New data from the UN World Health Agency (WHO) shows that cases of sexually transmitted infections (STIs) have increased in many parts of the world.
This rise in the incidence of sexually transmitted infections comes as global epidemics of HIV, viral hepatitis, and sexually transmitted infections continue to pose significant public health challenges, causing 2.5 million deaths each year.
According to the World Health Organization (WHO), four treatable STIs – syphilis, gonorrhea, chlamydia and trichomoniasis – cause more than a million infections per day. The largest increases were recorded in the Americas region and the African region.
Concerns about the rise in syphilis cases
The report notes an increase in adult and maternal syphilis (1.1 million) and associated congenital syphilis (523 cases per 100,000 live births per year) during the COVID-19 pandemic. In 2022, 230,000 deaths linked to syphilis were recorded.
In 2022, WHO Member States have set themselves the ambitious goal of dividing the annual number of syphilis infections in adults by ten by 2030, increasing it from 7.1 million to 0.71 million. Still, new cases of syphilis among adults aged 15 to 49 increased by more than 1 million in 2022 to 8 million.
“The increase in the incidence of syphilis raises serious concerns”said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO, adding: “Fortunately, significant progress has been made on a number of other fronts, including accelerating access to essential health products, including diagnostics and treatments.”
The new data also shows an increase in multidrug-resistant gonorrhea. In 2023, of the 87 countries where enhanced surveillance for antimicrobial resistance in gonorrhea was conducted, 9 countries reported high levels (5% to 40%) of resistance to the gonorrhea treatment ceftriaxone.
The WHO says it is monitoring the situation and has updated recommended treatments to reduce the spread of this strain of multidrug-resistant gonorrhea.
HIV prevalence rates among vulnerable groups
At the same time, the number of HIV-related deaths remains high. In 2022, there were 630,000 HIV-related deaths, including 13% among children under 15 years old. New HIV infections have only decreased from 1.5 million in 2020 to 1.3 million in 2022.
Five key population groups – men who have sex with men, people who inject drugs, sex workers, transgender people and people living in prison – still experience significantly higher HIV prevalence rates than the general population general. The WHO estimates that 55% of new HIV infections occur among these populations and their partners.
Furthermore, around 1.2 million new cases of hepatitis B and almost 1 million new cases of hepatitis C were recorded in 2022. The estimated number of deaths due to viral hepatitis increased from 1, 1 million in 2019 to 1.3 million in 2022, despite effective prevention, diagnosis and treatment tools.
Combined with insufficient declines in the reduction of new HIV and viral hepatitis infections, the report highlights threats to achieving the Sustainable Development Goals (SDGs) by 2030.
Progress in expanding access to services
“We have the tools to end these epidemics as public health threats by 2030, but we must now ensure that, in the context of an increasingly complex world, countries do everything in their power to achieve the ambitious goals they have set for themselves,” said Dr. Tedros.
However, progress is noted. The WHO has thus validated 19 countries for the elimination of mother-to-child transmission of HIV and/or syphilis. Botswana and Namibia are on the path to HIV elimination, with Namibia the first country to submit a dossier to be assessed for triple elimination of transmission of HIV, hepatitis B and syphilis from mother to child.
Globally, HIV treatment coverage has reached 76%, and 93% of people on treatment have had their viral load suppressed. Efforts to increase HPV vaccination and screening among HIV-positive women continue. Coverage of diagnosis and treatment of hepatitis B and hepatitis C has improved slightly globally.
Prevention, diagnosis and treatment
More generally, the report calls on states to strengthen the emphasis on primary prevention, diagnosis and treatment for all diseases. It is also about developing approaches and programs to eliminate several diseases, drawing on lessons learned from the triple elimination of mother-to-child transmission.
“We must also accelerate efforts to combat criminalization, stigma and discrimination in health establishments, particularly against populations most affected by HIV, viral hepatitis and STIs,” concluded the WHO.
