Global epidemics of HIV, viral hepatitis and sexually transmitted infections (STIs) continue to pose significant public health challenges, causing 2.5 million deaths each year, according to a new WHO report – Update implement the global health sector strategies on HIV, viral hepatitis and sexually transmitted infections, 2022-2030.
New data shows STIs are increasing in many regions. In 2022, WHO Member States set an ambitious target to reduce the annual number of syphilis infections among adults tenfold by 2030, from 7.1 million to 0.71 million. Still, new cases of syphilis among adults aged 15 to 49 increased by more than 1 million in 2022, to 8 million. The highest increases occurred in the Region of the Americas and the African Region.
Combined with the insufficient decline observed in the reduction of new HIV and viral hepatitis infections, the report signals threats to the achievement of the corresponding targets of the Sustainable Development Goals (SDGs) by 2030.
“There is serious concern about the increasing incidence of syphilis,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Fortunately, significant progress has been made on several other fronts, including accelerating access to essential health products, including diagnostics and treatments. We have the tools to end these epidemics that threaten public health by 2030, but we must now ensure that, in the context of an increasingly complex world, countries do everything that is necessary. in their power to achieve the ambitious goals they have set for themselves.
Rising incidence of sexually transmitted infections
Four curable STIs – syphilis (Pale treponema), gonorrhea (Neisseria gonorrhoeae), chlamydia (Chlamydia trachomatis) and trichomoniasis (Trichomonas vaginalis) – represent more than a million infections per day. 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.
New data also shows an increase in multidrug-resistant gonorrhea. In 2023, out of 87 countries where enhanced surveillance for antimicrobial resistance in gonorrhea was conducted, 9 countries reported high levels (5% to 40%) of resistance to ceftriaxone, the last-line treatment for gonorrhea. gonorrhea. WHO is monitoring the situation and has updated its recommended treatment to reduce the spread of this multidrug-resistant strain of gonorrhea.
In 2022, approximately 1.2 million new cases of hepatitis B and almost one 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 have only decreased 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, professional( gender, transgender people, and people in prisons and other closed settings have significantly higher HIV prevalence rates than the general population. An estimated 55% of new HIV infections occur among these populations and their partners. HIV-related deaths remain high. In 2022, 630,000 HIV-related deaths were recorded, including 13% among children under 15 years old.
Gains in expanding access to services
Efforts by countries and partners to expand services for STIs, HIV and hepatitis are generating significant progress. WHO has validated 19 countries for eliminating mother-to-child transmission of HIV and/or syphilis, reflecting investments in coverage of screening and treatment for these diseases among pregnant women. Botswana and Namibia are on the path to HIV elimination, with Namibia the first country to submit a dossier for evaluation for the triple elimination of mother-to-child transmission of HIV, hepatitis B and syphilis .
Globally, HIV treatment coverage has reached 76%, and 93% of people receiving treatment have achieved suppressed viral load. Efforts to increase HPV vaccination and screening of HIV-positive women are underway. Coverage of diagnosis and treatment of hepatitis B and C has seen slight improvements globally.
Sustainability planning needed in all three disease areas
The report makes the following recommendations for countries to strengthen common approaches to achieving the goals:
- implement political and financial dialogues to develop transversal investment files and sustainability plans at the national level;
- consolidate and further align disease-specific guidance, plans and implementation support within a primary health care approach;
- accelerate efforts to address current criminalization, stigma, and discrimination in health care settings, particularly against populations most affected by HIV, viral hepatitis, and STIs;
- expand approaches and programs to eliminate multiple diseases, building on lessons learned from the triple elimination of mother-to-child transmission and
- strengthen emphasis on primary prevention, diagnosis and treatment of all diseases to raise awareness, particularly on hepatitis and STIs.
Although ambitious targets set by Member States for 2025 and 2030 are helping to drive progress, progress is uneven across disease areas. With many indicators falling short of meeting the global goals, more political will and commitment is urgently needed to accelerate efforts.
Note to editor
This report, which describes progress made in implementing the global health sector strategies on HIV, viral hepatitis and sexually transmitted infections (STIs) for 2022-2030, will be discussed at the Seventy -Seventh World Health Assembly.
In 2022, the Seventy-fifth World Health Assembly noted with satisfaction the global health sector strategies, respectively against HIV, viral hepatitis and sexually transmitted infections (STIs), for the period 2022-2030. The strategies aim to guide the health sector in implementing strategically targeted responses to achieve the goals of ending AIDS, viral hepatitis B and C and sexually transmitted infections by 2030, as part of efforts to to achieve the 2030 Sustainable Development Agenda. The strategies promote synergies between disease areas within the framework of universal health coverage and promote implementation within a primary health care approach.