The National Sexual Health Policy, which took 10 years to see the light of day, is a watered down version of previous unpublished drafts seen by The Sunday Times.

Health authorities have consistently said the policy would only serve as a stepping stone towards a national strategy, but the 2009 version, and more so the 2003 one, provided a clearer picture of the way forward than the one released last month.

These are the more comprehensive policies of the three, delving into details about the provision of sexual healthcare and advice tailored for under-16s, and listing specific services and measures for prisoners, sex workers and gays.

Sexual health is an urgent matter. Initial figures for 2010, compiled by the Genitourinary Clinic, show record figures for two sexually transmitted infections (STIs) – syphilis (25 cases registered, compared with the previous record 21 cases in 2008) and chlamydia (127 compared with the previous record of 116 in 2008).

The rate of carelessness when sleeping around remains consistently high with 70 per cent of all those who visited the clinic in 2010 failing to use a condom to protect themselves against STIs.

For years the policy has been handled with kid gloves by the authorities who took great care not to offend the Church. This is why so many versions have been drafted over the past decade.

Health Minister Joe Cassar was the one who after all these years decided the country could no longer remain without direction in sexual health and during the policy’s launch said “there has been enough procrastination”.

However, the concern of upsetting the Church seems to have remained and sources told The Sunday Times that the final version had been sent to the Curia for its views.

A ministry spokesman confirmed it had consulted the Curia about the policy, and its feedback had been taken on board.

However, the ministry defended its decision and the spokesman said it had not consulted the Curia “exclusively”. She said the ministry had conferred with other entities and stakeholders but stopped short of saying who else was shown the document.

When asked why the final policy had been watered down, the spokesman said this level of detail would be featured in the final strategy, expected to be released in February.

The spokesman added that the 2003 and 2009 versions would be taken into consideration when the strategy was being drawn up.

When asked why the strategy was disconnected from the policy in the first place, the spokesman said this was not the case.

“The policy seeks to map out the clear direction the government wishes to pursue to inform the development of the strategy. The process started on the day the policy was launched and will continue in the new year.”

The approach adopted during the formulation of the final policy sought to be evidence-based. She emphasised that the previous policies were “only drafts” and “were changed, as drafts are expected to undergo changes”.

“The ministry has already established that one of the foremost priorities will be the conducting of research to continue to inform elements of the strategy for which local robust data is currently unavailable,” she said.

However, GU Clinic consultant head Philip Carabot believes there is enough data and agreement on several issues to start acting.

There was already enough evidence regarding the lack of adequate sex education in schools, he said when contacted.

“We also have enough evidence from the GU Clinic’s annual reports regarding the trends in STIs, as well as the unacceptably high levels of casual sex and failure to use condoms.”

“Research and implementation should run in parallel, with fine tuning as we go along. While it is true that ongoing research is very important, this must never be used as an excuse for delays,” he said.

When asked about the discrepancy in the versions, Dr Carabot, the lone crusader of sexual health promotion, said the 2010 policy was not something he would have written, preferring the original versions.

“However, what I personally think or would have written is now irrelevant. What is relevant is that finally the authorities have publicly admitted we have a problem and committed ourselves to solving it,” he said.

“The real test will come in February when we should have a viable strategy ready with a definite action plan as promised. No excuse will be justified if we delay a concrete action plan beyond February,” Dr Carabot stressed.

“As far as I’m concerned, what we need now is real commitment, determination... and some serious money!”

The final document of the sexual health policy is accessible at www.ehealth.gov.mt. Feedback will be received until the end of January.

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