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 Strategy 2026-2030.

Days later, during the campaign trail, Prime Minster Robert Abela 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 endometriosis and hormone replacement therapy.

Abela’s announcement sounds promising and positive but beneath the pledge lies a more complicated 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 multiple election cycles without implementation. Critics argue that the document avoids some of the most politically difficult conversations such as abortion, sexual violence and reproductive autonomy.

For years, stakeholders have argued Malta needed an updated sexual health strategy. The previous framework was outdated by at least a decade. But what finally arrived has been described by Doctors for Choice as less of a roadmap and more of a repackaged manifesto.

“This reads more like an electoral manifesto than a strategy,” Doctors for Choice members Isabel Stabile and Natalie Psaila Stabile wrote in an opinion on MaltaToday. They say the strategy contains “empty and non-meaningful words,” and lacks measurable timeframes. It also recycles policies that have “exited for years.”

The strategy repeatedly highlights programmes that are already in operation such as genito-urinary clinic services, which are already available at Mater Dei Hospital, with specialist services also operating in Gozo.

Community sexual health clinics 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 available over the counter from pharmacies since 2016. A national cervical screening programme is already in place. State-funded IVF services have already been broadened. Moreover, the Gender Wellbeing Clinic has operated since 2018.

Even some of the key measures in the strategy are not new initiatives 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 issues which already exist as new. It offers little detail on what will change over the next five years.

This frustration is felt the clearest when it comes to contraception. The strategy promises a tagged rollout of free conception, including reversible contraceptives (such as IUDs), implants, and the contraceptive pill. But free contraception has been promised before. In fact, it appeared 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 adding the medication to the national 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 Ministry in 2026, they said in time a timeline would be provided for the roll out. Emergency contraception on the national formulary 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 sexual 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 accessible 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 intends to explore telemedicine sexual health services, create an implementation steering group, establish specialised clinics for sex workers, introduce free condom schemes, expand rapid HIV testing and regulate STI self-testing kits. But the document once again provides few concrete implementation 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 healthcare 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 bleeding after taking abortion pills and was reported to the police by doctors when she sought treatment at Mater Dei Hospital.

The strategy also contains limited discussion of sexual violence, despite repeated calls from NGOs and healthcare professionals for stronger trauma-informed 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 education, reproductive autonomy and comprehensive sexuality education receive comparatively limited attention.

The document does propose several educational initiatives, including expanded Comprehensive Sexuality and Relationships Education (CSRE), training for educators, adult learning opportunities, and disability-focused programmes. But once again, most remain future commitments rather than active policy.

There is some good in there

However, despite the strategy leaving a lot to be desired it still represents some progress. Malta 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 reduction would have been politically unthinkable only a decade ago.

But whether those proposals survive beyond campaign season remains uncertain.