Health

STIs spreading at rate of more than 1m a day, says WHO


The World Health Organization has called for more honest discussion of sexually transmitted infections after reporting that more than 1m STIs are contracted around the world each day.

WHO data shows there are 376m infections annually of four diseases: chlamydia, gonorrhoea, syphilis and trichomoniasis. Sometimes people have recurring or multiple infections.

The infections can result in stillbirths, the deaths of newborns and infertility. Syphilis alone causes more than 200,000 newborn deaths and stillbirths each year.

The WHO says too little attention is paid to STIs, the data is inadequate and there is a risk that some will spiral out of control as the bacteria become resistant to antibiotics.

“These figures demonstrate an incredibly high global burden of these sexually transmitted infections,” said Dr Melanie Taylor, the lead author of a study published in the WHO Bulletin.

“These infections are treatable and curable with antibiotics but unfortunately most of these infections occur without symptoms and thus people don’t realise they have the infection, they don’t realise they are at risk and they don’t go in for testing and treatment. The opportunity to transmit the infection to their sexual partners but also from mothers to their unborn infants is very, very high.”

Dr Teodora Wi, the WHO’s medical officer for sexually transmitted infections, said STIs were more common than generally believed and did not get enough attention, and people who got infections were stigmatised and neglected.

“We need to talk openly and honestly about sexually transmitted infections. STIs should not be treated differently from any other infection,” Wi said. “Most importantly, we cannot sweep them under the carpet and pretend that they don’t exist.”

Sexual health budgets have been cut in many countries, including the UK, as the cost of healthcare soars. Wi pleaded for governments to think again: “We are all in this together. For policymakers: make sex safer and support STI services. Please do not cut the budget on STI control and STI services. Even increase it.”

She called for cheap and affordable tests that could be used to diagnose STIs in men and women all over the world and more data. Healthcare providers should “respect the right of everyone to make sexual choices that fit with their own personal values” and “normalise the discussion about sex”, she said. People should be open about their sexuality so they could get the right care and learn how to protect themselves.

“Be rational, be responsible, be safe and have fun. Use a condom correctly and consistently and if you think you have an STI, do not be ashamed. Go to your doctor and make sure you do not transmit the STI to others,” Wi said.

The WHO paper, published online, says there were 127m new cases of chlamydia, 87m cases of gonorrhoea, 6.3m cases of syphilis and 156m cases of trichomoniasis among men and women aged 15 to 49 in 2016, the latest year for which there is adequate data.

There has been no improvement from 2012, when the last data analysis was done. On average, one in 25 people globally have an STI.

The research looked at four curable and treatable bacterial diseases, and not sexually transmitted viruses such as HIV and human papillomavirus (HPV), which can cause cervical cancer.

Dr Peter Salama, the executive director for universal health coverage and the life-course at WHO, said: “We’re seeing a concerning lack of progress in stopping the spread of sexually transmitted infections worldwide. This is a wake-up call for a concerted effort to ensure everyone, everywhere, can access the services they need to prevent and treat these debilitating diseases.”

Dr Tim Jinks, the head of Wellcome’s drug-resistant infection programme, said increasing resistance to antibiotics was making treating and curing STIs harder.

“The rise in cases of STIs around the world is alarming, especially as the antibiotics we rely on to treat many of them are becoming less and less effective,” he said. “The high numbers of cases of gonorrhoea are of particular concern. We are increasingly seeing incidences of so-called super-gonorrhoea which are practically impossible to treat, with cases detected in the UK and Australia last year.”

He continued: “We do not know what the burden of super-gonorrhoea is in low- and middle-income countries, but with a broader rise in gonorrhoea cases we can expect to see drug-resistant forms of the disease become more common all over the world.

“Untreatable cases of gonorrhoea are harbingers of a wider crisis where common infections are harder and harder to treat. We urgently need to reduce the spread of these infections and invest in new antibiotics and treatments to replace those that no longer work.”



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