You have to admire Health Minister Jo Etienne Abela’s optimism when he launched the public consultation on the strategy for sexual health.
He declared to the Times of Malta that he thinks the proposals “will garner broad consensus within our society”.
It has been 14 years since the sexual strategy was last updated, and even then it was considered by some medical specialists to be too weak in certain aspects.
We are talking about a time when the headlines were buzzing because a students’ organisation, MOVE, unsuccessfully tried to install a condom machine at the University of Malta.
The attempt at least got people talking and, a year later, an outlet was opened there that sold condoms.
The brave proposals touch on so many elements that would have been taboo a decade or two ago, from emergency contraception to free condoms
Do we need to be reminded how many things have changed since then, from the increase in women in the workforce, to the influx of foreign workers and tourists? Twenty years have passed since then Archbishop Joseph Mercieca spoke about women only going out to work “if there were the need”, totally oblivious to the concept of shared parenting and women’s right to self-determination.
And now here we are, talking about being “enabled and supported to achieve sexual and reproductive health and well-being with a focus on respect of one’s sexual and reproductive rights and a commitment to create an enabling environment through intersectoral action and by tackling inequities”.
What is being proposed is a strategy in line with that of the WHO European region, which would take into account “all the Maltese population regardless of sex, age, gender, sexual orientation, gender identity, socio-economic condition, culture and ethnicity, and legal status”.
The brave proposals touch on so many elements that would have been taboo a decade or two ago, from emergency contraception to free condoms. While no one would question the benefits of morals and values, neither can we ignore the reality of freedom of choice about everything from sexual activity to sexual orientation.
Times have changed, and we have a responsibility to deal with the implications even when behaviour might be risky. Just as we deal with the effects of smoking and alcohol, we also have a duty to promote prevention and treatment.
As the minister said, sexuality and sexual behaviour are individual and private and should be approached with tolerance and not bias.
The strategy was drawn up after what he described as “robust research” – perhaps a dig at the strategy meant to be launched in 2021 which was sent back to the drawing board as the research it was based on was outdated. The strategy is open to public consultation for two months and received the endorsement of Superintendent of Public Health Charmaine Gauci, whose credibility built up during the COVID-19 pandemic remains untarnished.
Our metrics have been worrying for some time. Gauci pointed out that Malta’s rate of all sexually transmitted infections, except for chlamydia, is higher than the EU average. The report notes that there were over 100 new HIV-positive cases in 2022.
Five years ago, the Genito-Urinary clinic said it had seen its admissions double from 2,632 in 2009 to 5,864 in 2018, with long waiting times to get an appointment. Even then, the emphasis yearned for was a positive approach to sexuality, rather than simply focusing on the absence of disease.
We could, as we did in the past, moralise and judge and “tut tut” – or we can read the 61-page strategy and see it as the blueprint for the future we and the next generation deserve.