1 of 23 Young People’s Sexual health Royal College of Physicians London 29 June 2009 Robert Madelin Director General for Health and Consumers European Commission

2 of 23 Context Action

3 of 23 Definitions of Sexual Health WHO: Sexual health is not only the absence of sexually transmitted diseases (STDs) but a state of physical, emotional, mental and social well- being related to sexuality Council of Europe : the Right to sexual health implies the ability to establish a mutually satisfying and safe relationship free from coercion, violence or fear of STDs or unwanted pregnancies

4 of 23 Context EU committed to achieving a high level of health protection  stimulate and /or complement MS activities Increasing numbers of sexually transmitted infections, particularly in young people, all over Europe Mobility Sexual health / overall life skills

5 of 23 Drivers Socio-economic factors poverty education employment Demographic factors age structures mobility and migration, urban/rural movement socialdisruption Social influence influence of communications social norms cultural background Prevention and therapy access to prevention services and means access to treatment

6 of 23 Legal Framework : EU Role in health policy Art. 152 of the EC Treaty: A high level of human health protection shall be ensured in the definition and implementation of all Community policies and activities Community action, which shall complement national policies, shall be directed towards improving public health, preventing illness … Such action shall cover the fight against major health scourges, by promoting research into their causes, their transmission and prevention as well as health information and education. Community shall encourage cooperation between Member States and lend, if necessary support to their action Community action shall fully respect the responsibilities of Member States for organisation and delivery of health services

7 of 23 Chlamydia infection in selected European countries Fenton, K A et al. Sex Transm Infect 2004;80:

8 of 23 Chlamydia : Age distribution

9 of 23 Source: HBSC study University of Utrecht, The Netherlands

10 of 23 Source: HBSC study, University of Utrecht, The Netherlands

11 of 23 Sexual and reproductive trends in young people (Women aged 18/9-44; Natsal 2000)

12 of 23 Births per 1000 women aged under 20

13 of 23 EU action Round Table on Safer Sex for young people, with youth organisations, commercial advertisers, Durex, and some Member States Establishment of a Forum on Sexual Health 2008 – youth, communication experts, several Member States Integrate sexual health as a priority in the EU Research Programme and the Public Health Programme

14 of 23 Sexual health policy at EU level Target young people Focus positive health aspects of a full sexual life Impact general health status of next generation(s)

15 of 23 Challenges Sexual Health is a sensitive issue Sexual health is a new theme for the Commission Traditional messages from the „Nanny state“, „Don‘t do because ….“ do not stick any more Address young people in correct environment, tone, style and appropriate communication means, use relevant messages e.g. relating to their looks, love lives and their future Create a message that is effective for mixed groups as a whole, sensitive to cultural differences Involve young people at all levels of analysis, design and response

16 of 23 Contents of the approach Create sound knowledge base - Increased research on socio-economic settings & sexual behaviour of youth - collect and analyse behavioural strategies –ECDC, Research Programme - surveillance and epidemiology of STDs – ECDC - Eurobarometer survey on young people‘s knowledge of sexual and reproductive health in several Member States Create a Sexual Health Forum that provides a platform for different stakeholders, governments, civil society, youth Objectives: Raise awareness of the topic Improve methods and means of communication with young people Develop clear, strong and positive common messages Cooperate on access to a broad sexuality education and improved low threshold affordable services of quality

17 of 23 Structure and process projects Clear & positive messages Epidemiology Behavioral research Sexual health Platform communication cooperation

18 of 23 EU funding Health programme SAFE, SAFF II in negotiation, ESSTI ECDC behavioural surveillance for HIV and STI European guidelines for Chlamydia control (June 2009) STI surveillance - including all MS, data collection will start this summer RTD Call 2010 Presently elaborated

19 of 23 Projects Under the public Health Programme 2 big projects: European Partnership project – SAFE- to promote the sexual health and rights of young people. The project developed new and innovative ways to reach young people with information and services on sexual health and rights and inform, support and advance policy development. It developed recommendations. On a scientific level the Commission supported two projects on reproductive health indicators in European Union in REPROSTAT 1 and REPROSTAT 2 in REPROSTAT 2 assesses the usefulness of a comprehensive set of reproductive health indicators designed for the enlarged European Union, with particular emphasis on the reproductive health of adolescents and young adult (Phase 2) In 2009 call 6 projects proposed on Youth Sexual violence, strategies for European sex education, youth communication and reaching of youth with a migration background Under the Research Programme RTD Focus on sexual and reproductive health in international co- operation (Africa, China)

20 of 23 Process Bottom-up: Use results of: –Health Programme projects on sexual health –Youth forum on 9/10 July –Policy debate Top down Continue calls for project proposals Expand Sexual Health Forum to exchange experiences and commit to a responsible way to address young people’s sexuality

21 of 23 Member States Youth Formal education Advertisers, Broadcaster, Media EU Sexual Health Platform Medical profession, social worker Non formal education International Organisations, WHO,IOM Business producing for young people Stakeholders Research

22 of 23 Added value of a European Strategy? Shared vision of young people’s health Higher awareness in Member States Blueprint for Member States to act Empowerment of young people resulting in responsible behaviour Decrease of STDs and early pregnancies across Europe Sustainable improvement of young people’s sexual health and general health status

23 of 23 Thank you!