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New partnership to combat antimicrobial resistance in gonorrhoea

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Article published on the World Health Organization website on December 08, 2021

The US Centers for Disease Control and Prevention has awarded funding to nearly 30 organizations to combat antimicrobial resistance (AMR) and other healthcare threats through the establishment of 2 new networks: the Global Action in Healthcare Network (GAIHN) and the Global Antimicrobial Resistance Laboratory and Response Network (Global AR Lab & Response Network).

With funding from this initiative, WHO will enhance the national, regional and global understanding of epidemiology and AMR in Neisseria gonorrhoeae (N. gonorrhoeae). In partnership with WHO collaborating centres (1-3), the WHO Department of Global HIV, Hepatitis and STI Programmes will strengthen surveillance of AMR in N. gonorrhoeae by coordinating, consolidating and expanding the Enhanced Gonococcal Antimicrobial Surveillance Program (EGASP) at the global level within the Global AMR Surveillance System framework.

WHO launched EGASP to generate high quality and representative gonococcal AMR data. The initial implementation in Thailand and the Philippines proved that EGASP is a sustainable methodology in low- and middle-income countries (LMICs).

With this partnership, the project will expand EGASP globally by supporting implementation in 10 additional LMICs that have a high burden of N. gonorrhoeae and are at risk for the development of AMR. The project will further strengthen EGASP’s reach in the 2 early adopter countries of the methodology.

WHO will also implement new methods of molecular surveillance and AMR in N. gonorrhoeae isolates using whole genome sequencing.

“WHO welcomes this news,” said Meg Doherty, Director of WHO’s Global HIV, Hepatitis and STI Programmes. “We need to monitor for and work proactively to reduce the development of AMR in N. gonorrhoeae around the world if we hope to achieve the Sustainable Development Goals of controlling sexually transmitted infections by 2030 – this also means acting on this data to ensure no one suffers from untreatable gonorrhoea.” 

N. gonorrhoeae is the second most common bacterial sexually transmitted infection and results in substantial morbidity and economic costs worldwide. WHO estimates that there are 82.4 million new cases of gonorrhoea among adults and adolescents (15–49 years old) each year. The burden varies by geographic region, with the highest rates estimated in the WHO Regions of Africa, the Americas and the Western Pacific.

N. gonorrhoeae resistance to the most common antibiotics is recognized as a public health problem of global importance, and multi-drug resistant N. gonorrhoeae is included among the priority pathogens globally and nationally.

An expanded quality-assured and representative global gonococcal AMR surveillance system is needed to follow AMR trends, identify emerging AMR and inform WHO norms and standards and public health policies.

  1. WHO Collaborating Centre for Gonorrhea and other STIs, National Reference Laboratory for STIs, Department of Laboratory Medicine and Microbiology, Orebro University Hospital and Orebro University, Sweden;
  2. WHO Collaborating Centre for STIs and AMR, Department of Microbiology, the Prince of Wales Hospital, Australia;
  3. WHO Collaborating Centre for STI Prevention, Laboratory Reference and Research Branch, Division of Sexually Transmitted Disease Prevention, National Center for HIV, Viral Hepatitis, STDs and TB Prevention, US Centers for Disease Control and Prevention, United Sates of America.