Sir: The White Paper on health ('Five areas targeted to cut death and disease', 9 July) commendably includes sexual health and HIV/Aids as priorities in the Government's national strategy on health promotion.

Sex education in schools is central to an effective strategy and any new initiative must be led by joint action between the Department of Health and the Department for Education.

Today, 83 per cent of 18 and 19- year-olds claim to have experienced sexual intercourse, one in three pregnancies in this country is unplanned, and of the total number of women with Aids, 40 per cent are in the 15-25 age group. Urgent changes are clearly needed to improve sex education for young people.

Sex education remains the responsibility of each school's governing body, but more than a quarter have no policy on the subject, despite the legal obligations on every school to formulate a policy and present it to parents annually. Some schools have developed well-constructed programmes of personal, social and health education, but many others fail to provide sex education that goes beyond information on reproductive biology.

To be effective, sex education has to provide young people with knowledge and skills that are relevant to the life they lead: this means covering personal relationships, sexuality and moral issues as well as science. This is why, although we welcome the recent decision to include HIV/Aids subjects in secondary-school science classes, we know this will fail to meet pupils' needs.

Surely in the wake of the White Paper there should be a national review of sex education? We hope that the Secretary of State for Health will hold immediate talks with her colleague the Secretary of State for Education to get this in motion.

To those who are already asserting that extended sex education will only encourage risky behaviour, we would cite the experience of the Netherlands, which has a reputation for relaxed social policies and sexual tolerance, and has long had a comprehensive, open syllabus of school sex education. The Netherlands also has the lowest rate of teenage pregnancy in the developed world and the level of HIV infection and Aids is much lower than in other European countries, such as Switzerland or Italy, where education is limited and social attitudes inhibited.

The Department of Health has led the way by publishing The Health of the Nation - there now needs to be concerted, well- resourced, co-operative action with the education authorities.

Yours,

MARGARET JAY (Director, National Aids Trust), DOREEN MASSEY (Director, Family Planning Association), MICHAEL ADLER (Professor of Genito- Urinary Medicine)

London, NW1