Rates of syphilis have increased by over 17% compared to last year’s record-setting rate, reaching levels not seen since the 1950s. This worrying trend could potentially worsen if Congress does not prevent budget cuts to disease tracking efforts that are scheduled to occur this year.

The latest information from the Centers for Disease Control and Prevention, published on Tuesday, reveals a significant rise in syphilis and other sexually transmitted infections nationwide. This comes as local health departments strive to bounce back from their efforts in combating Covid-19 and Mpox.

In 2022, the CDC received reports of over 2.5 million cases of sexually transmitted diseases, although this number is likely lower than the actual amount due to difficulties with testing accessibility across the country. Health officials are particularly concerned about the rise in congenital syphilis, where an untreated infection can be passed from a parent to their baby during childbirth. In 2022, there were 3,755 cases recorded, resulting in at least 282 stillbirths and infant deaths. This represents an increase of over 30 percent from the previous year and is the highest it has been since 1991.

Laura Bachmann, the acting director of the CDC’s STD office, expressed deep concern about the current situation. She emphasized the need for a change in approach, with increased resources dedicated to improving infrastructure, developing new treatments, and enhancing diagnosis and prevention efforts. There is a significant amount of work that needs to be done in this area.

However, concerns arise among public health professionals that they may not have sufficient funds to carry out their tasks due to the ongoing disputes over the current budget in Congress. There is also a potential decrease of $400 million in funding for disease investigators if Congress follows the spending agreement made with President Joe Biden last year, whenever they approve the fiscal 2024 appropriations legislation.

Paul Ryan

“The potential agreement is still uncertain as Congress postponed the decision until the beginning of March in order to give more opportunity for discussions on the budget. Speaker of the House, Paul Ryan, has not yet made a decision.”Mike Johnson and Senate Majority Leader Chuck Schumer

The data has shown that the majority intend to continue with the previous agreement and, if anything, there may be further reductions to government initiatives.

According to a December study conducted by the National Coalition of STD Directors, proposed budget cuts would result in significant job losses for public health departments. If implemented, over 800 disease trackers would be laid off in 2024, with an additional 190 in 2025. This reduction in staff would have a direct impact on the ability to provide vital services such as administering HIV prevention medication, conducting STD testing, referring patients for treatment, contact tracing, and addressing outbreaks of diseases like viral hepatitis and tuberculosis.

The significance of disease intervention specialists in managing syphilis extends beyond just contact tracing and partner services. According to Bachmann, they possess valuable knowledge about the community and its culture, making their role even more difficult in light of current circumstances.

The areas with the highest rates of sexually transmitted diseases are at risk of being heavily impacted by the budget cuts.

In 2022, Texas, the state with the highest number of congenital syphilis cases, is expected to have 83 fewer disease trackers. Meanwhile, Arizona is currently experiencing the highest rates of HIV since the late 1980s and has the third-highest rate of congenital syphilis in the nation, and will be losing 60 disease trackers.

According to Rebecca Scranton, the deputy bureau chief for infectious disease and services at the Arizona Department of Health Services, if the proposed cuts by Congress are implemented, their STD testing efforts will be reduced by 50% beginning in the following year.

She stated that regardless of any circumstances, they will continue to assist the people of Arizona to the best of their abilities. She also mentioned that they have four open positions that they are unable to fill, which makes their job more challenging.

Last year, the Biden administration created the National Syphilis and Congenital Syphilis Syndemic Federal Task Force in response to the growing crisis.

The head of the task force, Rachel Levine, informed POLITICO that they have prioritized promoting quicker testing, specifically for pregnant individuals, enhancing availability of medications for potential exposure, and addressing racial inequalities caused by poverty and limited healthcare access since last year.

She expressed great worry about the rise in cases of congenital syphilis among American Indian and Alaskan Native individuals, but emphasized that this issue affects the entire population. The task force is specifically targeting 14 priority states with the highest rates of congenital syphilis, including both Democratic states like California and New York and Republican states like Arkansas and Florida. Within these states, their focus is on addressing the high rates of addiction and individuals transitioning out of incarceration, as they are at a heightened risk for syphilis.

The taskforce’s objective is to raise the percentage of syphilis cases prevented through testing and treatment by 5 percent by September. However, Levine, who is a pediatrician, emphasized that most cases of congenital syphilis can be prevented if infections are detected and treated early. This can only be achieved if more doctors feel at ease discussing sexual history with their patients and administering tests for the infection.

She stated that our objective is to decrease the number of syphilis cases and lessen the impact on infants affected by syphilis.