WHO warns drug-resistant gonorrhoea on the rise

The World Health Organisation (WHO) has warned that gonorrhoea, a common sexually transmitted infection, is becoming increasingly resistant to antibiotics, making it harder to treat.

New data from WHO’s Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP) show a sharp rise in resistance to several drugs. Resistance to ciprofloxacin now reaches 95% globally.

Resistance to ceftriaxone, the main treatment, has risen from 0.8% in 2022 to 5% in 2024, while resistance to cefixime rose from 1.7% to 11%. Resistance to azithromycin stayed at 4%.

EGASP, launched in 2015, collects data from multiple countries to track antibiotic resistance and guide treatment.

In 2024, 12 countries submitted data, up from 4 in 2022, showing more global commitment to tracking drug-resistant infections.

The WHO reported that 52% of gonorrhoea cases in men were from the Western Pacific region, and 28% were from Africa.

The median patient age was 27, ranging from 12 to 94 years. About 20% of cases involved men who have sex with men, and 42% of patients had multiple sexual partners in the last 30 days.

Recent antibiotic use and travel were also common among patients, which can contribute to spreading resistant strains.

Dr Tereza Kasaeva, Director of WHO’s HIV, TB, Hepatitis & STIs Department, stressed the importance of surveillance programs.

She urged countries to strengthen STI monitoring and include gonorrhoea in national health programs to prevent the spread of resistant strains.

WHO also reported progress in genomic surveillance, sequencing nearly 3,000 samples across eight countries in 2024. Research on new treatments like zoliflodacin and gepotidacin, as well as tetracycline resistance, is ongoing and will guide future prevention strategies.

Despite these advances, WHO noted challenges such as limited funding, incomplete reporting, and gaps in data, especially for women and infections in non-genital sites.

The organisation called for more investment in national surveillance systems to combat drug-resistant gonorrhoea worldwide.