Sexually transmitted infections (STIs) pose a significant public health challenge. Globally, more than 1 million new STI cases are diagnosed each day. To surmount this growing global health crisis, officials from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, have suggested that the biomedical research community should refocus its commitment to STI research.1
The NIAID experts advocating for a greater focus on STIs are Anthony S. Fauci, MD, NIAID director; Robert Eisinger, PhD, special assistant for scientific projects in the immediate office of the director; and Emily Erbelding, MD, director of the division of microbiology and infectious diseases.
Anthony S. Fauci, MD, NIAID.
The specialists note that a variety of STIs are contributing to the public health crisis, as cases of chlamydia, gonorrhea, and syphilis are all on the rise. Left untreated, many STIs can cause serious complications. Congenital syphilis can cause stillbirths and health complications in newborns, and chlamydia and gonorrhea can contribute to life-threatening ectopic pregnancies. Gonorrhea and syphilis, which are increasing among men who have sex with men and bisexual men, are also associated with an increased risk for HIV transmission and acquisition. Moreover, increasing antimicrobial resistance will make STIs only more difficult to treat, as many existing drugs will become less effective against the microbes that cause gonorrhea and other STIs.
Unfortunately, STI research efforts have not adequately addressed the ongoing spread of these diseases. To meet this public health threat, the experts say, biomedical research programs need to be refocused on developing innovative diagnostics, therapeutics, and vaccines for STIs. Healthcare providers need access to faster, low-cost diagnostics to identify both active and asymptomatic STIs. The STI vaccine pipeline also needs to produce effective new candidate vaccines for chlamydia, gonorrhea, and syphilis. As for STI therapeutics, the experts note that research efforts must focus on drug-drug interactions, toxicities, and side effects, while keeping ahead of spreading antimicrobial resistance.
In March 2019 NIAID launched an initiative involving six new STI cooperative research centers that will work to develop vaccines for chlamydia, gonorrhea, and syphilis. NIAID has also funded a large clinical trial examining doxycycline postexposure prophylaxis against STIs in groups at high-risk for HIV, and has supported additional novel research efforts.
No single entity, however, can tackle the growing public health problem posed by STIs. The experts say that the key to curbing STIs is cooperation among biomedical researchers in the public and private sectors, together with the efforts of community clinics and healthcare providers.
Reference
- Eisinger RW, Erbelding E, Fauci AS. Refocusing research on sexually transmitted infections. J Infect Dis. Epub ahead of print, September 9, 2019; doi: 10.1093/infdis/jiz442.
Featured image: Neisseria gonorrhoea
. Photo courtesy NIAID.
