This week, we submitted our response to the government’s health prevention green paper, which sets out a plan for preventing ill health by focusing on its causes. Though the green paper included HIV and sexual health, we say there is more to be done.
The green paper floated the idea of a sexual health and reproductive health strategy but did not go so far as committing to one.
The dire need for the government to commit to a national sexual health strategy is evident in the lack of vision surrounding sexual health, the insufficient investment in public health funding and the soaring rates of STIs. These include rises in syphilis and gonorrhoea, particularly among men who have sex with men, along with chlamydia, especially among young people.
Alongside the Local Government Association and British Association for Sexual Health and HIV, we're clear that a strategy is needed as a matter of urgency. The strategy must aim to reverse the increasing trends seen in the majority of STIs (syphilis, gonorrhoea, chlamydia, herpes, trichmoniasis, and Mgen), while continuing the progress made in others (genital warts and HPV). On top of that, let's not forget (and how could you?) about the ever-worrying threat of drug resistance.
In our response we’ve asked for the government to loosen the purse strings and provide adequate funding to support a cross-system sexual health strategy that will ensure funding for essential primary prevention and outreach efforts, as well as testing and treatment for all STIs.
Yes, that includes sneaky new STIs such as mycoplasma genitalium and older STIs such as trichomoniasis that just aren’t getting the attention they deserve. Primary prevention, testing, and treatment are critical for getting ahead of the trends seen in STIs, and we need a strategy that recognises that.
But it’s not all about the money. There are some principles that we think are key to a successful strategy.
What do these look like? Well, we're asking for the strategy to be cross-system, involving key stakeholders from across the sector. It can’t just be one government department writing it in isolation. It needs ownership and accountability from all organisations that have a vital role in improving the nations sexual health. And because community organisations are a direct channel to engaging communities who will be most affected by the strategy, it is vital that they're included.
Crucially, this strategy needs to be co-produced with people who are affected by poor sexual health, such as young people, men who have sex with men, ethnic minority communities (and drilling down to specific communities), trans and non-binary people, and people living with HIV.
The strategy will need to give more clarity on the future co-commissioning of sexual health services and address the dire concerns around the future of the sexual health workforce that our medical colleagues are raising.
Though it may not all be doom and gloom, the areas which are seeing successes still have a way to go. The Government's commitment to compulsory relationships and sex education is a welcome step, and we hope it will have a positive impact on sexual health across England. However, in order to do this, teachers need face-to-face training and resources that can support their teaching of these topics.
HIV transmissions are continuing to decline, and the government has committed to ending new transmissions by 2030. In order to achieve this, the government needs to continue with these successes, committing to funding the provision of PrEP at the end of the impact trial, and committing to listening to the HIV Commission.
Submitted consultations for the green paper are now being reviewed and the next stage is for the government to confirm any updates to its policy based on the consultation.
We look forward to seeing what the government has to offer in the way of a national sexual health strategy, hoping it encompasses all these important principles and aims to ensure its success.
- Amber Newbigging-Lister is a Policy and Campaigns Officer at Terrence Higgins Trust.