By Staff Reporter
The World Health Organization (WHO) has issued a renewed warning about the rapid rise of drug-resistant gonorrhoea, calling it a growing global threat that demands urgent action.
The alert follows the release of new findings from the Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP), which has tracked resistance patterns since 2015 and now reports sharp increases in resistance to key antibiotics.
The data release coincides with World Antimicrobial Resistance Awareness Week 2025, underscoring the global significance of the threat.
According to the latest EGASP report, resistance to the primary treatment options—ceftriaxone and cefixime—has surged dramatically between 2022 and 2024. Ceftriaxone resistance rose from 0.8% to 5%, while cefixime resistance climbed from 1.7% to 11%. Resistant strains were identified in more countries than ever before, signalling that the problem is both expanding and accelerating.
Resistance to azithromycin remained steady at 4%, but resistance to ciprofloxacin reached an alarming 95%. The highest resistance rates were reported in Cambodia and Viet Nam.
Despite the troubling trends, the WHO highlighted some areas of progress. In 2024, twelve countries across five WHO regions contributed data to EGASP, up from only four countries in 2022. These nations—Brazil, Cambodia, India, Indonesia, Malawi, the Philippines, Qatar, South Africa, Sweden, Thailand, Uganda, and Viet Nam—reported a total of 3,615 gonorrhoea cases.
Over half of all symptomatic male cases came from the WHO Western Pacific Region, particularly the Philippines, Viet Nam, Cambodia, and Indonesia. Africa accounted for 28% of reported cases, while the remaining cases came from South-East Asia, the Eastern Mediterranean, and the Americas.
The median age of patients was 27, though cases ranged from age 12 to 94. Notably, 20% of infections occurred among men who have sex with men, and nearly half of all patients reported multiple sexual partners in the previous month. Additional factors such as recent antibiotic use (8%) and international travel (19%) may also contribute to rising resistance trends.
WHO also advanced its genomic surveillance efforts in 2024, sequencing nearly 3,000 samples from eight countries. New research on emerging treatments—including zoliflodacin and gepotidacin—offers hope for future therapeutic options. However, EGASP still faces challenges, including limited funding and insufficient data from women and extragenital sites.
