Syphilis affects large numbers of pregnant women worldwide, causing serious health problems and even death to their babies. One study estimates the percentage of pregnant women tested for syphilis and adequately treated, ranges from 30% for Africa and the Mediterranean region to 70% for Europe. Another study suggests that, unless testing and treatment of syphilis in pregnancy are universally available, over half of pregnancies in women with syphilis will result in an adverse outcome.
Eliminating congenital syphilis is within our reach. Congenital syphilis is a neglected public-health problem. It has been around for many centuries. However, we are still witnessing new cases. Despite its high burden, its long and documented history, and the availability of cost-effective diagnosis and treatment, congenital syphilis is not a priority for many countries and remains a neglected public-health problem that continues to cause undue harm and suffering to women and their babies.
Now is an ideal time to eliminate congenital syphilis, because of a strong political will on the part of many governments in high burden countries to support the UN Global strategy for women’s and children’s health; resources and attention being devoted to achieving the Millennium Development Goals (MDGs) 4, 5 and 6; a push for dual elimination of MTCT of HIV and syphilis; increased availability and use of antenatal care (ANC) in many countries; and technological advances in screening for syphilis in low-resource settings.
A simple and inexpensive dual test for syphilis and HIV could improve the quality, acceptability and uptake of testing and treatment in rural areas to accelerate elimination of MTCT of syphilis and HIV. A proposal prepared by WHO to field test newly available dual rapid tests was shortlisted in May 2012 for the Grand Challenges: Saving Lives at Birth initiative. Although the WHO proposal was not funded through the Grand Challenges initiative, WHO has continued to develop a protocol for a multi-site study to understand the field performance and program implications of dual syphilis and HIV rapid tests