Revolutionary agenda to improve sexual health of people in Pacific
15 January 2015
Suva – With concern over high rates of teenage pregnancy and sexually transmitted infections (STIs), a collaborative effort
is getting under way to implement an ambitious sexual health agenda for the Pacific.
Promoting sexual and reproductive rights and reducing the prevalence of STIs and HIV, adolescent pregnancy, gender-based
violence and sexual assault – including among vulnerable populations – are at the heart of a comprehensive Pacific
Sexual Health and Well-Being Shared Agenda for 2015-2019.
Representatives of governments, civil society organisations, health networks and key populations took part in a 16-month
consultation process to shape the new health agenda, led by the Secretariat of the Pacific Community (SPC) and funded by
the Pacific Island Response Fund for HIV/STI, which is supported by the Government of Australia and the New Zealand Aid
Programme, and by the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Endorsed by Health Ministers from all 22 Pacific Island countries and territories in July 2014, the Shared Agenda is
available here: http://bit.ly/1Bg0sxn
This week work begins on detailed planning for its implementation among regional development partners aimed at
strengthening coordination to support countries and national stakeholders in shifting the focus from single diseases to
a rights-based approach.
In the Pacific context, the populations most vulnerable to poor sexual health and well-being are people living in
poverty, people living with HIV or non-communicable diseases, women, young people, people living with disabilities, and
those who identify as lesbian, gay, bisexual, transgender, queer and intersex.
An aim of the new agenda is to expand the reach of sexual health services through greater integration with related
services and programmes which is of particular importance for Pacific Islands where sexual and reproductive health
services are not always available at the primary health care level.
The agenda complements and builds on other regional plans, including the Pacific Youth Development Framework. Key points
to be addressed from 2015 onwards, as per the document, include:
• Health systems suffer from a shortage of human and financial resources which means people in the Pacific, particularly
on remote outer islands, are not able to access comprehensive sexual and reproductive health information, services and
• Many services focus on married women and expectant mothers while the range of tailored services for single women,
older women, men and transgender people is low or non-existent;
• Teenage pregnancy is generally high – for instance the Republic of the Marshall Islands has the region’s highest rate
of teenage pregnancy with 85 births per 1,000 females aged 15–19 years, well above the global average;
• Sexually transmitted infections are hyper-endemic in the region – on average 25 per cent of sexually active young
people have an STI and in some countries this is as high as 40 per cent;
• The estimated prevalence of HIV amongst adults aged 15 to 49 in the 17 countries with HIV cases in the Pacific is less
than 0.1 per cent. All but Papua New Guinea are on track to achieve the goal of universal access to treatment for HIV
and AIDS. However, factors such as high rates of STIs and low condom use mean that acquiring HIV remains a risk for the
• Half of all Pacific Island countries and territories are on track to improving maternal health but progress towards
universal access to reproductive health care has been slow, with contraceptive use averaging around 26 per cent compared
to the developing region average of 61 per cent;
• The human papillomavirus infection (HPV), which can lead to reproductive cancers, is an emerging area of concern
although there is limited data on the extent of HPV transmission in the region;
• Discriminatory legislation, policy and social practices act as barriers to sexual health and well-being and promote
stigma and discrimination.
The document recognises that to improve sexual health and well-being in the Pacific, emphasis needs to be placed on the
delivery of accessible, comprehensive and high-quality sexual and reproductive health services and programmes based on
individual country needs.
Its implementation will be guided by five key approaches, namely: improving the flow of strategic data to inform policy
and planning; expanding links between services for STIs and HIV, sexual and reproductive health and other related
services; health communication and sexuality education; empowering stakeholders to create inclusive environments through
legal, social, structural and policy reform, and tailoring services and programmes to meet the needs and rights of key
With governments facing competing priorities in health financing, donors and other development partners will play a
vital ongoing role in the region’s sexual and reproductive health activities.
The President of Fiji, Brigadier-General Ratu Epeli Nailatikau, and the Deputy Secretary-General (Strategic Partnerships
and Coordination ) for the Pacific Islands Forum Secretariat, Ms Cristelle Pratt, were among the guests at a launch for
the Shared Agenda in Suva in December hosted by SPC and UNAIDS.