Article from The Guardian's Global Health Blog, by Sarah Boseley
Electron micrograph of the Treponema pallidum bacterium which causes syphilis. Photograph: Kallista Images/Getty Images/Kallista Images
Diseases are not always as hard to defeat as tuberculosis and HIV, even when the damage they inflict is devastating. But when the disease is effectively taboo – its name an unmentionable word in polite conversation – it doesn't get the attention it deserves.
Syphilis kills around 1 million babies a year. These babies die because their mothers have a sexually transmitted disease that often has no symptoms and is not talked about. Some survive, but are blind or deaf. It's a terrible price to pay for our prurience.
But now the realisation that tackling syphilis will make a sizeable dent in the millennium development goal to cut child deaths has provided a big incentive to tackle the last taboo. As I wrote here last June, a study published in the Lancet Infectious Diseases journal showed that infant deaths from syphilis could be halved by the use of a simple blood test for pregnant women and same-day antibiotic treatment.
Today a new group was launched in London to ensure that this test and treatment get to the women who need it. The Global Congenital Syphilis Partnership includes major players such as the Bill and Melinda Gates Foundation, Save the Children, the World Health Organisation and the US Centres for Disease Control and Prevention, as well as from the London School of Hygiene and Tropical Medicine, whose dedicated scientists developed the test.
And it's beautifully simple. At the launch, Professor Rosanna Peeling of the London School, who has pioneered the work, held up a small piece of white plastic that houses a tiny well. Into the well go a drop of blood from the pregnant woman's finger and two drops of buffer. Like a pregnancy test, either one or two lines appear in a window within 15 minutes. If she is positive for syphilis, she gets a dose of antibiotics on the spot and is cured. And that's that. Done early enough in the pregnancy, this simple intervention will probably save her baby's life.
Peeling and her colleagues have now demonstrated the efficacy of the test in a variety of settings in seven countries, including the steamy heat of the Amazon jungle. All seven – Brazil, China, Haiti, Peru, Zambia, Uganda and Tanzania – have chosen to adopt it. It costs less than £1 per woman. Peeling, who has been in global health for many years, talked of "incredible progress with a very simple solution".
The test can be offered to women when they come for their first antenatal check-up, along with an HIV test. And the trials have shown that the numbers not only of women but also of men who come for antenatal checks increase if they are being offered a test and same-day cure for syphilis. This simple intervention, it appears, could have an even bigger benefit than the massive gain of ending congenital syphilis. It would be criminal if it did not now reach all those who need it.