Fiona O'Malley (Dún Laoghaire, Progressive Democrats)
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I am grateful for the opportunity to discuss the need for a national sexual health strategy and I always take the opportunity to do so when it arises. I have been afforded the opportunity this week because it is National Condom Week.

Fewer than 100 people have died worldwide of the avian flu virus, yet the international community is galvanised in an extraordinary way to tackle it. The Government has put together a plan in this regard involving the Ministers for Health and Children, Agriculture and Food, and Finance. This is commendable, but the approach to sexually transmitted diseases is not so commendable.

Last month the Joint Committee on Health and Children heard from Dr. Susan Clarke, a consultant in the field of infectious diseases at St. James's Hospital, and the statistics she outlined are quite alarming. There has been an increase in the incidence of chlamydia in Ireland in the order of 2,000% in ten years, a 426% increase in the incidence of herpes in five years and a 45% increase in gonorrhea over two years. These figures are from 2003 and 2004. There was a 12% increase in the incidence of sexually transmitted infections. Dr. Clarke introduced her figures by issuing a caveat to the effect that these infections are widely recognised as under-reported. The increase in sexually transmitted infections represents a runaway problem despite the fact that a certain condom manufacturer is highlighting what can be achieved through condom use in protecting against sexually transmitted diseases, not to mention HIV and AIDS.

The usual suspects condemn any highlighting of increased use of condoms or sexual activity generally. Sexual health is the one area in which people are criticised for trying to inform and educate the public. The figures speak for themselves. It is high time we had a national sexual health strategy. The good news is that we do not need to reinvent the wheel. The Minister of State is probably aware that the former North Eastern Health Board had prepared a sexual health strategy. Much of the groundwork has, therefore, been done in this area and I hope, on foot of the alarming and unreported annual increases in sexually transmitted infections, we finally grasp the nettle.

Young people are looking for access to services and information that is presented in a non-judgmental way, but unfortunately they do not always get that. In an article in The Irish Times this week, a commentator stated it is most unfortunate that people are being asked to consider the use of condoms. The commentator is an individual with particular religious beliefs, which I respect, but it is not sensible to tell people not to use a product that is very effective in combating sexually transmitted diseases.

In the United Kingdom a group of young students has launched a campaign called Just Say Know. "Know" is rooted in the word "knowledge", which is what the students want. There is no point in keeping people in the dark about sexual activity. Statistics show how sexually active young people really are. Given that our population partly comprises such people, we need to face the reality and inform them.

A core element of the Just Say Know campaign is to demand from the UK Government services in both the education and health sectors. Those behind the campaign are perfectly right to do so. In any other area of health one is provided with the necessary information. Why are people not presented with information on sexual health? Is it because of our traditions and prudishness regarding the subject? I hope we can overcome this and consider seriously the development of a national sexual health strategy.

We need to be mature in our approach and it is important that we educate and protect the young. If we do not do so and fail to treat sexually transmitted diseases, many difficulties associated with infertility will arise. I hope, therefore, that the Minister will listen to my request to devise a national sexual health strategy.

Brian Lenihan Jnr (Dublin West, Fianna Fail)
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I am speaking on behalf of my colleague, the Tánaiste and Minister for Health and Children, Deputy Harney. I thank the Deputy for raising this matter.

The Department of Health and Children has supported sexual health at strategic and executive levels across the health sector for a number of years. At national level, policy has been formulated clearly in the report of the national AIDS strategy committee, the national health promotion strategy and the strategy of the Crisis Pregnancy Agency. All these strategies contribute to maintaining and improving sexual health in terms of education and awareness, service delivery, capacity building and research and surveillance.

The National Health Promotion Strategy 2000-2005 recognises that sexuality is an integral part of being human and healthy sexual relationships can contribute to an overall sense of well-being. The strategic aim is to promote sexual health and safer sexual practices among the population.

The health promotion unit of the Department works closely with the Health Service Executive on a range of awareness and education initiatives and interventions. These include working in partnership with the Department of Education and Science, the Health Service Executive and other youth structures to support schools and other bodies in the introduction and delivery of social personal and health education, of which relationships and sexuality education is an integral part. Included also is a national public awareness advertising campaign to promote sexual health. It is aimed at men and women in the 18 to 35 age group and is designed to increase awareness of safe sex and sexually transmitted infections.

The overall goals are to increase safe sexual practices and reduce the incidence of sexually transmitted infections and unwanted pregnancies among young people. The campaign runs in third level colleges, places of entertainment, such as pubs, clubs and discos, and youth venues and health centres. The initiatives also include the production of a range of awareness-raising leaflets on STIs and safe sex practices, and these are available nationwide.

In response to the specific issues regarding unplanned pregnancy, the Crisis Pregnancy Agency was established by statutory instrument in 2001 and is funded in its entirety by the Department of Health and Children. The agency is a planning and co-ordinating body established to formulate and implement a strategy to address the issue of crisis pregnancy through a reduction in the number of crisis pregnancies by the provision of education, advice and contraceptive services, a reduction in the number of women with crisis pregnancies who opt for abortion by offering services and supports which make other options more attractive and the provision of counselling and medical services after crisis pregnancy.

The first strategy to address the issue of crisis pregnancy was officially launched in November 2003 and provides a framework for understanding the causes and consequences of crisis pregnancy and a clear set of actions to address the complex and interacting factors that contribute to the experience of a crisis pregnancy. The agency works on an ongoing basis with statutory and non-statutory agencies to ensure successful implementation of the strategy.

The Crisis Pregnancy Agency is committed to the use of research as a basis for understanding behaviour, assessing need, building on previous practice and promoting the use of evidence-based practice. The goal of the agency's research programme is to foster greater understanding of the contributory factors and solutions to sexual risk taking and crisis pregnancy at individual, community, policy and social level.

Through the national AIDS strategy committee and the structures in place to implement the recommendations of the AIDS strategy, more than €6 million additional annual funding has been provided to health services since 1997. This has been used to address the treatment of HIV-AIDS and other STIs and to develop, deliver and expand initiatives, in partnership with NGOs, for vulnerable groups, such as sex workers, drug users, and those from migrant populations who come from high endemic areas for HIV as well as homosexual men.

At present there are seven consultants specialising in the treatment of HIV-AIDS and STIs, five of whom are in Dublin and one of whom deals with children. In addition, routine antenatal testing was introduced in 1999 and is effective in identifying women who are HIV positive at an early stage in pregnancy which allows for treatment to greatly reduce the perinatal transmission rate.

In recent years with the growth in demand for services and significantly increased government investment, all of the key national players from the statutory and non-statutory sector have come together under the guidance of the Department and the Crisis Pregnancy Agency to plan a common way forward. This has resulted in the first ever national survey of sexual knowledge, attitudes and behaviours in Ireland. This study is now in its final stages and has been carried out in line with those in other European countries. The research is being carried out by a consortium from the Economic and Social Research Institute, the Royal College of Surgeons in Ireland, Trinity College and an independent research consultant.

The aim of the research is the collection of reliable nationally representative baseline information. The key issues on which the research will focus include social and demographic characteristics, risk reduction practices, adverse and positive outcomes and the degree of knowledge and learning about sex. The first of four reports detailing the research findings will be published in September of this year. It is intended that the findings will inform all future sexual health policy and practice developments.