Political Prioritisation of the Prevention and Control of STIs

What drives the position of sexually transmitted infections on global policy agendas?

Project Summary

Sexually transmitted infections (STI) are not only a neglected public health problem but also a societal one. One million new curable STIs occur every day in the world, mostly in low – and middle – income countries. STIs, such as syphilis, chlamydia and gonorrhoea may have serious complications, especially for women’s reproductive health. Others, such as human papillomavirus, can cause cancer. Even though effective interventions to prevent and treat STI exist, neither governments nor other policy makers give them high priority or grant investments in their prevention.

This project is structured around three questions:

  • What are the factors that influence the political prioritisation of STIs as a global health issue?
  • What is the total global burden of disease caused by STI, based on statistical methods to combining data from different sources?
  • What are community views about STI in pregnancy?

The methods employed in the project include policy analysis, estimations of the total global burden of disease as well as interviews with pregnant women and key informants in Papua New Guinea and Zambia. Gender will be one of the main research lenses while examining these questions.

This project’s findings will help public health officials make the changes needed to prioritise the prevention and control of STI worldwide.

Academic Output

Executive Summary

Every day worldwide, the World Health Organization (WHO) estimates that there are one million new infections with any one of four curable sexually transmitted infections (STIs, gonorrhoea, chlamydia, syphilis, or trichomoniasis) among 15 to 49 year olds. When untreated, these STIs are they are associated with a range of poor health outcomes, particularly for women and newborn babies. There is widespread belief that these curable STIs receive low priority on policy agendas, especially in comparison with HIV. There has been no previous systematic analysis of what drives the attention paid to curable STIs as a global public health issue and why these infections gain priority as conditions for health policy makers to pay attention to. Public policy decisions are driven by a mix of factors including the scale and size of the problem, how the issue is framed and the value attached to the problem. This project addressed the question of what drives the position of STIs on the global policy agenda through three specific objectives.


STIs are widely regarded as a neglected public health problem, receiving low priority and inadequate resources on health agendas. The estimated costs of global STI control and prevention and allocations from donors show a substantial funding gap. There are several reasons that may contribute to the apparent low salience of STIs. First, the curable STIs rarely result in death, but there is insufficient understanding of the sources, selection and quality of data inputs to quantify the reduction in people’s quality of life. Second, on-site tests or laboratory capacity for STI diagnosis are lacking in many settings, making it challenging to monitor progress towards targets. Third, whilst there are effective interventions for several STIs they receive lower global priority than those for HIV. Fourth, STIs are sustained and perpetuated by socio-cultural and political inequalities, stigma and discrimination, meaning that political attention, leading to resource allocation is challenging to achieve. Finally, despite the importance of civil society for prioritisation, there is little visible advocacy and mobilised support for curable STI control.

Research Team

Nicola Low
University of Bern

Eva Cignacco Müller
Bern University of Applied Sciences

Hira Imeri
Principal Member
University of Zurich


Sarah Hawkes
Principal Member
University College London

Angela Kelly-Hanku
Principal Member
Papua New Guinea Institute of Medical Research

Wu Dadong
Principal Member
Independent Consultant

Mae A Dirac
Principal Member
University of Washington

Kelvin Kapungu
Principal Member
Tropical Research Centre, Zambia



Andrew Vallely
Associated Member
Papua New Guinea Institute of Medical Research

Matthew Chico
Associated Member
London School of Hygiene & Tropical Medicine

William Pomat
Associated Member
Papua New Guinea Institute of Medical Research





Policy domains



Papua New Guinea, Zambia, China

Host Institution