The Global Fight to End STIs: A Comprehensive Plan by WHO

The World Health Organization (WHO) has unveiled a comprehensive plan aimed at eliminating sexually transmitted infections (STIs) as a public health concern by 2030. The framework emphasizes the importance of strategic data collection, robust monitoring, and broad intervention strategies. It aims to ensure equitable access to STI prevention, testing, and treatment services while integrating these efforts into broader health initiatives.

In a world where sexual health often remains a taboo topic, the World Health Organization (WHO) has laid out a bold and ambitious plan to tackle sexually transmitted infections (STIs) head-on. The recently released “Framework for Monitoring Sexually Transmitted Infections and Strengthening Surveillance” details the strategies and goals for combating STIs globally by 2030. This framework is not just about controlling infections; it’s about eliminating them as a public health concern.

Every day, over one million people worldwide contract an STI, leading to significant health and social consequences. From syphilis and gonorrhea to chlamydia and trichomoniasis, these infections impact millions, often silently. The WHO's framework emphasizes that identifying, testing, and preventing STIs are critical steps in halting their spread and improving global health.

A Growing Health Crisis

The 2022 global health sector strategies on HIV, viral hepatitis, and STIs for the period 2022–2030 (GHSS) set the stage for a comprehensive approach. The goal is clear: end STIs as a public health concern by 2030. However, achieving this requires more than just medical intervention. It calls for social, cultural, and economic shifts to ensure that everyone has access to prevention, testing, and treatment services.

To effectively combat STIs, the collection and analysis of data are paramount. The WHO framework outlines the importance of strategic information in shaping policies and programs. This includes data on policies, funding, access to services, clinical case reporting, infection prevalence, causes of STI syndromes, and monitoring antimicrobial resistance.

Monitoring the provision and use of STI services from public, private, and nongovernmental organizations is crucial. Regular data collection helps in national planning and resource targeting, ultimately improving STI programs and supporting advocacy efforts.

A Framework for Action

The WHO framework introduces 11 core indicators to monitor the health sector's response to STIs. These indicators cover a broad spectrum, from plans and policies to financing, surveillance, supply of medicines, prevention, clinical services, testing services, prevalence, and incidence. These core indicators help in tracking the progress and identifying gaps in the health sector’s response to STIs. The indicators include strategic information for STIs, collecting and analyzing data from all service delivery and administrative levels, and GHSS 2022-2030 strategies, which identify five strategic directions for country actions to end STIs by 2030. The national monitoring framework for STIs is structured around inputs, processes, outputs, outcomes, and impact.

Strengthening Surveillance and Monitoring

Strengthening STI monitoring and surveillance involves a three-step approach. Step 1 focuses on strengthening public sector facility-based reporting, ensuring that standard procedures, tools, and trained personnel are in place to report STI data consistently across healthcare delivery points providing STI-related services. Key actions include establishing and disseminating standard procedures for collecting and reporting STI-related data, ensuring standard data collection procedures are followed, establishing a data quality review assurance system, developing and implementing digital health tools, investing in human capacity, and ensuring data and feedback dissemination.

Step 2 focuses on expanding surveillance activities, including laboratory and person-centered surveillance, health facility assessments, and population-based studies. Key actions include strengthening laboratory systems for monitoring antimicrobial resistance in N. gonorrhea, expanding person-centered surveillance to monitor individuals over time, conducting periodic health facility assessments, and identifying opportunities for incorporating STIs into population-based surveys.

Step 3 involves expanding data collection beyond the public sector to include private practitioners, NGOs, pharmacies, laboratory services, and community-based monitoring. Collecting routine data from these service providers is challenging and requires establishing a functional and sustainable data collection system that meets national healthcare system requirements while being acceptable to private providers.

Towards a Healthier Future

Achieving the GHSS targets necessitates a significant scale-up in resources for STI prevention and treatment, integration of STI services into other health initiatives, improved data collection, and investment in new prevention, diagnostic, and treatment technologies. Moreover, strengthening national health information systems to ensure timely and high-quality data collection is essential.

Ensuring access to these interventions provides an opportunity to reduce the STI burden and will contribute to achieving the Sustainable Development Goals. The WHO's comprehensive approach includes working with communities, civil society, and other stakeholders to address the factors that contribute to the spread of STIs.

The WHO's “Framework for Monitoring Sexually Transmitted Infections and Strengthening Surveillance” is a critical step towards ending STIs as a public health concern by 2030. Through strategic data collection, robust monitoring, and comprehensive intervention strategies, the framework aims to improve global sexual health and well-being. By integrating these efforts into broader health initiatives and ensuring equitable access to services, the vision of a world free from the burden of STIs can become a reality.