Letter from the President

Two Presidents. Professor Angelika Stary (right) is the current President of IUSTI until 2009, when Professor King Holmes (left) will take over. Photograph taken at the IUSTI-ISSTDR Joint conference in Seattle, 2007.

The Global View of STIs

Sexually transmitted infections (STIs) represent a major health problem in both developed and developing countries, reflected by the estimated 300 million new cases occurring worldwide every year (WHO). Although a decline in STIs has been observed since the 1950s, in many countries an increase has been reported during the last few years, especially in syphilis, gonorrhea and certain viral infections including HIV. Outbreaks of rectal lymphogranuloma venereum, predominantly in HIV positive individuals, have been observed in many European countries, and the increase in syphilis is highest in men having sex with men indicating a failure of behavioural prevention in high risk groups. Individuals at risk have become less frightened, and physicians and public health institutions are less aware of HIV as an ongoing life threatening infection.

At present drugs exist which can eradicate bacterial, protozoal or ectoparasitic infections. However, challenges remain in countering genital pathogens even where antibiotics are available with the increasing incidence of antibacterial resistance in gonococci. While initial reports were focused in Asia, high levels of resistance in gonococci especially against quinolones has now become a worldwide problem and reflects the ability of microorganisms to escape antibacterial strategies.

The major impact of STIs on public health today derives from viral rather than bacterial infections and many viral infections still represent a major therapeutic challenge. Hepatitis B and AIDS are a substantial problem in Western Europe and the USA but represent devastating epidemics in Central and South Africa, certain parts of Asia and Eastern Europe. Antiviral resistance is an ongoing and increasing problem in the treatment of HIV infected individuals. Pre-exposure vaccination against hepatitis B is recommended for individuals at risk but vaccination strategies may fail because of the high costs in developing countries and public resistance against vaccination in general. It is known that high risk genotypes of human papilloma viruses (HPV) may occasionally carry the risk of malignancy and lead to invasive carcinoma of the genital tract in women and men. The initial results of HPV vaccines are promising and give hope that genital cancer can be reduced or even eradicated by large scale vaccination programmes, some of which are already being planned.

How can the International Union against Sexually Transmitted Infection (IUSTI) contribute to the global challenge of STIs?

IUSTI, with a tradition stretching over 80 years as an official nongovernmental organisation in consultative status with the WHO, is based on a worldwide cooperation of 5 regions comprising Africa, Asia-Pacific, Europe, Latin America, and North America, and has as its aims the control of sexually transmitted diseases and HIV infection, and the development of educational programmes. It offers training and management in the field of STIs, and information resources in different regions: the European Branch has established “European STI-Management Guidelines”, the Asian-Pacific Branch has published an STI textbook, and a compendium on STIs on a CD-Rom is available. In the different branches, a regional network of experts act as a link between different countries, regions, and globally. The regular publication of newsletters has started with this very first one, and the organisation’s homepage (www.iusti.org) offers an additional option for our members to gain information.

Conferences and meetings on a worldwide or regional basis are regularly planned in different parts of the world, and information is also available on the internet. You are welcome to join the regional meetings in Kuala Lumpur, Malaysia (14th IUSTI-Asian Pacific Conference, 27-30 July, 2006) or in Versailles, France (22nd IUSTI Europe Conference on STIs, 19-21 October 2006) and to attend the world conference on STIs in 2007, a joint meeting together with the ISSTDR in USA (Seattle).

Do you want to actively contribute, do you have ideas, comments or suggestions for collaborative work with us?

Let me assure you that you are most welcome to join IUSTI and collaborate with us in order to decrease and prevent STIs in your own country and as a platform for cooperation and communication, for the exchange of experience, and to share new developments in all aspects of STIs.

Angelika Stary
IUSTI World President

Reviewed by webmaster February 4th 2008