The World Health Organisation (WHO) has issued a stark warning about the growing threat of antibiotic-resistant gonorrhoea, a sexually transmitted infection that is becoming harder to treat worldwide.
Recent findings from WHO’s Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP) show a sharp increase in resistance to essential antibiotics, highlighting a rising public health challenge. Between 2022 and 2024, several countries reported a worrying number of cases where standard treatments no longer work.
Resistance to ceftriaxone, one of the main antibiotics used to treat gonorrhoea, increased from 0.8 per cent to five per cent, while cefixime resistance climbed from 1.7 per cent to 11 per cent.
WHO also noted that resistant strains have been detected in more countries over the same period. Resistance to azithromycin remained at four per cent, whereas ciprofloxacin resistance reached 95 per cent, with Cambodia and Viet Nam reporting the highest levels.
The EGASP 2024 data came from 12 countries across five WHO regions, up from four countries in 2022. These include Brazil, Cambodia, India, Indonesia, Malawi, the Philippines, Qatar, South Africa, Sweden, Thailand, Uganda, and Vietnam, which collectively reported 3,615 gonorrhoea cases.
Men in the Western Pacific Region accounted for 52 per cent of symptomatic infections, particularly in the Philippines (28 per cent), Vietnam (12 per cent), Cambodia (nine per cent), and Indonesia (three per cent).
The African Region represented 28 per cent of cases, South-East Asia 13 per cent (Thailand), the Eastern Mediterranean four per cent (Qatar), and the Americas two per cent (Brazil).
The report revealed that the median age of patients was 27 years, with cases ranging from 12 to 94 years. Among those affected, 20 per cent were men who have sex with men, 42 per cent had multiple sexual partners in the past month, eight per cent had recently taken antibiotics, and 19 per cent had traveled.
WHO highlighted the urgent need to improve surveillance systems, expand access to reliable diagnostics, and make new treatments available to all affected populations. The findings were released during World Antimicrobial Resistance Awareness Week, underscoring the global urgency to act against drug-resistant infections.
EGASP, launched in 2015, gathers laboratory and clinical information from selected sites around the world to track antibiotic resistance and inform treatment recommendations.
“This global effort is essential to tracking, preventing, and responding to drug-resistant gonorrhoea and to protecting public health worldwide,” said Tereza Kasaeva, Director of WHO’s Department for HIV, TB, Hepatitis & STIs. She urged governments to integrate gonorrhoea monitoring into national STI programmes.
In 2024, WHO further advanced genomic surveillance by sequencing almost 3,000 samples from eight countries. Studies on new treatment options, including zoliflodacin and gepotidacin, as well as research on tetracycline resistance, were conducted at WHO’s Collaborating Centre in Sweden.
This research is expected to guide future strategies for controlling gonorrhoea and supporting doxycycline-based prevention approaches.
