The World Health Organisation (WHO) has warned that some African countries are now reporting cases of drug-resistant gonorrhoea, as new global data show a sharp rise in resistance to key antibiotics used to treat the sexually transmitted infection.
The growing threat is particularly worrying for high-risk groups, such as men who have sex with men (MSM), who make up 20% of reported cases.
WHO said that increasing antibiotic resistance puts these groups at higher risk of serious complications and treatment failures, especially in areas with limited access to advanced testing or alternative treatments.
The findings were released during World Antimicrobial Resistance (AMR) Awareness Week and come from WHO’s Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP), which tracks the spread of drug-resistant gonorrhoea and helps guide treatment recommendations.
The report shows that resistance to ceftriaxone, the main treatment for gonorrhoea, rose from 0.8% in 2022 to 5% in 2024. Resistance to cefixime jumped from 1.7% to 11% over the same period.
Resistance to azithromycin stayed steady at 4%, while resistance to ciprofloxacin has reached a staggering 95%, with the highest levels reported in Cambodia and Vietnam.
Dr Tereza Kasaeva, Director of WHO’s Department for HIV, TB, Hepatitis & STIs, urged all countries to include gonorrhoea surveillance in their national STI programmes to better track and respond to the threat.
“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.”
In 2024, 12 countries across five WHO regions submitted data to WHO’s Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP), up from just four countries in 2022, showing a growing global commitment to monitoring antibiotic resistance.
The reporting countries included Malawi, South Africa, and Uganda in Africa, as well as Brazil, Cambodia, India, Indonesia, the Philippines, Qatar, Sweden, Thailand, and Vietnam. Together, they reported a total of 3,615 gonorrhoea cases.
WHO revealed that more than half (52%) of all symptomatic cases in men came from the Western Pacific Region, driven by high numbers in the Philippines (28%), Vietnam (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%).
