Silent Syphilis: Zambia Sounds Alarm as STI Cases Surpass Half a Million

 

By Alain Kabinda

A person can feel healthy, watch the symptoms disappear and assume the danger has passed. But with syphilis, the silence can be deceptive.

The infection can remain in the body long after visible symptoms have disappeared, potentially progressing to serious complications affecting the brain, nervous system, eyes, ears, heart and other organs if it is not diagnosed and treated.

That silent nature of syphilis is now at the centre of a renewed public health campaign in Zambia, where authorities are confronting a much wider sexually transmitted infection (STI) challenge.

The Ministry of Health says Zambia recorded more than half a million STI cases last year, a figure it says represents a significant increase compared with previous years.

The numbers have prompted Government and the AIDS Healthcare Foundation (AHF) Zambia to launch the Stop Syphilis Campaign, with a message that prevention and treatment must move beyond health facilities and into communities.

Presenting the finding Ministry of Health National STI Coordinator Dr. Irene Bwalya said the statistics are a warning that the country cannot afford to simply watch STI infections increase.

“We are dealing with an epidemic. We can't afford to sit and watch these numbers increase,” Dr. Bwalya said.

Dr. Bwalya says the Ministry has improved testing among pregnant women following the introduction and scale-up of dual HIV and syphilis testing in antenatal clinics.

According to Ministry data presented during the campaign launch, Lusaka, Central, Copperbelt and Southern provinces continue to record some of the highest numbers of newly diagnosed STIs.

And preliminary figures for the first half of 2026 suggest that Zambia has not yet managed to bring the situation under control.

And AHF Zambia Country Programmes Manager Dr. Webster Walubita, said that the greatest danger posed by syphilis is that people may not realise they have it.

“This can be silent. Symptoms can disappear, and yet it is there,” he said.

Dr. Walubita said AHF's experience at its wellness centres demonstrates why active testing is necessary.

AHF operates three wellness centres—two in Lusaka and one on the Copperbelt—and reports that approximately 9 percent of people tested for syphilis at its facilities have been biologically confirmed positive.

If people are only tested after symptoms become obvious, some infections will inevitably remain undetected.

“If we wait only for people to show up with symptoms, we are definitely going to miss it,” Dr. Walubita said.

Untreated syphilis can progress and affect the nervous system, eyes, ears and cardiovascular system. Some patients can develop visual impairment, hearing problems and other serious complications.

Yet, unlike many diseases that are difficult to treat, syphilis can be diagnosed and cured. That is what makes the continuing burden particularly concerning for health authorities.

An untreated pregnant woman can transmit the infection to her unborn child, potentially resulting in miscarriage, stillbirth, premature delivery, neonatal death or congenital syphilis.

Children born with congenital syphilis can experience complications involving their bones, brain, hearing and other organs.

She further said that it is the continued increase in congenital syphilis.

For a disease that is both preventable and curable, the continued impact on newborn children presents a significant challenge.

“No child should be in life burdened by a disease that is curable, and a disease that the nation has power to eliminate,” Dr. Bwlaya said.

The Ministry says STI infections are particularly affecting the 18 to 25-year-old age group.

Dr. Bwalya says several factors are contributing to the trend, including early sexual activity among young girls, limited condom use and delayed treatment seeking.

Challenges in partner notification can also lead to reinfection, while poverty and transactional sex are among the broader socioeconomic factors identified by the Ministry.

In many communities, sexual health remains difficult to discuss openly, leaving young people to obtain information from friends and social media. And Zambia's progress in HIV prevention could also be affected if STIs are left behind.

Dr. Bwalya says STIs can increase susceptibility to HIV infection and facilitate HIV transmission.

“We've done very well with our HIV prevention programme, but if we leave STIs behind, STIs have been shown to increase susceptibility as well as transmission of HIV,” she said.

Speaking on behalf of Permanent Secretary for Technical Services Dr. Kennedy Lishimpi, Director of Clinical Care and Diagnostic Services Dr. Lisulo Walubita said Zambia needed to move health promotion from conventional hospital settings into communities.

He said the campaign's messages should be simple enough for ordinary community members to understand.

The objective is not merely to increase the number of people who know about syphilis, but to make testing, prevention and treatment part of everyday community health services.

Dr. Lisulo said partnerships with organisations such as AHF Zambia were helping Government take that response closer to communities.

AHF Zambia has committed significant resources to its community-based sexual health response.

The organisation says it has invested close to US$6 million since 2024 in its three wellness centres, supporting infrastructure, healthcare workers, diagnostics, commodities, outreach, testing, treatment and linkage to care.

During the Stop Syphilis Campaign, AHF plans to test up to 1,500 people for syphilis and other STIs, provide HIV testing to 2,500 people, distribute more than 100,000 condoms and reach over 20,000 people with prevention and treatment information.

But Dr. Walubita says the campaign should not be judged simply by how many people attend testing sites.

People who test positive must receive treatment. Their partners need to be reached. Pregnant women need continued screening and treatment. Communities need ongoing access to condoms and accurate information.

These include improving the supply of testing kits and treatment commodities, training healthcare workers in syphilis case management, improving data systems and integrating STI services into existing health platforms.

The government is also strengthening STI services in youth-friendly spaces and using the ECHO virtual platform to provide technical support to healthcare workers.

Provincial STI and data teams are being brought together to analyse the numbers and develop responses tailored to the circumstances of individual provinces.

A congenital syphilis elimination plan is also being developed, while new STI guidelines and an operational plan are being rolled out.

The Ministry is calling on healthcare workers to integrate syphilis screening into antenatal clinics, outpatient departments and community outreach programmes.

For AHF Zambia, the real measure of the Stop Syphilis Campaign will not be the banners, roadshows or launch events.

And whether a pregnant woman is screened early enough to prevent an infection from reaching her unborn child.

That is why both Government and AHF Zambia are calling for the campaign to become part of a sustained national response rather than a one-week intervention , Zambia's more than half a million STI cases provide the scale of the challenge and the 9 percent biologically confirmed syphilis positivity reported by AHF's wellness centres provides another warning.

And the continued increase in congenital syphilis gives the crisis its most vulnerable face—the unborn and newborn child. The country now has a disease that can be detected, treated and cured, but health authorities say the tools will only work if people can access them. For Zambia, the fight against syphilis is therefore not simply about treating an infection.

It is about breaking the silence around sexual health, taking services into communities and ensuring that a disease capable of remaining hidden does not continue causing preventable harm.