WHO launches landmark consolidated operational handbook to strengthen the global STI response amid rising infections

The World Health Organization (WHO) has just released its first-ever consolidated operational handbook on sexually transmitted infections, to help countries urgently strengthen the prevention, diagnosis, treatment and care of sexually transmitted infections (STIs) across health systems.

The handbook equips programme managers, policy-makers, clinicians, community organizations and partners with practical guidance that translates WHO's recommendations on STIs into concrete operational approaches. It helps countries implement, integrate and sustain high-quality STI services within primary health care and universal health coverage frameworks.

With more than 1 million new curable STIs acquired every day worldwide, and syphilis cases rising to an estimated 8 million globally in 2022 alone, including about 700 000 cases of congenital syphilis, the handbook responds to a growing need for coherent, actionable guidance at the country level.

"For the first time, countries have a single operational reference that brings together all WHO guidance on STI prevention and care. This handbook translates years of normative work into practical tools that can be adapted to any setting, helping close the gap between what we know and what we deliver," said Dr Tereza Kasaeva, Director of WHO's Department for HIV, Tuberculosis, Hepatitis and STIs.

The operational handbook presents several important features:

• consolidates for the first time all WHO normative and operational guidance on STI prevention, diagnosis, treatment, surveillance and service delivery that was published between 2016 and 2025, into a single reference document;
• introduces the STI prevention and care cascade as a structured framework, mapping how people engage with health systems from primary prevention through to partner management, and identifying where programmes commonly fall short;
• provides operational package-based guidance on integrating STI services within primary health care (PHC), community services, and other HIV, sexual and reproductive health, adolescent health, and maternal and child health platforms;
• addresses antimicrobial stewardship for treatment, aligned with the WHO Global action plan to control the spread and impact of antimicrobial resistance in Neisseria gonorrhoeae;
• includes implementation guidance on emerging interventions, including doxycycline post-exposure prophylaxis and mpox vaccination for populations at higher risk of exposure; and
• situates STI service delivery within the context of sustainable financing, responding to the shifting global funding landscape as countries transition from external donor support to domestic resource mobilization.

STIs remain among the most common infections worldwide, yet services continue to fall short for the people who need them most. This handbook gives countries a clear path to strengthen STI services within primary health care, ensuring that prevention, diagnosis and treatment reach all populations equitably, allowing the STI response to move from fragmented responses to integrated, people-centred services.