Adding It Up

Investing in Sexual and Reproductive Health in the African Union

Investing in Treatment for Curable STIs in the African Union

Reproductive rights are under attack. Will you help us fight back with facts?

In recent decades, most African countries have increased the availability of sexual and reproductive health care, yet many people still lack access to these essential services. This fact sheet presents evidence as of 2019 on the need for, impact of and cost of fully investing in treatment for the major curable STIs among women aged 15–49 in 53 African Union member states.

This fact sheet underscores the recommendations made in Article 43 of the Addis Ababa Declaration on Population and Development in Africa Beyond 2014, which commits member states to taking certain concerted actions. Those include providing affordable and accurate rapid diagnostic tests for HIV, other STIs and reproductive tract infections, as well as information, education and treatment for all women and men.

Unmet need for services

  • Approximately 50 million women aged 15–49 in Africa become infected annually with one of the four major curable STIs: chlamydia, gonorrhea, syphilis and trichomoniasis.
  • Forty-two million (85%) do not receive treatment, often because they do not have symptoms and do not know they are infected.
  • More than eight million cases of pelvic inflammatory disease occur annually as a result of untreated chlamydia and gonorrhea, and more than one million of these cases result in infertility.

Impact and cost of STI treatment

  • If all women with any of the four major curable STIs received timely and effective treatment, new cases of pelvic inflammatory disease and infertility caused by these STIs would be prevented.
  • In Africa, the annual cost of treating all women of reproductive age who are infected with any of the four curable STIs would be US$960 million, or 74 cents per capita.


African Union member states should invest in STI treatment, which is an essential health service, and expand screening programs to focus on chronically underserved populations and asymptomatic individuals. To reduce the incidence of new infections, member states should also commit to comprehensive sexuality education for adolescents—a group at high risk of acquiring STIs.


The information in this fact sheet can be found online in the appendix tables accompanying Sully EA et al., Adding It Up: Investing in Sexual and Reproductive Health 2019, New York: Guttmacher Institute, 2020, Data pertain to all member states of the African Union except Seychelles and the Sahrawi Arab Democratic Republic (Western Sahara).


This fact sheet was made possible by support from UK Aid from the UK Government and grants from the Bill & Melinda Gates Foundation and the Dutch Ministry of Foreign Affairs. The findings and conclusions are those of the authors and do not necessarily reflect the positions and policies of the donors. The authors thank International Planned Parenthood Federation—Sub Office to the African Union and the United Nations Economic Commission for Africa, the African Institute for Development Policy, and the African Population and Health Research Center for reviewing this fact sheet.