Addressing Global Public Health Challenges: HIV, Viral Hepatitis, and STIs

The report shows a troubling increase in STI cases, with adult syphilis infections rising to 8 million in 2022, up from 7.1 million.

The World Health Organization (WHO) report "Implementing the Global Health Sector Strategies on HIV, Viral Hepatitis and Sexually Transmitted Infections, 2022–2030" highlights significant public health challenges posed by these infections, which result in approximately 2.5 million deaths annually. The report raises concerns about the increasing incidence of sexually transmitted infections (STIs), including syphilis, and the insufficient progress in reducing new infections of HIV and viral hepatitis, which threaten the attainment of the Sustainable Development Goals (SDGs) by 2030.

Rising Incidence of STIs

The report shows a troubling increase in STI cases, with adult syphilis infections rising to 8 million in 2022, up from 7.1 million. This surge is most pronounced in the Americas and Africa. Four curable STIs—syphilis, gonorrhea, chlamydia, and trichomoniasis—account for over 1 million infections daily. The COVID-19 pandemic exacerbated this issue, with 1.1 million maternal syphilis cases and 230,000 syphilis-related deaths reported in 2022.

Multi-resistant gonorrhea is also on the rise, with 9 out of 87 countries reporting significant resistance to ceftriaxone, the last-line treatment. The WHO has updated treatment recommendations to address this growing threat.

Viral Hepatitis and HIV Trends

In 2022, new cases of hepatitis B and C were 1.2 million and nearly 1 million, respectively, with deaths from viral hepatitis increasing from 1.1 million in 2019 to 1.3 million. Despite available prevention, diagnosis, and treatment tools, the number of new HIV infections only slightly decreased from 1.5 million in 2020 to 1.3 million in 2022. High-risk populations, including men who have sex with men, people who inject drugs, sex workers, transgender individuals, and individuals in prisons, still experience significantly higher HIV prevalence rates, accounting for 55% of new infections. HIV-related deaths remain high, with 630,000 in 2022, 13% of which were children under 15.

Progress in Service Access and Elimination Efforts

Countries have made notable progress in expanding services for STIs, HIV, and hepatitis. WHO validated 19 countries for eliminating mother-to-child transmission of HIV and/or syphilis. Botswana and Namibia are on the path to eliminating HIV, with Namibia being the first country to submit a dossier for the triple elimination of mother-to-child transmission of HIV, hepatitis B, and syphilis.

Global HIV treatment coverage reached 76%, with 93% of those receiving treatment achieving suppressed viral loads. Efforts to increase HPV vaccination and screening for women with HIV are ongoing, and there have been slight improvements in the diagnosis and treatment coverage for hepatitis B and C.

Recommendations for Strengthening Efforts

To achieve the targets set for 2025 and 2030, the report outlines several recommendations:

Policy and Financing Dialogues:

Develop cross-cutting investment cases and national-level sustainability plans to support comprehensive disease management strategies.

Consolidate Disease-Specific Guidance:

Align and streamline disease-specific guidance, plans, and support within a primary health care framework.

Address Stigma and Discrimination:

Intensify efforts to combat criminalization, stigma, and discrimination in healthcare settings, particularly against populations most affected by HIV, viral hepatitis, and STIs.

Expand Multi-Disease Elimination Approaches:

Draw lessons from the triple elimination of mother-to-child transmission to develop integrated approaches and packages for disease elimination.

Strengthen Prevention, Diagnosis, and Treatment:

Enhance primary prevention, diagnosis, and treatment efforts to raise awareness, particularly for hepatitis and STIs.

While ambitious targets and progress in some areas are encouraging, many indicators remain off-track. Achieving the global targets for 2030 requires increased political will and commitment to accelerate efforts across all fronts. Ensuring comprehensive and inclusive healthcare strategies will be crucial to overcoming these public health challenges and improving global health outcomes.