Posted on: Mon 24-11-2025

The World Health Organization (WHO) has sounded a fresh alarm over the rapid spread of drug-resistant gonorrhoea as new global data reveal a sharp rise in resistance to key antibiotics used to treat the sexually transmitted infection.

 

The findings, released under WHO’s Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP) to mark World Antimicrobial Resistance (AMR) Awareness Week, show that more countries are now reporting strains of gonorrhoea that no longer respond to standard treatment.

 

According to WHO, resistance to ceftriaxone and cefixime — the primary antibiotics recommended worldwide — increased steeply between 2022 and 2024, rising from 0.8% to 5% and 1.7% to 11% respectively. Resistance to ciprofloxacin climbed to 95%, while azithromycin resistance remained stable at 4%. Cambodia and Viet Nam recorded some of the highest resistance levels.

 

“This global effort is essential to tracking, preventing, and responding to drug-resistant gonorrhoea and to protecting public health worldwide,” said Dr Tereza Kasaeva, Director of the WHO Department for HIV, TB, Hepatitis & STIs. She urged governments to integrate gonorrhoea surveillance into national STI programmes and scale up actions to curb rising infections.

 

More countries now reporting cases

The number of countries feeding data into EGASP has grown, with 12 countries across five WHO regions reporting in 2024 — up from just four in 2022. These include Brazil, Cambodia, India, Indonesia, Malawi, the Philippines, Qatar, South Africa, Sweden, Thailand, Uganda and Viet Nam.

 

A total of 3,615 gonorrhoea cases were recorded in 2024. Over half of all symptomatic cases in men (52%) came from the Western Pacific Region, led by the Philippines (28%), Viet Nam (12%) and Cambodia (9%). The African Region accounted for 28% of cases, followed by South-East Asia (13%), the Eastern Mediterranean (4%) and the Americas (2%).

 

The median age of patients was 27 years, with cases ranging from ages 12 to 94. WHO noted that 20% were men who have sex with men, 42% reported multiple sexual partners in the past month, 8% had taken antibiotics recently, and 19% had travelled shortly before diagnosis.

 

Growing surveillance, but major gaps remain

WHO said it made significant advances in genomic surveillance in 2024, sequencing nearly 3,000 samples from eight countries. Key studies on new treatments — including zoliflodacin and gepotidacin — and research on tetracycline resistance were carried out through WHO’s Collaborating Centre in Sweden.

 

The organisation also expanded EGASP’s reach, with Brazil, Côte d’Ivoire and Qatar joining the network, while India is set to begin reporting data in 2025 under its national STI programme.

 

Despite progress, WHO warned that surveillance remains patchy, with persistent challenges such as inadequate funding, incomplete reporting, and limited data on women and extragenital infections. The agency called for urgent investment to support national and global efforts in tracking and curbing gonococcal antimicrobial resistance.

 

WHO reiterated that without stronger surveillance, improved diagnostics and equitable access to new STI treatments, the world risks losing one of its most important lines of defence against a rapidly evolving public health threat.

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