A WHO report shared in May 2024 details the continued “significant public health challenges” posed by HIV, viral hepatitis epidemics, and sexually transmitted infections (STIs). The report identifies increasing cases of STIs across “many regions”, flagging “threats to the attainment” of targets outlined in the Sustainable Development Goals (SDGs) for 2030. The report is the first in a series of biannual progress reports on implementation of global health sector strategies for the period 2022-2030.
Infections increase
WHO states that four curable STIs – syphilis (Treponema pallidum), gonorrhoea (Neisseria gonorrhoeae), chlamydia (Chlamydia trachomatis), and trichomoniasis (Trichomonas vaginalis) – account for “over 1 million infections daily”. A reduction of 20% in these four infections must be achieved to realise targets by 2025 and a reduction of 60% is needed for the 2030 targets.
“The available data suggest that the world is off track to meet targets, with increasing rather than declining trends in new infections.”
Syphilis case increases have been driven by an “increase in the number of estimated new cases of syphilis in the WHO African Region and the WHO Region of the Americas”. These regions regularly share data within the Global AIDS Monitoring process. The report identifies “unprecedented high levels of new infections”, demanding an “urgent acceleration of efforts”.
The data also suggest an increase in “multi-resistant gonorrhoea”. By 2023, from the 87 countries with enhanced gonorrhoea antimicrobial resistance surveillance, 9 countries reported elevated levels.
HIV and hepatitis B challenges
The report suggests that “key achievements demonstrate the feasibility of ending AIDS as a public health concern by 2030. However, “many challenges remain”. For example, in 27 low- and middle-income countries, “less than 50% of people living with HIV were receiving antiretroviral therapy” in 2022. The current rate of declining incidence and HIV-related deaths is “insufficient” to achieve 2025 targets. Furthermore, children under 15 are bearing a “disproportionate burden of mortality”, reflecting “policy and programmatic failings”.
Viral hepatitis is “one of the leading infectious causes of death worldwide”, despite interventions that would support elimination of hepatitis B virus and hepatitis C virus by 2030. These include effective hepatitis B vaccines and effective treatments.
“Access to prevention, testing, and treatment remains low, resulting in increasing mortality and large numbers of new infections…Regaining the trajectory will require strengthening political will and mobilising greater investment.”
Major concerns
Dr Tedros Adhanom Ghebreyesus, WHO Director-General, finds “major concerns” in the rising incidence of syphilis.
“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.”
Dr Meg Doherty, Director of the Department of Global HIV, Hepatitis, and Sexually Transmitted Infections Programmes at WHO, commented that there has been “impressive uptake” of WHO policies and “expansion of service access”. This is “particularly notable for HIV testing and antiretroviral therapy coverage” alongside expansion of hepatitis C treatment in a “small number of countries”. However, “many challenges persist”.
“While working to further expand services, especially for viral hepatitis and sexually transmitted infections, countries also must prioritise person-centred approaches and sustainability planning across all disease areas, focusing on political commitment, programmatic integration, and financing, while combatting stigma and discrimination in healthcare settings.”
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