Issue link: https://maltatoday.uberflip.com/i/1544987
14 maltatoday | SUNDAY • 17 MAY 2026 NEWS ELECTION 2026 Malta's sexual health strategy: Repackaging old promises WITH little public fanfare and two weeks before Malta heads to the polls, Health Minister Jo Etienne Abela quietly published the National Sexual Health Strat- egy 2026-2030. Days later, during the campaign trail, Prime Minster Robert Abe- la pledged a Labour government would prioritise women's health. He promised specialised clinics offering gynaecological check- ups and access to contraception, alongside free treatment for en- dometriosis and hormone re- placement therapy. Abela's announcement sounds promising and positive but be- neath the pledge lies a more com- plicated reality because much of what appears in the strategy released a few days earlier by his health minister already exists. Several proposals have been promised repeatedly across mul- tiple election cycles without im- plementation. Critics argue that the document avoids some of the most politically difficult conver- sations such as abortion, sexual violence and reproductive au- tonomy. For years, stakeholders have ar- gued Malta needed an updated sexual health strategy. The pre- vious framework was outdated by at least a decade. But what fi- nally arrived has been described by Doctors for Choice as less of a roadmap and more of a repack- aged manifesto. "This reads more like an elec- toral manifesto than a strategy," Doctors for Choice members Isabel Stabile and Natalie Psaila Stabile wrote in an opinion pub- lished this Sunday (see MT2). They say the strategy contains "empty and non-meaningful words," and lacks measurable timeframes. It also recycles pol- icies that have "exited for years." The strategy repeatedly high- lights programmes that are al- ready in operation such as geni- to-urinary clinic services, which are already available at Mater Dei Hospital, with specialist services also operating in Gozo. Community sexual health clin- ics already provide routine STI testing and free HIV testing and anti-retroviral treatment already exists. The document also heavily references the HPV vaccination programme, which has been part of the national immunisation schedule for girls since 2013 and was expanded to boys in 2024. Furthermore, the emergency contraceptive pill has been avail- able over the counter from phar- macies since 2016. A national cervical screening programme is already in place. State-funded IVF services have already been broadened. Moreover, the Gen- der Wellbeing Clinic has operat- ed since 2018. Even some of the key measures in the strategy are not new ini- tiatives but services that already exist. And while there is nothing wrong with these programmes existing, the concern lies in the fact that the strategy presents is- sues which already exist as new. It offers little detail on what will change over the next five years. This frustration is felt the clear- est when it comes to contracep- tion. The strategy promises a tagged rollout of free conception, including reversible contracep- tives (such as IUDs), implants, and the contraceptive pill. But free contraception has been promised before. In fact, it ap- peared in the 2022 Labour Party manifesto. However, four years later, it has still not materialised. Emergency contraception is another promise that has not materialised, even though add- ing the medication to the na- tional formulary list was one of the corner stones of the public consultation published at the end of 2024. When MaltaToday reached out to the Health Min- istry in 2026, they said in time a timeline would be provided for the roll out. Emergency con- traception on the national for- mulary list features in the new strategy but with no timeline for implementation. Until now, the morning-after is currently only provided for free in cases of sex- ual assault through Mater Dei Hospital. In this regard Doctors for Choice have criticised the fact that emergency contraception is legally available in pharmacies but it is still not broadly acces- sible through hospital systems. "No political party should make repeated unfulfilled promises to attract votes," the activist groups says. Aspirational rather than operational The strategy said that it in- tends to explore telemedicine sexual health services, create an implementation steering group, establish specialised clinics for sex workers, introduce free con- dom schemes, expand rapid HIV testing and regulate STI self-test- ing kits. But the document once again provides few concrete im- plementation dates. Furthermore, many proposals are framed in tentative language, such as "explore", "consider", "discuss" and "propose." This combined with the absence of timelines is particularly striking given that some proposals have already existed in draft form for many years. What is omitted Despite abortion being one of Malta's most contentious health- care debates, the strategy all but ignores it. The omission comes amid estimations that hundreds of women in Malta continue to access abortion every year and multiple women have appeared in court. One woman had severe bleed- ing after taking abortion pills and was reported to the police by doctors when she sought treat- ment at Mater Dei Hospital. The strategy also contains lim- ited discussion of sexual vio- lence, despite repeated calls from NGOs and healthcare profes- sionals for stronger trauma-in- formed systems. A further criticism is that the document conflates sexual and reproductive health rights with genito-urinary medicine. The document focuses heavily on HIV presentation and men who have sex with men (MSM), while issues such as consent ed- ucation, reproductive autonomy and comprehensive sexuality education receive comparatively limited attention. The document does propose several educational initiatives, including expanded Compre- hensive Sexuality and Relation- ships Education (CSRE), train- ing for educators, adult learning opportunities, and disability-fo- cused programmes. But once again, most remain future com- mitments rather than active pol- icy. There is some good in there However, despite the strategy leaving a lot to be desired it still represents some progress. Mal- ta has historically treated sexual health cautiously within public policy. The inclusion of proposals around gender-affirming care, free contraception, sex worker outreach, and chemsex harm re- duction would have been politi- cally unthinkable only a decade ago. But whether those proposals survive beyond campaign season remains uncertain. LAURA CALLEJA lcalleja@mediatoday.com.mt