New report points to significant rise in STIs amid challenges of HIV and hepatitis

According to a new report from the World Health Organization (WHO), the global epidemics of HIV, viral hepatitis and sexually transmitted infections (STIs) continue to pose significant public health challenges and cause 2.5 million deaths each year. Implementation of global health sector strategies on HIV, viral hepatitis and sexually transmitted infections, 2022-2030.

New data shows that STIs are increasing in many regions. In 2022, WHO Member States set the ambitious goal of reducing the annual number of syphilis infections in adults tenfold by 2030, from 7.1 million to 0.71 million. However, new syphilis cases among adults ages 15 to 49 increased by more than 1 million in 2022, reaching 8 million. The largest increases occurred in the Americas Region and the African Region.

Combined with the insufficient decline observed in reducing new HIV infections and viral hepatitis, the report points out threats to the achievement of the related Sustainable Development Goals (SDG) targets for 2030.

“The increasing incidence of syphilis raises major concerns,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus. “Fortunately, there have been important advances on several other fronts, including accelerating access to critical health products, including diagnosis and treatment. We have the tools necessary to end these epidemics as public health threats by 2030, but now we must ensure that, in the context of an increasingly complex world, countries do everything possible to achieve the ambitious goals we they noticed.”

Rising incidence of sexually transmitted infections

Four curable STIs: syphilis (Treponema pallidum), gonorrhea (Neisseria gonorrhoeae), chlamydia (Chlamydia trachomatis) and trichomoniasis (trichomonas vaginalis) – represent more than 1 million daily infections. 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, there were 230,000 syphilis-related deaths.

The new data also show an increase in multidrug-resistant gonorrhea. In 2023, of 87 countries where enhanced antimicrobial resistance surveillance of gonorrhea was carried out, 9 countries reported high levels (5% to 40%) of resistance to ceftriaxone, the last-line treatment for gonorrhea. The WHO is monitoring the situation and has updated its recommended treatment to reduce the spread of this multidrug-resistant strain of gonorrhea.

In 2022, around 1.2 million new cases of hepatitis B and almost 1 million new cases of hepatitis C were recorded. The estimated number of deaths from viral hepatitis increased from 1.1 million in 2019 to 1.3 million in 2022 despite effective prevention, diagnosis and treatment tools.

New HIV infections alone fell 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 in prisons and other closed settings) still experience significantly higher HIV prevalence rates than the general population. It is estimated that 55% of new HIV infections occur among these populations and their partners. HIV-related deaths remain high. In 2022, there were 630,000 HIV-related deaths, 13% of which occurred in children under 15 years of age.

Gains in expanding access to services

Efforts by countries and partners to expand STI, HIV and hepatitis services are generating tremendous progress. WHO has validated 19 countries to eliminate mother-to-child transmission of HIV and/or syphilis, reflecting investments in testing and treatment coverage for these diseases among pregnant women. Botswana and Namibia are on the path to HIV elimination, with Namibia being the first country to submit a dossier to be evaluated for triple elimination of mother-to-child transmission of HIV, hepatitis B and syphilis.

Globally, HIV treatment coverage reached 76%, and 93% of people receiving treatment achieved a suppressed viral load. Efforts are underway to increase HPV vaccination and screening for women with HIV. Coverage of the diagnosis and treatment of hepatitis B and C has seen slight improvements worldwide.

Sustainability planning is needed in all three disease areas

The report outlines the following recommendations for countries to strengthen shared approaches to achieving the goals:

  • implement policy and financing dialogues to develop cross-cutting investment cases and sustainability plans at the national level;
  • further consolidate and align guidance, plans and implementation support for specific diseases within a primary health care approach;
  • accelerate efforts to address current criminalization, stigma and discrimination within healthcare settings, particularly against populations most affected by HIV, viral hepatitis and STIs;
  • expand multi-disease elimination approaches and packages, building on lessons learned from triple elimination of mother-to-child transmission and
  • strengthen the focus on primary prevention, diagnosis and treatment of all diseases to raise awareness, especially on hepatitis and STIs.

While the ambitious targets set by member states for 2025 and 2030 are helping to drive progress, progress is patchy across disease areas. With many indicators still lagging behind in achieving global goals, more political will and commitment is needed to urgently accelerate efforts.

This press release was published by the World Health Organization on May 21, 2024.

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