WHO Launches Global Operational Handbook on sexually transmitted infections

The new handbook translates years of WHO normative guidance into practical, country-level action at a time when STI infections remain alarmingly high worldwide.

The World Health Organization (WHO) has released its first-ever consolidated operational handbook on sexually transmitted infections (STIs), providing countries with a comprehensive roadmap to strengthen prevention, diagnosis, treatment and care across health systems.

The new handbook translates years of WHO normative guidance into practical, country-level action at a time when STI infections remain alarmingly high worldwide.

Over 1 Million New Curable STIs Every Day

The handbook comes amid growing concern over the global burden of STIs.

According to WHO:

• More than 1 million new curable STIs are acquired every day worldwide

• An estimated 8 million syphilis cases were recorded globally in 2022

• Around 700,000 cases of congenital syphilis were reported in the same year

These figures highlight significant gaps in prevention, early detection and treatment.

“For the first time, countries have a single operational reference that brings together all WHO guidance on STI prevention and care,” said Dr Tereza Kasaeva, Director of WHO’s Department for HIV, Tuberculosis, Hepatitis and STIs.

“This handbook translates years of normative work into practical tools that can be adapted to any setting, helping close the gap between what we know and what we deliver.”

A Single Reference for STI Programmes

The handbook consolidates all WHO guidance on STI prevention and management published between 2016 and 2025, bringing it together into one unified operational reference.

It is designed for:

• Programme managers

• Policy-makers

• Clinicians

• Community organizations

• Development partners

The goal is to support countries in integrating high-quality STI services into primary health care (PHC) and universal health coverage (UHC) frameworks.

Introducing the STI Prevention and Care Cascade

A key innovation in the handbook is the introduction of an STI prevention and care cascade, a structured framework that maps how individuals interact with health systems — from primary prevention and testing through to treatment and partner management.

The cascade approach helps countries identify where systems are failing and where interventions are needed most.

Integrated, Package-Based Service Delivery

The handbook promotes integration of STI services across broader health platforms, including:

• Primary health care services

• HIV services

• Sexual and reproductive health programmes

• Adolescent health services

• Maternal and child health systems

• Community-based care

By embedding STI care into existing platforms, WHO aims to shift from fragmented responses toward integrated, people-centred services.

Addressing Antimicrobial Resistance

The guidance also tackles antimicrobial resistance (AMR), particularly in relation to Neisseria gonorrhoeae, where drug resistance has become a growing global threat.

The handbook aligns with WHO’s global action plan on controlling the spread and impact of AMR, emphasizing antimicrobial stewardship and appropriate prescribing practices.

Emerging Interventions Included

For the first time, WHO provides operational guidance on newer preventive and clinical tools, including:

• Doxycycline post-exposure prophylaxis (PEP) for certain higher-risk populations

• Mpox vaccination strategies for populations at increased risk of exposure

These additions reflect evolving epidemiological trends and the need for adaptable service models.

Responding to Shifting Financing Landscapes

The handbook also situates STI services within the context of sustainable financing.

As many countries transition away from heavy reliance on external donor funding, WHO underscores the importance of domestic resource mobilization and long-term integration within national health budgets.

Closing the Service Gap

Despite being among the most common infections globally, STI services remain uneven and under-resourced in many countries, particularly for vulnerable populations.

WHO says the new handbook offers a clear pathway for strengthening STI services within primary care systems, ensuring prevention, testing and treatment reach those most at risk.

By moving toward integrated and equitable service delivery, the organization hopes to reduce transmission, prevent complications such as infertility and congenital infections, and improve overall sexual and reproductive health outcomes.