According to the recent WHO report, Implementing the global health sector strategies on HIV hepatitis, and sexually transmitted infections, 2022-2030, viral hepatitis and other sexually transmitted diseases (STDs) are on the rise. Annually, 2.5 million people around the world die from such diseases, which thus pose significant public health challenges. In this regard, members of the WHO have set out an ambitious plan which entails reducing the annual numbers of syphilis, for example, from 7 million to 0.71 million by the year 2030. The Netherlands’ RIVM (National Institution for Public Health and the Environment) is also concerned with the growing number of STDs in the country. In 2023, the number of tests for STDs increased by 4 per cent in comparison to the previous year. The number of gonorrhea diagnoses (13,853) was much higher than in 2022 (10,600), an increase of 31 percent. There were also more syphilis diagnoses in 2023 (1,693) than in 2022 (1,574).
STDs on the rise
With these alarming increases, the Netherlands is working hard to fight the spread of STDs, especially the city of Amsterdam. One of the reasons STDs are spreading more rapidly in recent years is that people are not being tested and treated, which means they continue to spread the disease. In the first six months of 2024, the Amsterdam GGD (Municipal Centre for Public Health) saw 8% fewer STD consultations than in the same period the previous earlier. According to Elske Hoornenborg, head of the Amsterdam GGD, the decline in testing is noticeable in Amsterdam: “There are alarmingly fewer registrations than before; last year we were at around 66,000 consultations around this time, this year there are 7,000 fewer. If people do not test for STDs, then they cannot be treated, and we cannot prevent them from spreading them.”
Testing without symptoms
A possible explanation for the decline in STD consultations, according to the GGD, is that people without actual symptoms of STDs were discouraged in the past by long waiting times and therefore simply refrained from getting tested at all. Previously, people with actual physical symptoms were given priority over people without symptoms, which meant that most people in the second group did not get an appointment at all. Many people without symptoms still wanted to get tested for STDs, for example because they had many sexual partners. Sometimes they simply indicated that they suffered from symptoms, so that they could be tested. This resulted in even longer waiting periods for the others, as everyone who claimed to have symptoms, whether it was true or not, got priority. As a result, the waiting period increased more and more.
Alexander Scholtes, deputy mayor of Amsterdam and responsible for public health and disease prevention, last month initiated a pilot to test more people without symptoms. According to Scholtes, Amsterdam’s GGD is now freeing up more testing capacity for people without immediate symptoms, and those with symptoms are no longer given priority, as they had in the past. Scholtes points out there will now be more quick consultations, which means more people can be tested.
However, the new conservative Dutch coalition government plans to cut government spending on health care by ten percent. It looks as if Amsterdam’s solution might not last for long. According to Scholtes: “We need money from the national government. The budget we receive has remained the same since 2017. While costs have increased, the demand has only increased.” Therefore, Amsterdam’s deputy mayor encourages everyone to get tested as soon as possible!
Written by Benjamin B. Roberts