Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP)

The 2025 WHO EGASP report provides a global overview of gonorrhoea cases and antimicrobial resistance across 12 participating countries, documenting 3615 urethritis episodes and widespread resistance trends that threaten current treatment regimens. The report highlights that ceftriaxone, cefixime and azithromycin resistance is emerging, with resistance rates of 5%, 11% and 4%, respectively, and very high ciprofloxacin resistance (95%), particularly in Asia. Cambodia and Viet Nam show the highest resistance levels across key antibiotics, underscoring urgent regional concerns. The programme’s expanded surveillance—covering demographic, behavioural and clinical data and analysing 2429 confirmed isolates—reveals high-risk sexual behaviours, frequent multi-partner exposure and limited HIV/STI testing. EGASP continues to strengthen laboratory capacity, early detection of resistant N. gonorrhoeae strains and treatment optimization, while showing that many countries still rely on dual therapy despite rising resistance. Overall, the report reinforces the critical need for continuous global surveillance and adaptation of treatment guidelines to combat rapidly evolving gonococcal AMR.