Explainer: EU funds for abortion access outside Malta

This week, the European Commission told member states they can use existing EU funds to pay for safe abortions to help women from other EU countries who do not have access to legal terminations. Claudia Calleja explains what this means for Malta – where abortion is illegal.

How did this all start?

The issue began with an EU-wide petition called My Voice, My Choice. The campaign was not just a petition – it was a formal European Citizens’ Initiative – a mechanism that allows citizens to request new EU legislation.

If an initiative gathers at least one million signatures from at least seven EU countries, the European Commission must examine it and formally respond. The European Parliament must also hold a debate.

The initiative gathered more than 1.2 million signatures across the bloc, surpassing the required threshold. In Malta, 4,278 people signed – that’s 101% of the national threshold.

What sparked the initiative?

Although abortion is allowed in most of the 27-nation bloc, the termination of pregnancies remains severely restricted in some countries – notably Malta and Poland.

This means that not all women across the EU have equal access to safe abortion care. The campaigners set out to change this by proposing the creation of a mechanism that allows countries that allow abortions to support women from countries that do not.

What, exactly, did the initiative ask for?

Campaigners asked the commission to submit a proposal for financial support to member states that, in line with their national laws, would provide safe and legal abortions to women from other EU countries where access is restricted.

They proposed an opt-in system: member states choosing to participate would receive EU financial support to help cover the costs of providing abortion services to women travelling from countries with limited or no access.

Importantly, organisers stressed that the initiative did not seek to harmonise abortion laws across Europe or interfere with national legislation. Instead, it aimed to use the EU’s supporting competence in public health to promote access where abortion is already legal.

What did the European Commission decide?

On Thursday, the European Commission decided not to create a new, dedicated EU funding scheme for abortion access, as requested.

However, it clarified that member states can already use existing EU funds to support women seeking legal abortion services. Specifically, countries may voluntarily use money from the European Social Fund Plus (ESF+) to help cover travel and accommodation costs, fund medical scans and procedures and support cross-border access to abortion services.

This could apply to women travelling to another EU country, or even within their own country if access varies regionally.

The commission stressed that any such use of funds must comply with national laws and remain entirely voluntary for member states. This is non-binding, which means it is not legally binding.

What was the rationale behind the decision?

The commission cited public health concerns. It noted that, according to the World Health Organisation, around 483,000 unsafe abortions take place in Europe each year. Unsafe procedures can lead to serious physical harm and psychological distress, posing risks to women’s lives and health.

While healthcare policy remains a national competence, the commission argued, the EU can support member states in improving access to healthcare services under existing treaty rules. The commission argued that the ESF+ already provides a legal pathway for countries wishing to expand access to safe and affordable healthcare, including abortion, where legal. Countries choosing to use the fund for this purpose may need to amend their national ESF+ programmes, unless it is already included.

European Commissioner for Equality, Preparedness and Crisis Management Hadja Lahbib, left, and EU Executive Vice-President for Social Rights, and Skills, Quality Jobs and Preparedness Roxana Minzatu, right, at a press conference in Brussels. Photo: AFP

What is the ESF+?

The ESF+ is the European Union’s main instrument for investing in people and social rights. With a budget of €142.7 billion for the period 2021-2027, it supports employment, education, social inclusion and healthcare initiatives. 

Amounts allocated per country depend on population size. Malta is allocated €124.4 million in ESF+ funds to support projects promoting education and training, access to employment and healthcare.

Why are campaigners calling this a victory?

Although the commission refused to create a new funding mechanism, pro-choice campaigners say the decision is still significant. For starters, the commission recognised that abortion is healthcare.

Campaigners argue that this establishes, for the first time, clear political recognition, at EU level, that access to abortion can be supported financially through existing EU structures. While disappointed by the lack of new funding, they see the clarification as a step forward.

What does this mean for Malta?

Abortion is illegal in Malta except when performed by doctors to save a woman’s life. Under the commission’s decision, Malta is not required to change its abortion laws or to use EU funds to support abortion access.

However, other EU countries may use EU funding to assist Maltese women seeking abortions in that country. Up until now, Maltese women could still get abortions in other EU member states, but they would have to pay for the procedure.

In practical terms, this means that, while Malta’s legal framework remains unchanged, financial barriers for women travelling abroad for abortion could potentially be reduced – depending on whether other member states choose to use the ESF+ for this purpose.

How impactful would this be, and how will it work?

The mechanics are still being ironed out. However, when the ball is set in motion, it will provide an option to those women who travel to other EU countries for safe and legal abortions.

While there is no accurate data for women who travel for this reason, pro-choice activists believe this will mostly affect those women who travel to terminate wanted pregnancies after learning that their baby will be born with a serious birth anomaly.

At the moment, Maltese law does not allow termination in the case of non-viable foetal anomalies, which means the baby will die in the womb or soon after birth.

The commission’s decision is unlikely to impact the way the abortion pill is being used in Malta since it will remain easier to get the pill to Malta (where it remains illegal) than to travel to take the pill or get a procedure done.

Data shows that the number of women in Malta receiving abortion pills at home through telemedicine services continues to increase from 93 in 2017, to 289 in 2020, 590 in 2024 and 667 in 2025.