Antimicrobial-resistant gonorrhoea in Africa: An important public health threat in need of a regional gonococcal antimicrobial surveillance programme

According to the World Health Organization’s (WHO) prevalence and incidence estimates for 2005, gonorrhoea is the second most common sexually transmitted bacterial infection worldwide. Antimicrobial resistance among gonococci is worsening and multidrugresistant strains, no longer responsive to oral cephalosporins, are now circulating in the Western Pacific region and emerging in other parts of the world. Sustainable high-quality antimicrobial resistance surveillance programmes for Neisseria gonorrhoeae exist in only a few countries. With the exception of South Africa, gonococcal antimicrobial resistance surveillance data are few or absent for most of Africa. There is thus an urgent need to revitalise gonococcal laboratory-based surveillance on the continent. In order to respond to this challenge, renewal of the WHO Gonococcal Antimicrobial Surveillance Programme is now taking place in various regions of the world, including sub-Saharan Africa, where the National Institute for Communicable Diseases, a division of the National Health Laboratory Service, has been asked to play a leading role.