Statement from the Council of Chief Medical Officers of Health on Addressing the Growing Concern of Syphilis in Canada

From: Public Health Agency of Canada

Statement
As we mark Sexual Health Week (February 10-16th, 2025), the Council of Chief Medical Officers of Health^{Footnote 1} would like to emphasize the importance of sexual health as a key component of overall health and well-being. Sexual health encompasses physical health, consensual relationships, bodily autonomy, and equitable access to culturally safe care and information, which helps empower all people to make informed choices that are right for them.

The Public Health Challenge of Syphilis

Supporting positive sexual health outcomes for people in Canada means taking swift and coordinated action to address the rise in various sexually transmitted and blood-borne infections (STBBI). Of particular concern among these infections is syphilis. Despite being both preventable and curable, syphilis rates have been rising in recent years. Between 2018 and 2023, infectious syphilis cases nearly doubled, rising from 6,371 cases to 12,135 cases. Congenital syphilis cases have also increased, rising from 17 cases in 2018 to 53 cases in 2023, more than three times the number in 2018. Left untreated, syphilis can lead to serious health complications, including damage to the heart, brain, blood vessels, and nervous system. It also increases the risk of acquiring HIV. When contracted during pregnancy, syphilis can result in fetal loss, stillbirth, or lifelong health challenges for those infected in during pregnancy, labour or delivery.

Diverse factors drive the rise of STBBI, including syphilis, in Canada. Social and systemic barriers such as colonialism, racism, stigma, discrimination, and structural inequities limit equitable access to testing, treatment, and care.

Addressing this challenge requires a comprehensive public health response, with continued collaboration to drive meaningful progress and ensure lasting impact. Simultaneously implementing a strengthened range of actions across health systems can help prevent and address syphilis and other STBBI, alongside ongoing efforts to allocate resources where they are needed most. Health and social service providers at the local, provincial, territorial, and national levels all have a vital role to play.

Opportunities for Actions

1. Improve Access to Culturally Safe, Timely and Equitable Testing and Treatment: Increase access to STBBI testing and treatment by integrating routine screening into primary care, prenatal care, and emergency settings. Regular screening during key stages of pregnancy, as per national and provincial or local guidance, is critical for early detection and timely intervention, to prevent further transmission and complications. For individuals diagnosed with syphilis, prompt staging assessments help guide appropriate treatment selection and follow-up care. PHAC’s Syphilis Guide, various resources, and recommendations from the National Advisory Committee on Sexually Transmitted and Blood-Borne Infections are available to support health professionals. Strengthening pathways from diagnosis to treatment will ensure people get the care they need without delays. Effective strategies can include expanding point-of-care testing, self-testing, self-sampling, mobile clinics, pharmacy-led screening, as well as providing low-barrier, culturally safe services, including flexible, community-based, and trauma-informed care. These supports can help build trust, foster positive care experiences, and ultimately improve overall health and well-being.
2. Promote STBBI Prevention Strategies and Healthy Sexual Relationships: A combination of evidence-based strategies plays a critical role in preventing STBBI. While scientific advancements have introduced new prevention tools such as HIV pre- and post-exposure prophylaxis, established methods like condoms and dental dams, regular screening as per Canadian guidelines, vaccinations, and safer injection drug use remain effective. Raising public awareness of and access to the range of options available and actively promoting healthy sexual relationships, helps people make informed decisions about how to protect their health and their partners.
3. Foster Inclusive, Culturally Safe and Stigma-Free Health Systems: Eliminating stigma and discrimination across health and social systems is essential to ensuring equitable access to prevention, testing, and treatment. This requires addressing stigma and discrimination, as well as systemic barriers, while fostering supportive environments for diverse communities and normalizing healthy sexuality and STBBI screening. Tailoring support and care to individual needs, cultural background, sexual orientation, and gender identity ensures that services are inclusive and accessible. This includes recognizing and respecting sexual and gender diversity, bodily autonomy, active listening, and providing trauma-informed support that recognizes and seeks to counteract the lasting effects of historical trauma, such as colonialism and anti-Black and anti-Indigenous racism.
4. Collaborate Across Sectors to Address Social and Systemic Barriers: Achieving lasting impact requires collaboration across sectors to address the root causes of health inequities. Systemic barriers such as housing instability, food insecurity, poverty and substance use harms limit access to care. Strengthening policies that remove financial and social barriers will improve access to prevention, testing, and treatment.
5. Strengthen Surveillance and Knowledge Mobilization: Enhancing STBBI data collection, integration, and reporting can support more informed public health responses and resource allocation. Fostering data-sharing agreements may help streamline surveillance and ensure timely, evidence-informed decision-making. Supporting Indigenous-led data governance ensures that data are collected, interpreted, and used in ways that align with community priorities. This approach strengthens culturally relevant public health responses and empowers communities to make informed decisions based on their own health data.

By working collaboratively across jurisdictions, health and social sector partners can strengthen our response to the rising rates of syphilis and other STBBI and create positive health outcomes for all people in Canada.

The Council of Chief Medical Officers of Health includes the Chief Medical Officer of Health from each provincial and territorial jurisdiction, Canada’s Chief Public Health Officer, the Chief Medical Officer of Public Health of Indigenous Services Canada, the Chief Medical Officer from the First Nations Health Authority, and ex-officio members from other federal government departments.

Associated links

• STBBI: Guides for health professionals: Summary of Recommendations for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Syphilis – Canada.ca
• Diagnosis and management of congenital syphilis – Avoiding missed opportunities | Canadian Paediatric Society (cps.ca)
• Syphilis – Sex & U
• PHAC’s STBBI Guides for Health Professionals
• Let’s talk about syphilis: a case-based clinical overview (presented by the Public Health Agency of Canada (PHAC) on 17 June, 2024): presentation slides and meeting recording
• A person-centered approach to sexual health – Canada.ca

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