While maternal and newborn health is improving around the world, the well-being of every mother and newborn cannot be assured unless countries prioritize and address sexually transmitted infections (STIs), including syphilis. While not typically thought of as a maternal or newborn health issue, syphilis is one of several STIs that can be passed from a pregnant woman to her baby during pregnancy and childbirth, known as “mother-to-child transmission” (MTCT) or “parent-to-child transmission”
(PTCT). In 2012, nearly 1 million pregnant women (930,000) were estimated to be infected with syphilis. These pregnancies resulted in 350,000 adverse outcomes, including early fetal loss, stillbirths, neonatal deaths, preterm or low-birth-weight babies, and babies born with syphilis (known as congenital syphilis).1 Having syphilis can also increase a woman’s risk of acquiring HIV by two to five times, posing even greater risks to her and her baby, as HIV can also be transmitted from mother to child. Yet, no mother or baby needs to suffer from syphilis. Every effort should be made to prevent a woman from being infected with syphilis in the first place, including provider counseling on safer sex and provision of male and female condoms. Should a pregnant woman be infected, syphilis is relatively easy to detect and treat, and MTCT of syphilis is entirely preventable. A range of syphilis diagnostics are available, including rapid, point-of-care (POC) tests that can expand access and reach pregnant women in resource-constrained settings. Syphilis is also simple to cure with appropriate antibiotics. Syphilis diagnosis and treatment have been shown to be cost-effective and feasible in low-resource settings. The World Health Organization (WHO) includes routine syphilis screening of pregnant women—and treatment if positive—in its required package of basic antenatal care (ANC) services. Over the past decade, several global policies have been issued that highlight the importance of syphilis screening and treatment in ANC. These include a range of guidelines and tools developed in support of WHO’s global initiative to eliminate congenital syphilis, as well as mention of congenital syphilis in United Nations strategies focused on reproductive, maternal, newborn, child, and adolescent health (RMNCAH), such as the Every Newborn Action Plan (ENAP) and the Global Strategy for Women’s, Children’s, and Adolescents’ Health, among others (see Annex: Key global guidelines and strategies that address syphilis).