Gonorrhoea, one of the most common sexually transmitted infections, is becoming harder to treat as the bacteria continue to resist available antibiotics, according to the World Health Organisation (WHO).
The latest findings, released on Wednesday through the Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP), show that drug-resistant gonorrhoea is on the rise across the world, and countries must urgently strengthen disease surveillance, improve testing services, and ensure fair access to new treatments if the world is to contain the spread of sexually transmitted infections.
The warning comes during the World Antimicrobial Resistance Awareness Week, a global campaign that highlights the growing threat of drug-resistant infections. EGASP, which has been running since 2015, collects laboratory and clinical data from selected health facilities worldwide to help guide treatment decisions.
Dr Tereza Kasaeva, Director of the WHO Department for HIV, TB, Hepatitis and STIs, said the new data is a reminder that countries should step up their fight against sexually transmitted infections. She encouraged governments to integrate gonorrhoea monitoring into their national health programmes to protect communities.
Between 2022 and 2024, resistance to the most reliable gonorrhoea medicines increased sharply: resistance to ceftriaxone rose from 0.8 per cent to 5 per cent, while cefixime resistance jumped from 1.7 per cent to 11 per cent. Resistance to azithromycin remained at 4 per cent, but ciprofloxacin resistance reached an alarming 95 per cent. Cambodia and Viet Nam recorded the highest levels of drug resistance.
Twelve countries, including Uganda, submitted data in 2024, up from only four countries previously. Together, they reported 3,615 cases of gonorrhoea. More than half of all symptomatic cases in men (52 per cent) came from countries in the Western Pacific Region, led by the Philippines, Viet Nam, Cambodia and Indonesia. African countries contributed 28 per cent of the reported cases, while Thailand (South-East Asia) contributed 13 per cent, Qatar (Eastern Mediterranean) 4 per cent and Brazil (Region of the Americas) 2 per cent.
The median age of the patients was 27 years. Among them, 20 per cent were men who have sex with men, and 42 per cent reported having multiple sexual partners within the previous 30 days. Eight per cent had recently used antibiotics, while 19 per cent had travelled in the same period.
WHO also reported progress in expanding global surveillance. In 2024 alone, nearly 3,000 samples were genetically sequenced in eight countries. The organisation is also testing new treatments, including zoliflodacin and gepotidacin, and studying resistance to older medicines like tetracycline.
Findings from these studies are expected to shape future guidelines, including new prevention strategies such as DoxyPEP, which is currently being assessed.