I drive frequently enough in the Philippines that I have a Philippine drivers license.

Driving in Manila is much more challenging than in NYC. Car density is higher in Manila (yes, really), and the drivers are less predictable.

I can't give you much input on car rentals, since I have access to a locally registered car, although I used to rent from a local agency a while back. Local companies are small and their cars tend to be a little older. Sometimes the odometer might read over 100000 km.