Some African countries are now among those detecting cases of drug-resistant gonorrhoea, the World Health Organisation (WHO) has said, as new global data show a sharp rise in resistance to key antibiotics used to treat the sexually transmitted infection.
WHO also noted that the growing threat is particularly concerning for high-risk groups, including men who have sex with men (MSM), who accounted for 20% of reported cases.
The organisation warned that rising antimicrobial resistance (AMR) places such groups at heightened risk of severe complications and treatment failures, especially in settings with limited access to advanced diagnostics or alternative therapies.
The findings, released during World Antimicrobial Resistance (AMR) Awareness Week, come from WHO’s Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP), which tracks the spread of drug-resistant gonorrhoea and guides treatment recommendations.
According to the report, resistance to ceftriaxone, the primary treatment for gonorrhoea, increased from 0.8% in 2022 to 5% in 2024, while resistance to cefixime rose from 1.7% to 11% over the same period. Although resistance to azithromycin remained stable at 4%, global resistance to ciprofloxacin has reached 95%. The highest levels of resistance were recorded in Cambodia and Viet Nam.
Director of the WHO Department for HIV, TB, Hepatitis & STIs, Dr Tereza Kasaeva, urged all countries to integrate gonorrhoea surveillance into national STI programmes.
“This global effort is essential to tracking, preventing, and responding to drug-resistant gonorrhoea and protecting public health worldwide. WHO calls on all countries to address the rising levels of sexually transmitted infections and integrate gonorrhoea surveillance into national STI programmes,” Dr Kasaeva said.
In 2024, 12 countries from five WHO regions submitted data to EGASP, up from four in 2022, indicating growing commitment to AMR monitoring. These included Malawi, South Africa and Uganda in the African region, alongside Brazil, Cambodia, India, Indonesia, the Philippines, Qatar, Sweden, Thailand and Viet Nam. Collectively, they reported 3,615 gonorrhoea cases.
WHO noted that 52% of all symptomatic cases in men were reported in the Western Pacific Region, driven by high numbers in the Philippines (28%), Viet Nam (12%), Cambodia (9%) and Indonesia (3%). African countries accounted for 28% of cases, followed by South-East Asia (13%), the Eastern Mediterranean (4%) and the Americas (2%).
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