Cases of sexually transmitted infections (STIs) are surging rapidly in many regions of the world, according to new data released by the World Health Organization (WHO).
Global rates of HIV, viral hepatitis and STIs continue to "pose significant public health challenges", the WHO's 2024 report states, and are responsible for approximately 2.5 million deaths each year.
In 2022, WHO Member States set out a target of reducing the annual number of adult syphilis infections from 7.1 million to 0.71 million by 2030. However, new syphilis cases among adults aged 15 to 49 increased by over a million in 2022 to 8 million. The highest increases occurred in the American and African continents, the report said.
"The rising incidence of syphilis raises major concerns," said WHO Director-General Dr Tedros Adhanom Ghebreyesus. "Fortunately, there has been important progress on a number of other fronts, including in accelerating access to critical health commodities including diagnostics and treatment.
"We have the tools required to end these epidemics as public health threats by 2030, but we now need to ensure that, in the context of an increasingly complex world, countries do all they can to achieve the ambitious targets they set themselves."
According to the new data syphilis, gonorrhoea, chlamydia and trichomoniasis - all curable STIs - account for over one million infections daily. There was a surge in adult and maternal syphilis cases and associated congenital syphilis, when the disease is passed from mother to baby, during the COVID-19 pandemic (523 cases per 100 000 live births per year), with 230,000 syphilis-related deaths in 2022 alone.
'Super' gonorrhoea - which is resistant to several different drugs, including in some cases the 'last line' treatment ceftriaxone - is also on the rise in nine of the 87 counties monitoring the disease, the data found. As of 2023, nine countries out of 87 reported elevated levels (from 5 percent to 40 percent) of resistance to ceftriaxone. Meanwhile in Australia, gonorrhoea cases rose between 2021 and 2022 after declining from 2019.
WHO said it is monitoring the situation and has updated its recommended treatment in a bid to reduce the spread of the multi-resistant strain.
In 2022, around 1.2 million new hepatitis B cases and nearly a million new hepatitis C cases were recorded globally, while the estimated number of deaths from viral hepatitis rose from 1.1 million in 2019 to 1.3 million in 2022 - despite effective prevention, diagnosis and treatment tools.
HIV bucked the trend - but not as much as experts had hoped, with new infections only falling from 1.5 million in 2020 to 1.3 million in 2022. Five key groups continue to experience markedly higher prevalence rates of HIV than the general population: men who have sex with men, people who inject drugs, sex workers, transgender individuals, and individuals in prisons and other closed settings. It's estimated that 55 percent of new HIV infections occur among those five key populations and their partners. HIV-related deaths continue to be high.
There were 630,000 HIV-related deaths recorded in 2022, with 13 percent occurring in children under 15.
The good news is that efforts to expand healthcare services for STI, HIV and hepatitis patients are making progress. WHO has validated 19 countries for eliminating mother-to-child transmission of HIV and/or syphilis, while Botswana and Namibia are "on the path" to eliminating HIV.
The report stated that HIV treatment coverage has reached 76 percent worldwide, with 93 percent of those receiving treatment achieving suppressed viral loads. Meanwhile, efforts are ongoing to increase HPV (human papillomavirus) vaccination and screening for women with HIV, while diagnosis and treatment coverage for hepatitis B and C have seen slight improvements globally.
The report also outlined a series of recommendations for countries to strengthen their approaches towards achieving reduction targets. These included accelerating efforts to address criminalisation, stigma and discrimination, particularly against populations most affected by HIV, viral hepatitis and STIs, and strengthening the focus on primary prevention, diagnosis and treatment across the diseases to raise awareness.
While the report noted the positive progress regarding treatment access and improved services in many countries, it warned we are currently off track to achieve the targets of the Sustainable Development Goals (SDGs) by 2030.
"Despite our best efforts, we will not meet the global targets for 2025 and 2030 agreed at the 75th World Health Assembly, unless we have a significant acceleration of focus and effort," Dr Ghebreyesus said.
The report will be discussed at the 77th World Health Assembly in Geneva, Switzerland from May 27 to June 1.
