on with life, continued my public health advocacies, my studies, and my fieldwork in the Visayas region; organized big health events; and continued my bellydancing recitals. These were my joy and pride until the pain in my joints spread around my body. The pain became too difficult to bear because of the fatigue I felt. I was referred to a Rheumatologist and I took prescribed medicines for a while, but stopped. I did not believe that my disease could be reversed so I tried an integrative approach to my treatment, combining western and complementary medicine. My work supervisor, who was both a medical doctor and an acupuncturist, took care of me. I also changed to a vegan diet to help me manage the inflammation of my joints. Gradually, I lost weight and the delay in my acceptance of the disease brought me severe pain, limiting my mobility. It affected my daily activities. My first flare up was an eye opener. My joints were so inflamed that they were obvious in my frail physique. My husband had to move me between the bed and the bathroom because I couldn't stand up from our lower frame bed and I also had problems controlling my bladder so he had to help me remove my underwear. Complementary medicine no longer helps me, thus, I sought my Rheumatologist. I had to go back to eating a normal diet so I could gain weight. I also had to make lifestyle changes, including a choice to reduce my advocacy actions.

My second flare up happened in 2020. Due to restrictions from the pandemic, I was not able to have a check-up for a long time. My shoulders and arms were paralyzed but I didn't stop working. I owe my pain endurance to the strong spiritual support found in my Christian faith.

With my experience, I wanted to help other patients like me persevere. I became active at the Healthy Philippines Alliance (HPA). I believe that leadership is not about winning battles alone through one's strength but about taking others by the hand to act collectively. While humbling ourselves, also acknowledging our need for space to breathe and regain strength. It is helping without hurting them or ourselves.

The COVID-19 pandemic three years ago was an opportunity to reflect and harness the strength of our community.

In 2020, I was commissioned to collect stories of coping, adapting and survival during the pandemic for a report. At this time, I was in pain due to my second flare of rheumatoid arthritis. For three months, I was paralyzed from my shoulders down to my upper arms. It was exhausting being in so much pain, but it did not stop me reaching out to people living with NCDs like myself who needed emotional connection at this time. I did not do this in my own strength, but through God’s grace that I was able to endure and persevere.

The Healthy Philippines Alliance (HPA) champions both disease-focused advocacy and broader initiatives, aimed at improving the health and well-being of the entire population. Not only did I find fellow advocates who share a common goal, but a community of warriors filled with care and compassion for one another.

We fight our diseases together. One example where advocates came together under HPA was during the development of the Civil Society Agenda for Food, Nutrition and Healthy Eating Towards NCD Prevention and Control and the People’s Overall Health, where I joined efforts with people living with all types of NCDs, not just the ‘big four’.

We contributed to a three-part research series on NCDs – current profile and NCD status, types of food policies in place, and assessment of the government budget spent on food and nutrition. The findings of this initial research fed into the development of a shared agenda focused on the national consumption of fruits and vegetables; salt and sugar reduction through taxes; and phasing-out trans fats.

Through this initiative, we strengthened our bond as a community. As a result, the government and other sectors have begun to recognize our perspectives—not only on patient safety, but also on broader health systems issues such as governance and financing. Civic spaces for people living with NCDs have become more open and respected. This growing recognition empowered us to collectively raise our voices, urging the government to restore funds to the State’s social health insurance system and to defer amendments to the Universal Health Care (UHC) Law until meaningful public consultations are conducted.

There is power in voices. Leadership can be collective, thriving through shared vision and collective action. I saw the importance of building trusting relationships, when we mourn and rejoice around our losses at a time when social distancing became necessary, and emotional connection was needed. Among people living with NCDs, leadership is not about uniformity but about honouring our varied journeys and uniting around a common cause. Our strength lies in shared purpose and diverse experience.

As patients we understand our individual limitations but together, we can make a difference. While I wanted others to know more about autoimmune diseases, my desire as a public health advocate is to push for systemic reforms. I advocate for NCD prevention, promotion and control; access to treatment and long-term care; meaningful involvement of people living with NCDs; and sustainability of the health system through health information, human resources and financing. Many members of Healthy Philippines Alliance (HPA) were instrumental in the push for the UHC Law. In 2017-2018 we came together to study the Philippine health system, proposed provisions and lobbied lawmakers in the halls of Congress. In addition, some members were also active in driving progress on cancer control and mental health laws and policies.

Together, we advocate not only for our individual interests but for those who are marginalised and don't have a voice. The health policy reforms we fought for are now being eroded by regressive policies which weaken the Sin Tax laws, defund social health insurance, and amend the UHC law without public consultation. In response, we have allied with other civil society organisations and participated in various actions, disseminating letters to policymakers, and issuing media statements on our position. Our efforts delayed the UHC amendments pending consultations, and gained a policymaker's support to block a proposed tobacco tax cut.

The impact of our sustained engagement as a civil society and patient alliance showed policymakers that there is a strong constituency behind these demands who are holding them accountable. With our presence, the community hopes that the policy reforms it fought for will continue strengthening the health system not only for those who can afford healthcare but also for those often left behind.

Building on the alliance’s progress, we urge the government—including policymakers—to take action on the following priority areas outlined in our NCD and Food and Nutrition Advocacy Agenda:

• Include Filipinos with chronic or life-threatening NCDs (e.g., autoimmune disorders, diabetes, heart and kidney diseases) under the Magna Carta for Persons with Disabilities to ensure access to medical and social benefits;
• Reduce out-of-pocket costs for NCD patients by expanding access to early diagnosis and appropriate treatment through trained healthcare providers; and
• Earmark health tax revenues (e.g., from sugar and salt) to incentivize local government units in supporting neighbourhood stores to offer healthier food options like fresh produce.

Leadership is an act of service—rooted in the humility to listen, the courage to engage diverse perspectives, and the willingness to be changed by them. It requires stepping beyond comfort zones to build bridges, not walls—fostering genuine collaboration rather than reinforcing the status quo. Servant leadership places the needs of the community first, creating space where others can rise and co-create solutions. It has the power to transcend public health and inspire other sectors by showing the shared value of investing in people and systems.