Global Surge in Antibiotic-Resistant Gonorrhoea Alarms WHO

Based on the latest findings from its Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP), the WHO has raised concerns over the growing resistance of gonorrhoea to ceftriaxone and cefixime, the two primary antibiotics used to treat the infection globally.

A comparison of surveillance data from 2022 and 2024 shows a worrying upward trend. Resistance to ceftriaxone rose from 0.8% to 5%, while resistance to cefixime increased more sharply, from 1.7% to 11%. Highlighting the seriousness of these findings, Dr Teresa Kasaeva, Director of the WHO Department for HIV, TB, Hepatitis and STIs, called on countries to urgently address the rising burden of gonorrhoea and integrate robust gonorrhoea surveillance into their national STI programmes.

The scope of data collection has also expanded. In 2022, surveillance data was gathered from just five countries, a number that increased to twelve by 2024. Participating countries included Brazil, Cambodia, India, Indonesia, Malawi, the Philippines, Qatar, South Africa, Sweden, Thailand, Uganda, and Vietnam. The median age of participants was 27 years. Among male participants, 20% reported sexual activity with other men, and nearly 42% reported having multiple sexual partners within the previous 30 days.

In light of these developments, the WHO plans to strengthen global gonorrhoea surveillance by supporting the introduction of new treatment options such as zoliflodacin and gepotidacin, as well as exploring doxycycline-based preventive measures, including doxycycline post-exposure prophylaxis (DoxyPEP). However, both the WHO and EGASP face significant challenges in implementing these strategies. These include funding constraints, inconsistent or inaccurate reporting, and insufficient data collection from women.

To overcome these barriers and prevent the further spread of drug-resistant gonorrhoea, the WHO has urged all countries to expand and improve their national STI surveillance systems. Strengthening local surveillance, the organisation emphasises, is essential to building a more effective and comprehensive global response.

Source: WHO