England has the opportunity to be a global leader in sexual and reproductive health, with our dedicated health care professionals and world-class surveillance systems. However, the past few years have seen a concerning lack of ambition from the central Government, with sexually transmitted infections (STIs) skyrocketing, year on year real-term cuts to local authority sexual health budgets, and notably the recent changes to downgrade the National Chlamydia Screening Programme.
The new strategy must reverse this trend and set commitment and actions to improve sexual wellbeing and significantly reduce the incidence of STIs so that they are eliminated as a public health concern – a World Health Organisation target that the UK Government is yet to commit to. This target can be achieved by both maximising access to interventions we already have available and also investing in research so that new innovative interventions may be developed.
Our sexual and reproductive health services must be commended for their resilience during the COVID-19 pandemic, efficiently moving services online and coping with the redeployment of staff. But there is now a need for not only a recovery plan but a full funding package. Our sexual and reproductive health services need a workforce that has the capacity and capability to not only cope with everyday pressures but also be responsive to unexpected emerging demands, such as the current monkeypox outbreak.
To be fully effective, sexual health services and interventions must be both co-designed and co-commissioned to ensure joined-up care and equity of access, with appropriate culturally sensitive services available for all. This means ensuring the continuation of face to face appointments, as well as promoting and innovating online access models. There is also a need for the new strategy to acknowledge the vital role of key primary prevention services not currently mandated, such as community outreach and health promotion. It is only through these targeted prevention efforts that we will see equitable progress, including in the most marginalised groups of the population.
The inequalities seen in sexual and reproductive health are stark and unacceptable. As are the ever-increasing pressure on services, lack of funding and unmet need. A new strategy is a chance to set this right, but three years since the Government committed to a new sexual and reproductive health strategy, it is yet to be published. All the more worrying is the striking lack of engagement with the sexual and reproductive health sector in the strategy’s development. For this new strategy to have a meaningful impact, full input must be sought from community and system organisations, both in its development but also in implementation. There is also a need for the strategy to set out a clear framework of accountability including annual reporting to parliament on progress.
The Government has talked of ‘building back better', now is the time to show its commitment to this rhetoric in all aspects of our lives. The new sexual and reproductive health strategy is a vital opportunity to deliver a world-leading ambitious vision for the nation. An opportunity the Government must now seize.
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