Resurgent Syphilis Across the Globe: A Public Health Perspective on Bridging Surveillance and Strategy.

Syphilis, a curable sexually transmitted infection, has resurged globally, challenging public health systems in both high-income countries and low- and middle-income countries (LMICs). In nations like the United States, the United Kingdom, parts of Europe, Canada, and Japan, cases have surged due to declining condom use, digital platforms facilitating casual sex, and practices like chemsex and broader drug use for sex, with rising congenital syphilis rates. In LMICs, such as those in East Africa, South Asia, Latin America, and Southeast Asia, limited healthcare access, inadequate prenatal screening, and socioeconomic barriers drive persistent high prevalence, particularly among pregnant women and vulnerable populations. Despite contextual differences, shared drivers include stigma, health disparities, and outdated surveillance systems. This resurgence underscores the need for globally coordinated, equity-focused strategies, including universal syphilis testing, modernized surveillance, and context-specific sexual health education. Addressing structural and behavioral factors through collaborative international efforts is critical to reversing this trend and strengthening global STI control.