It has the flavour of a classic ‘whodunnit’: a draft document for a National Sexual Health Policy, submitted by the Sexually Transmitted Infections Prevention Committee, was returned by the Health Department with virtually every single mention of the word “condom” deleted... and yet, nobody has assumed responsibility for these changes.
Coming soon after the publication of statistics which suggest a sharp increase of sexually transmitted diseases (STDs) among adolescents, the decision to water down a draft sexual health policy was met with incredulity among health experts: including Dr Philip Carabot of the Sr Paul Boffa Hospital’s genitourinary unit, who described the resulting document as “nothing but a paper exercise with no bite whatsoever.”
But government yesterday distanced itself outright from the censorship, with an OPM official making it clear that “the cabinet of ministers had nothing to do with these deletions.”
Similarly, a spokesperson for the health ministry has also denied any involvement, and although she stopped short of defending the decision, communications co-ordinator Amanda Ciappara outlined the minister’s position that “condoms are not necessarily the answer”.
“It would be wrong to believe that campaigns promoting condom use are the solution to these problems,” she said. “The Health Division has never been against advocating the use of condoms. The Division has always conducted its campaigns advocating safe and responsible sexual activity.”
Ciappara added that Malta was not isolated in experiencing such changes.
“It is worth putting the Maltese problem within an international perspective. The problem of sexual activity starting at a younger age, the rise in teenage pregnancies and the increasing incidence of sexually transmitted diseases are not unique to Malta, but these are public health problems that are being encountered across the board, even in countries with more liberal and aggressive condom promotion campaigns.”
Efforts to contact Health Promotion director Charmaine Gauci yesterday evening proved futile.

Let’s (not) talk about sex
Condoms have long been ‘prophylactics non grate’ among the Maltese authorities, despite indications that the nation’s sexual health is deteriorating at an alarming rate.
The initiative to come up with a policy on sexual health originated in 1999, when, prompted by the European Union, government requested a draft policy as a matter of urgency.
In 2002, former Health Promotion director, Dr Mario Spiteri, was approached to co-ordinate the exercise. Although there was initially consensus among various government departments and agencies – as well as Church organs such as the Diocesan Youth Commission (KZD) – the issue quickly became controversial when reference after reference to condoms was removed from any proposed document.
The national sexual health policy has now gone through countless draft incarnations over the past nine years – none of which has ever resulted in a final version.
Matters came to a head in 2006, when Dr Spiteri refused to fund KDZ’s abstinence-only campaign, arguing that although abstinence was one of the four policy platforms recommended by World Health Organisation, any campaign based only on abstinence would be doomed to failure.
What followed was an acrimonious public wrangle between Dr Mario Spiteri, Fr Anton Gouder of KDZ, and “Roamer” – anonymous correspondent with the Sunday Times – after which Dr Mario Spiteri found himself peremptorily replaced by Dr Charmaine Gauci.
The upshot was that the KDZ’s abstinence-only campaign went ahead as planned, funded by the taxpayer, and modelled on the notoriously unsuccessful campaign launched by US president George W. Bush the previous year.
In an ironic twist, one of the more prominent billboards produced in this campaign – a sugary reminder that sex was best left until after marriage – was almost immediately vandalised, with the sarcastic message “U mela z***, Sur Kapillan?” scrawled right across it.
More ominously still, statistics published earlier this year revealed an exponential growth in pregnancy and sexually transmitted diseases among adolescents aged between 11 and 15.
The most recent Health Behaviour of School-aged Children study (HBSC), co-ordinated by WHO and published last month, revealed that 64% of sexually active adolescents had never used a condom. The incidence of STDs such as chlamydia, gonorrhoea and syphilis had increased dramatically – with syphilis almost doubling in the past four years – as had the rate of teenage pregnancy.
The same survey also showed a dramatic increase in single-parent children, with a staggering 37.5% of respondents claiming to live with only one biological parent.

rvassallo@mediatoday.com.mt