Why you need to worry about the global surge in drug-resistant gonorrhoea, according to WHO

DCM Editorial Summary: This story has been independently rewritten and summarised for DCM readers to highlight key developments relevant to the region. Original reporting by WHO, click this post to read the original article.

The World Health Organization (WHO) is alerting you to a growing global health concern: gonorrhoea is becoming increasingly resistant to antibiotics. According to new findings from its Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP), which tracks drug-resistant strains of the infection, resistance to ceftriaxone and cefixime—the main treatments—has significantly increased between 2022 and 2024. This raises major red flags about limited treatment options and the urgent need for improved surveillance and public health responses worldwide.

You should know that the data, released during World Antimicrobial Resistance Awareness Week, highlights a pressing need for countries to improve diagnostic capacities, ensure wider access to effective treatments, and integrate gonorrhoea tracking into broader STI control programmes. While resistance to azithromycin remains steady at around 4%, ciprofloxacin resistance has ballooned to 95%, particularly in regions like Cambodia and Viet Nam. With reports coming from 12 nations across five WHO regions in 2024, more than 3,600 cases were identified, showing both progress in tracking and the scale of the challenge.

The majority of these cases were reported from countries in the Western Pacific Region, including the Philippines, Viet Nam, Cambodia, and Indonesia. Findings also show that young adults are most affected, with a median age of 27. Many cases involve men who have sex with men, multiple sexual partners, recent travel, or antibiotic use—factors that are crucial for you to understand in the context of STI prevention and control.

To help combat this issue, WHO has expanded its genomic surveillance to nearly 3,000 samples and supported research into alternative treatments like zoliflodacin and gepotidacin. This research is guiding new prevention strategies such as doxycycline-based prevention, known as DoxyPEP. WHO continues to encourage countries like India, which is joining EGASP in 2025, to strengthen national STI surveillance systems.

However, you should be aware that despite these advancements, challenges persist. These include funding limitations, incomplete data, and insufficient reporting from women and non-genital sites. WHO is urging immediate global investment to ensure continued progress in monitoring and controlling drug-resistant gonorrhoea, aiming to protect public health on an international scale.