The World Health Organization has warned that cases of
untreatable, antibiotic-resistant gonorrhoea are on the rise due
to unsafe oral sex and a decline in condom use.
Data from 77 countries showed that when someone contracts the
common sexually-transmitted infection — which infects roughly 78
million people each year — it is now “much harder, and sometimes
impossible, to treat,” according to the
This is because the infection is rapidly developing a resistance
Gonorrhoea is spread by unprotected vaginal, oral, and anal sex.
It can infect the genitals, rectum, and throat. The BBC reported that the WHO is most
concerned about the throat, stating that “thrusting gonorrhoea
bacteria into this environment through oral sex can lead to
super-gonorrhoea,” the untreatable form of the disease.
Complications disproportionally affect women, according to WHO,
including “pelvic inflammatory disease, ectopic pregnancy and
infertility, as well as an increased risk of HIV.” “The bacteria
that cause gonorrhoea are particularly smart,” said Dr Teodora
Wi, a medical officer in human reproduction at WHO.
The rise in the infection is due to “decreasing condom use,
increased urbanisation and travel, poor infection detection
rates, and inadequate or failed treatment all contribute to this
increase,” according to WHO.
It added that there are no “affordable, rapid, point-of-care
diagnostic tests for gonorrhoea,” and since many people infected
do not have symptoms, cases often go undiagnosed and untreated.
Two papers, set to be published before the STI HIV World
Congress in Rio from July 9 to 12, will show that while in many
instances the resistance is to older and cheaper antibiotics, in
some countries cases of the infection are untreatable by all
“These cases may just be the tip of the iceberg, since systems to
diagnose and report untreatable infections are lacking in
lower-income countries where gonorrhoea is actually more common,”
In most countries, there is only a single antibiotic that remains
effective for treating gonorrhoea, but resistance to it now been
reported by the WHO in more than 50 countries.
The quest for new antibiotic treatment
According to the BBC, the
outlook is “fairly grim” with only three new candidate drugs “in
various stages of clinical development.” The WHO said the
development of new antibiotics is “not very attractive for
commercial pharmaceutical companies” because they are taken for
short periods, become less effective as resistance develops, and
constantly need replenishing.
In order to address the issue, the WHO and The Drugs for
Neglected Diseases initiative (DNDi) have launched a Global
Antibiotic Research and Development Partnership (GARDP), a
not-for-profit research and development organisation with a
mission of “developing new antibiotic treatments and promoting
appropriate use while ensuring access for all in need.”
Dr Manica Balasegaram, GARDP director, said: “To address the
pressing need for new treatments for gonorrhoea, we urgently need
to seize the opportunities we have with existing drugs and
candidates in the pipeline.
“In the short term, we aim to accelerate the development and
introduction of at least one of these pipeline drugs, and will
evaluate the possible development of combination treatments for
public health use.”
The WHO added: “Today, lack of public awareness, lack of training
of health workers, and stigma around sexually transmitted
infections remain barriers to greater and more effective use of
The organisation added that the infection can be prevented
through “safer sexual behaviour, in particular, consistent and
correct condom use.”
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