Global HIV, viral hepatitis and sexually transmitted disease (STD) epidemics remain major public health challenges, claiming 2.5 million lives annually, according to a new WHO report - Implementing global strategies. To the health sector on combating HIV, viral hepatitis and sexually transmitted infections for the period 2022-2030 .

New data proves that sexually transmitted disease infections are increasing in many regions. In 2022, the member states of the organization set an ambitious target to reduce the number of syphilis infections among adults annually by tenfold by 2030, from 7.1 million cases to 0.71 million cases. However, new cases of syphilis among adults aged 15 to 49 years increased by more than one million cases in 2022, reaching 8 million cases, with the highest increases in the Americas and the African regions.

In addition to the observed reduction in new cases of HIV and viral hepatitis, the report indicates that there are risks in achieving the relevant targets of the Sustainable Development Goals by 2030.

Dr. Tedros Adhanom Ghebreyesus, Director-General of the Organization, said: “The rising rates of syphilis raise great concerns. Fortunately, significant progress has been made on a number of other fronts, including accelerating access to critical health goods, including diagnostics and treatment. “We have the tools to end these pandemics as public health risks by 2030, but now we need to ensure that, in the context of the increasing complexity of our world, countries do everything they can to reach the ambitious targets they have set for themselves.”

Increased incidence of sexually transmitted diseases

There are four treatable sexually transmitted diseases - syphilis ( Treponema pallidum ), gonorrhea ( Neisseria gonorrhoeae ), chlamydia ( Chlamydia trachomatis ), and trichomoniasis ( Treponema vaginalis ) - accounting for more than one million infections daily. The report notes a sudden increase during the COVID-19 pandemic in adult and maternal syphilis (1.1 million cases) and associated congenital syphilis (523 cases per 100,000 live births per year). The year 2022 also witnessed 230,000 deaths resulting from syphilis.

New data also demonstrates an increase in multi-drug-resistant gonorrhea. As of 2023, of the 87 countries where antimicrobial resistance surveillance for gonorrhea has been strengthened, 9 countries reported high rates of resistance to ceftriaxone (from 5% to 40%), the last-line treatment for the disease. The organization continues to monitor the situation after updating the recommended treatment to limit the spread of this multi-drug-resistant gonorrhea strain.

In 2022, approximately 1.2 million new cases of hepatitis B and approximately one million new cases of hepatitis C were recorded. Estimates also indicated an increase in the number of deaths resulting from viral hepatitis from 1.1 million deaths in 2019 to 1.3 million. Death in 2022, despite the availability of effective tools to prevent, diagnose and treat the disease.

New HIV infections have only reduced from 1.5 million cases in 2020 to 1.3 million in 2022. Five major demographic groups remain - men who have sex with men, people who inject drugs, Sex workers, transgender people, and people in prisons and other closed settings - have significantly higher HIV prevalence rates than the general population. It is estimated that 55% of new infections with this virus affect individuals from these population groups and their partners. Deaths resulting from the virus are still high, as the year 2022 witnessed 630,000 deaths resulting from it, of which 13% occurred among children under the age of 15 years.

Gains achieved in increasing access to services

Tremendous gains continue to be made through efforts by countries and partners to increase access to services for sexually transmitted infections, HIV and hepatitis. The organization has verified that 19 countries have eliminated mother-to-child transmission of HIV and/or syphilis, reflecting the investments made in covering the tests and treatments needed to combat these diseases among pregnant women. Botswana and Namibia are on the right track towards eliminating HIV, noting that Namibia is the first country to submit a dossier for its assessment of eliminating mother-to-child transmission of three diseases: HIV, hepatitis B, and syphilis.

Globally, coverage of HIV treatment reached 76%, with 93% of those receiving treatment able to suppress their viral loads. Efforts to increase HPV vaccination rates and to screen women for HIV are continuing. There have also been slight improvements in coverage rates for the diagnosis and treatment of hepatitis B and C globally.

Sustainable planning on the three disease areas is needed as a whole

The report briefly outlines the following recommendations for countries to strengthen common approaches to achieve the desired goals:

• Establish policy and financing dialogues to develop investment justifications and comprehensive sustainability plans at the national level;
• Continue to standardize and harmonize guidelines, plans and implementation support efforts specifically for these diseases within the primary health care approach;
• Accelerate efforts to address persistent criminalization, stigma and discrimination within health facilities, especially against population groups most affected by HIV, viral hepatitis and sexually transmitted disease infections;
• Expanding multi-disease approaches and packages by building on lessons learned from eliminating mother-to-child transmission of three diseases;
• Increase the focus on the primary prevention, diagnosis and treatment of these diseases as a whole, to raise the level of awareness of hepatitis and sexually transmitted diseases in particular.

While the ambitious targets set by Member States for 2025 and 2030 help drive progress, progress in these disease areas as a whole is lacking. Given the presence of many indicators that are off track to achieve the desired global goals, it is necessary to show more political will and make commitments to urgently accelerate the pace of efforts in this field.

Editor's note

The Seventy-seventh World Health Assembly will discuss this report summarizing progress in implementing global health sector strategies to combat HIV, viral hepatitis and sexually transmitted infections for the period 2022-2030 .

In 2022, the Seventy-fifth World Health Assembly took note with appreciation of the global health sector strategies to combat HIV, viral hepatitis and sexually transmitted infections, respectively, for the period 2022-2030. These strategies aim to guide the work of the health sector in implementing strategically focused responses to achieve the goals of eliminating AIDS, hepatitis B and C, and sexually transmitted infections by 2030 in the context of efforts to implement the 2030 Agenda for Sustainable Development. The strategies promote synergies between disease areas Under the universal health coverage framework and strengthen its implementation in the context of a primary health care approach.

• Copied from the World Health Organization website