In June, state and local health departments in the United States were informed that they would no longer receive the remaining $1 billion of funding dedicated to improving the capabilities of those who monitor and work towards preventing sexually transmitted diseases, with a particular focus on the growing number of syphilis cases.
The consequences were swift: Nevada, which experienced a 44% increase in congenital syphilis cases from 2021 to 2022, was promised over $10 million to support its STD program budget. However, the state’s budget for STD prevention was ultimately reduced by more than 75%, significantly limiting its ability to address syphilis, as reported by Dawn Cribb of the Nevada Division of Public and Behavioral Health.
According to multiple states interviewed by The Associated Press, the primary consequence of the national debt ceiling agreement canceling the program is the challenge of growing their workforce of disease intervention specialists. These individuals are responsible for conducting contact tracing and outreach efforts, which are crucial in curbing the spread of syphilis. While the disease reached its lowest point in the U.S. in 2000, it has seen a steady increase each year since then. In 2021, there were a total of 176,713 reported cases, a 31% jump from the previous year.
Sam Burgess, the director of the STD/HIV program at the Louisiana Department of Health, expressed deep disappointment over the situation. Despite their efforts to strengthen their workforce and introduce new initiatives, the state only received $8.6 million out of the expected $14 million. This amount must be utilized by January 2026. Burgess shared that they are currently working to find solutions to cover the remaining funding needs.
Although men who engage in sexual activity with other men are more likely to be affected by syphilis, both the U.S. Centers for Disease Control and Prevention and health officials nationwide have observed a rise in cases of pregnant women transmitting the infection to their infants. This can result in severe health complications for newborns, such as blindness and bone damage, and may even lead to stillbirths. In the year 2021, there were 77.9 cases of congenital syphilis for every 100,000 live births.
Specialists in disease intervention frequently connect mothers and their partners who have contracted syphilis to receive treatment. This can effectively prevent the transmission of congenital syphilis, as the infection typically presents with mild symptoms in adults such as fever and sores. Additionally, these specialists offer assistance to pregnant patients in locating prenatal care.
Deneshun Graves, a public health investigator with the Houston Health Department, stated that it can be emotionally challenging to explain to someone whose mother was unaware of her syphilis diagnosis. He also emphasized the potential for prevention if the infection had been detected earlier.
Lupita Thornton, who manages public health investigations at the health department, expressed concern about being able to provide treatment for pregnant patients with syphilis “prior to 30 days before delivery, for the well-being of the baby.”
The Houston Health Department is currently implementing a “rapid community outreach response” due to a 128% rise in syphilis cases among women from 2019 to 2022, and a jump from 16 to 151 cases of congenital syphilis between 2019 and 2021.
The STD/HIV department was initially allocated $10.7 million from the government grant, but will ultimately receive approximately 75% of that amount.
The funds have been utilized by the department to employ experts in disease intervention and epidemiology, such as Graves. However, Thornton expressed a desire for even more resources and had intended to reduce the workload for her investigators by hiring additional staff.
Assisting Graves, who is responsible for managing over 70 cases simultaneously.
According to Graves, there are individuals who refuse to seek treatment and others who avoid answering their phone, requiring repeated attempts at communication.
A recent study revealed that Mississippi has experienced a significant increase in cases of congenital syphilis, with a tenfold rise between 2016 and 2022. Health authorities cited a lack of funding and inadequate access to prenatal care as contributing factors to their limited ability to control the spread of syphilis.
The Mississippi State Department of Health was scheduled to receive over $9 million in federal funding over a span of five years to increase its disease intervention team. Dr. Dan Edney, the head of the agency, stated that his main focus currently is obtaining funds from other areas of the state’s health budget.
He stated that the state is facing challenges due to insufficient funding, and therefore, must reallocate resources from various programs in order to improve diagnostic and treatment rates, and effectively conduct investigations.
Arizona has the highest rate of congenital syphilis in the nation: 232.3 cases per 100,000 live births. The federal money helped the state Department of Health Services clear out a backlog of several thousands of non-syphilis STD investigations that had been stalled for years, said Rebecca Scranton, the deputy bureau chief of infectious disease and services.
Scranton stated that they had reached a stage where they could catch their breath and begin actively addressing the issue.
Scranton recognizes that addressing syphilis will require time and effort, and plans to save some of the unused grant funds for future needs.
“You don’t know what challenges are going to come. You know they’re going to come, and you just keep getting creative because our job is really to get services to the folks,” she said. “And that doesn’t change just because you get a funding cut.”
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