Gonorrhea. It’s a very common STI, so common in fact that we even give it a common name – “the clap”. If you’re interested in obscure etymology (and who isn’t?) then you should look at this article for an eye-watering discussion on the origins of Gonorrhea’s nickname. Every year around 106 million people are infected with the disease globally (around 700,000 in the US alone). According to the Centers for Disease Control and Prevention (CDC) these poor unfortunates may suffer bleeding, pain when urinating or a discharge. More seriously:
“Untreated, [gonorrhoea] can cause complications such as infertility, infections, stillbirths and increased susceptibility to HIV infection. Babies born to mothers with gonorrhea have a 30 to 50 percent chance of developing eye infections, and potentially blindness.”
Furthermore, it can lead to pelvic inflammatory disease in women which in turn increases the risk of ectopic pregnancies which is itself a life-threatening condition. In either men or women, it can spread to the blood or joints which also can be life-threatening. It’s a common name, but it can be deadly. Gonorrhea is easily and cheaply cured with a course of antibiotics. But the World Health Organisation has announced it is now becoming drug-resistant. Cases have been reported of resistance to the last treatment option (cephalosporin antibiotics) in Australia, France, Japan, Norway, Sweden and the UK. According to the Dr Manjula Lusti-Narasimhan, a scientist in the WHO’s department of sexually transmitted diseases:
“This organism has basically been developing resistance against every medication we’ve thrown at it…In a couple of years it will have become resistant to every treatment option we have available now…It’s not a European problem or an African problem, it’s really a worldwide problem.”
The reasons for this resistance seem to be both the bacteria’s ability to quickly adapt and to our over-reliance on antibiotics:
“Scientists believe overuse or incorrect use of antibiotics, coupled with the gonorrhea bacteria’s astonishing ability to adapt, means the disease is now close to becoming a super bug.
Bacteria that survive antibiotic treatment due to a mutation that makes them resistant then quickly spread their genes in an accelerated process of natural selection. This is a general problem affecting all antibiotics, but gonorrhea is particularly quick to adapt because it is good at picking up snippets of DNA from other bacteria, said Lusti-Narasimhan.”
Gonorrhea is but one example of these new “super-bugs” that occasionally pop up in the news. Much of our population growth over the last few decades has been due to the incredible increase in our medical knowledge and the concomitant decrease in our mortality rates. If our tried and true methods of curing diseases become less effective then we will see global mortality rates increase. This will in turn result in a decrease in population growth and even absolute population decline if the disease is virulent enough.
On the brighter side, WHO has a plan. But the plan does not involve a panacea, as Maryn McKenna at the Wired Science Blog argues:
“…the plan calls specifically for improvements in lab capacity, diagnosis and surveillance, as well as asking for things that apply to the greater problem of antibiotic resistance: improved awareness, bigger efforts at prescribing antibiotics appropriately and better drugs. One thing that it particularly calls for — as the CDC did in the New England Journal last February — is for physicians to start applying a “test of cure,” actually checking microbiologically to see whether a patient who was prescribed an antibiotic for gonorrhea is clear of infection, or harboring a resistant strain.
The problem, of course — you can see this coming — is that once you start bringing patients back and giving them additional and different tests, STD control becomes more costly. (That’s not even to mention the additional, distributed costs of developing new education efforts, surveillance systems or drugs.) In my read, that’s the real news in the WHO’s decision to sound a global alarm: a tacit admission that the era of cheap STD control may be over.”
So more drugs and more screening. Also, of course, more condoms:
“Better sex education is also needed, as proper condom use is an effective means of stopping transmission, said Lusti-Narasimhan.
‘We’re not going to be able to get rid of it completely,’ she said. ‘But we can limit the spread.’”
Why, whenever it comes to things revolving around STIs (and in particular AIDS) the answer is always first and foremost more condoms or a cure? Why does no one mention the fail safe cure that is also COST FREE? As the CDC says:
“The most certain way to avoid gonorrhea is to not have sex or to be in a long-term, mutually monogamous relationship with a partner who has been tested and is known to be uninfected.”
Shout it from the rooftops. It’s not hard. We’ve mentioned before on this blog that it works with HIV in Zimbabwe. And it doesn’t rely on the guy using a condom properly when he is drunk as a skunk on early Sunday morning with someone whose name he has already forgotten. Unfortunately, celibacy and monogamy require self-control. And the whole point of birth control is to allow for fewer births and no control. So as gonorrhea and other STIs become more resistant to our current medicine, we will demand scientists to come up with a cure. We will demand that more condoms are available (and used properly of course!) But we will continue with the same course of action – because after all, science is here to save us from our moral turpitude. And we will figuratively crucify anyone who dares say anything to the contrary.