New data from WHO’s Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP) show a sharp increase in resistance to several commonly used antibiotics. Resistance to ciprofloxacin, a widely prescribed drug, now affects 95% of global cases. Resistance to ceftriaxone, currently the main treatment for gonorrhoea, has risen from 0.8% in 2022 to 5% in 2024, while cefixime resistance climbed from 1.7% to 11%. Resistance to azithromycin remained stable at 4%.
EGASP, launched in 2015, collects data from participating countries to monitor antibiotic resistance and guide treatment strategies. In 2024, 12 countries submitted data, up from four in 2022, demonstrating an increased global commitment to tracking drug-resistant infections.
The WHO report highlights that 52% of gonorrhoea cases in men were reported in the Western Pacific region, while 28% occurred in Africa. The median patient age was 27, ranging from 12 to 94 years. Approximately 20% of cases involved men who have sex with men, and 42% of patients reported having multiple sexual partners in the preceding 30 days. Recent antibiotic use and international travel were also common, factors that can contribute to the spread of resistant strains.
Dr. Tereza Kasaeva, Director of WHO’s HIV, TB, Hepatitis & STIs Department, emphasized the importance of robust surveillance programs. She urged countries to strengthen STI monitoring and integrate gonorrhoea into national health strategies to prevent the further spread of resistant strains.
WHO also reported progress in genomic surveillance, sequencing nearly 3,000 samples from eight countries in 2024. Research on new treatments, including zoliflodacin and gepotidacin, as well as investigations into tetracycline resistance, is ongoing and expected to guide future prevention and treatment strategies.
Despite these advances, the organisation warned of persistent challenges, including limited funding, incomplete reporting, and data gaps—particularly regarding women and non-genital infections. WHO called for increased investment in national surveillance systems to curb the rise of drug-resistant gonorrhoea worldwide.