The World Health Organisation (WHO) has announced an exponential increase in the resistance of gonorrhea, a common s*xually transmitted infection, to antibiotics making the disease much harder and at times impossible to treat.
According to Dr Teodora Wi, Medical Officer, Human Reproduction at WHO, “the bacteria that cause gonorrhea are particularly smart. Every time a new class of antibiotics is used to treat the infection, the bacteria evolve and resist the antibiotic.”
Based on data collected from 77 countries, WHO claimed that gonorrhea is resistant to older as well as cheaper antibiotics.
Dr. Wi explained further that “the cases that are being discovered may just be the tip of the iceberg since systems to diagnose and report untreatable infections are lacking in lower-income countries where gonorrhea is actually more common,” especially in sub Saharan Africa, Nigeria included.
Of particular interest is the disclosure that gonorrhoea spreads through unprotected vaginal, oral or anal s*x, as well as through the sharing of s*x toys that have not been washed properly or covered with a new condom. Many of those who contract the disease experience no symptoms, but if left untreated the disease can cause infertility and, in pregnant women, puts babies at risk of blindness.
WHO, via its Global Gonococcal Antimicrobial Surveillance Programme (WHO GASP) has been monitoring trends in the drug resistant gonorthea and have detected from data acquired that there has been an extensive resistance to the antibiotic ciprofloxacin.
In addition, data retrieved from the surveillance pointed to the fact that there has been an 81 per cent increased resistance to antibiotic azithromycin and an emergence of 66 per cent resistance to the extendedspectrum cephalosporins (ESCs), oral cefixime or injectable ceftriaxone, which is, at present, the last reported treatment.
The report states that “currently, for the effective treatment of gonorrhea, ESCs remain the sole available antibiotics in most countries. Yet, in more than 50 countries, the resistance to cerixime and more uncommonly to ceftriaxone has been reported.”
Also, as resistance develops, the antibiotics become less effective, which leads to the need of constant replenishment for the supply of new drugs.
To tackle the problem of resistance, the Global Antibiotic Research and Development Partnership (GARDP) have been launched by the Drugs for Neglected Diseases initiative (DNDi) and WHO.
Developing new antibiotic treatments, promoting appropriate use for its long lasting effectiveness and ensuring access for all in need are the main objectives of the organisation, according to the WHO report.
GARDP Director, Dr Manica Balasegaram, has also expressed the need to address the challenge of resistance. Balasegaram said “to address the pressing need for new treatments for gonorrhea, we urgently need to seize the opportunities we have with existing drugs and candidates in the pipeline”.
He suggested that GARDP must be aimed at speeding up the development of drugs in the near future and begin to introduce at least one of the drugs currently in the developmental pipeline, as well as continuing to evaluate the potential use of combination treatments.
It has been disclosed that along with the stigma towards s*xually transmitted infections, lack of public awareness and training of health workers, act as barriers to effective prevention of gonorrhea.
“There is a need for safer s*xual behavior as the proper use of reliable condoms can prevent the disease,” the WHO report announced.
In addition, the report encouraged increasing public awareness of safer s*x practices, ability to recognize the symptoms of gonorrhea and other s*xually transmitted infections.
As far as diagnosis goes, “most of the cases go undiagnosed as the affected person may not have any visible symptoms. However, if patients exhibit symptoms like discharge from the urethra or the vagina, sometimes the doctor mistakes it for gonorrhea and prescribes antibiotics. Antibiotic resistance in gonorrhea as well as other bacterial diseases increases due to this inappropriate overuse of antibiotics,” as stated by the WHO report.
Dr Marc Sprenger, Director of Antimicrobial Resistance at WHO further explained that to “to control gonorrhea, we need new tools and systems for better prevention,
treatment, earlier diagnosis and more complete tracking and reporting of new infections, antibiotic use, resistance and treatment failures”.
Sprenger also underlined the need of a vaccine to prevent gonorrhea.
An estimate of 78 million people is infected with gonorrhea every year. It infects the genitals, rectum, as well as the throat. Pelvic inflammatory disease, ectopic pregnancy, infertility, increased risk of HIV are complications of the disease that affects women disproportionally.
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