Good morning.
I would like to acknowledge the Kaurna people, the traditional custodians of this land. I pay my respects to Elders, past and present. I also acknowledge Aboriginal and Torres Strait Islander people joining us today.
I am very pleased to be here today with my fellow panellist, Dr Dawn Casey from NACCHO, to discuss the recent declaration of syphilis as a Communicable Disease Incident of National Significance – or CDINS.
It’s not often that the Chief Medical Officer of the Commonwealth, declares a CDINS. It only happens when we are faced with a disease incident that needs national policy, interventions or public messaging.
This could be because a state or territory’s resources are overwhelmed, or because the disease incident has complex management implications.
Over the past 5 years, we’ve only done it 3 times – for COVID-19 in 2020, Japanese encephalitis in 2022, and mpox, also in 2022.
These were new diseases or outbreaks, and declaring them as CDINS enabled early response efforts, with a view to get on top of them as quickly as possible.
For syphilis, it’s quite different, because case numbers have been growing over the past decade, with an average year-to-year increase of 13% since 2011.
In 2023, we saw record high numbers – more than 6,500 cases of infectious syphilis.
Last year was not much better – almost 6,000 cases.
And this year, we’re already over 4,000 notifications (4,067 as at 9 September 2025).
With these increases have come devastating cases of congenital syphilis.
Since 2023, we have seen 41 cases causing the deaths of 18 babies.
That is 18 tragic deaths, 18 families in mourning, for deaths that were preventable.
Syphilis is preventable and it’s easy to treat if caught early.
And yet, it’s still killing babies in Australia, especially in Aboriginal and Torres Strait Islander communities, and among culturally and linguistically diverse communities as well.
This cannot continue.
It’s become clear that what we’ve been doing, collectively across governments and working with other partners, just isn’t working, or at least not on the scale we need it to, especially in overcoming barriers to antenatal care and to syphilis screening for women at risk of syphilis infection.
So it’s now time for us to step up our public health response.
I declared a CDINS for syphilis as a whole – not just congenital syphilis. There are two reasons for this.
Firstly, if we don’t address the wider outbreak of syphilis, congenital syphilis cases will keep on happening, no matter how good our programs, policies and care are for pregnant people.
Secondly, untreated syphilis can be devastating for anyone – not just babies. It can affect all organ systems, and cause blindness, dementia, permanent disability and death.
Between 2014 and 2023, 99 are reported to have people died in Australia from non-congenital syphilis. And again, these were preventable deaths that shouldn’t have happened.
Declaring a CDINS clearly establishes syphilis as public health priority – for both governments and the non-government sector.
It enables all partners involved in the delivery of public health interventions to reprioritise and increase our efforts, for example, by embedding changes into primary care.
And it enables us to include new areas in our response – for instance, we know many social determinants of health, such as domestic violence, housing insecurity, and alcohol and other drug use, can all have an impact.
To guide our work over the next 5 years, the Australian Health Protection Committee has set out new goals and 34 priority actions to achieve them in the new National Syphilis Response Plan – published last month.
Through the AHPC network of committees, these actions were agreed by governments, experts, and peak body members of the Australian Health Protection Committee and its expert subcommittees.
The actions in the response plan cover testing, treatment, partner notification, prevention and education. They cover ways to support and grow the health workforce, who are critical in the delivery of testing and care, and need to be supported.
And they cover data, reporting and evaluation – so that we build a strong evidence base to ensure our efforts are making a difference.
As we progress the work, AHPC and its expert committees will review and revise the goals, the actions, the populations and the settings. This will ensure we continue to focus our attention where it is most needed at any given time.
We will be engaging across the health sector – and I will be looking to sit down with professional colleges and sector peak bodies, to work together to continue to raise awareness of syphilis amongst the health workforce and communities, and to hear from them opportunities to improve the response.
I will be setting up some focused meetings in the coming months. We already have some really good work under way at a national level.
As you know, health workers are one of the most critical pieces of the puzzle in tackling the high rates of syphilis, including our midwives, general practitioners, primary care nurses, obstetricians, sexual health clinicians, Aboriginal and Torres Strait Islander community controlled health service team members, emergency department staff, and many more.
They’re on the coal face, seeing patients every day. They’re in a strong position to raise awareness and to encourage more people to get tested – whether they have symptoms or not.
That’s why making sure our workforce is supported and armed with knowledge is critical. We have already been investing in workforce initiatives, and we will see these having more impact in the coming year.
We’re funding ASHM to run an awareness campaign for the health workforce, and to provide training and education.
This will help ensure the workforce is prepared and confident to undertake the clinical procedures and to make the decisions needed to test and treat syphilis.
We’re investing in Doxy-PEP National Clinical Guidelines and a decision-making tool to support clinicians in making decisions on recommending and prescribing Doxy-PEP easier.
In 2023, we stepped up funding to Aboriginal Community Controlled Health Services, so that services can have male and female workers delivering culturally safe sexual health care.
We are also using existing opportunities to raise awareness among health workers, including our social channels and Primary Health Networks communication channels.
As Minister Butler mentioned earlier today, the Australian Government is looking at options for reforming primary care.
Last year, we published 4 major reports on primary care reform, following reviews of some of our programs. The reports looked at general practice incentives, after-hours primary care, working with Medicare, and scope of practice. They recommend ways we can strengthen primary care. Improving access to care is a major theme.
The department is now consolidating this into advice to government on a primary care reform agenda, which will include sexually transmissible infections, including syphilis.
The Australian Government is continuing to invest in public awareness campaigns. The ‘Young Deadly Free’ campaign provides culturally appropriate resources for Aboriginal and Torres Strait Islander communities, including in local languages, and we are proud to support this. Our ‘Beforeplay’ STI campaign ran last year, and those resources are still available for anyone to use. And we recently funded Sexual and Reproductive Health Australia to develop the ‘Many STIs are hidden’ national campaign.
All of these help to remind people, particularly priority populations, to get their sexual health checks and to get tested. And, importantly, these awareness campaigns are designed to be ‘sex-positive’ which helps address stigma around STI.
To tackle congenital syphilis, we’re revising national guidelines, so that standard pregnancy care involves 3 syphilis tests. This is a universal recommendation. It’s not reliant on discussing sexual history or assessing risk, so no one feels judged or targeted by the testing.
This will help stop congenital syphilis, especially any from re-infections in pregnant people. It sends a powerful message to everyone involved in antenatal care about the importance of testing for syphilis in pregnancy.
Through the Interim Centre for Disease Control, are also looking further to the future to make sure we stay up to date with the latest developments and innovations.
We are funding a review of new syphilis point-of-care testing technologies, to see what innovations can improve testing. And, in partnership with NACCHO, we are evaluating 3 First Nations BBV and STI programs that the Australian Government funds.
This will help build the evidence base for future policy and program improvements and making the case for funding.
As we all continue existing work and introduce new strategies to tackle syphilis, working together is going to be critical. We still face significant challenges for many populations, including those pregnant people who are missing out on antenatal care, due to many and varied reasons.
How do we increase partner testing, for example? How do we get more heterosexual men – who we know are reluctant to access health services – to get regular sexual health checks? And how do we reach more Aboriginal and Torres Strait Islander communities when notification rates among First Nations people are still 7 times higher than for non-Indigenous Australians.
We know these are just some of the significant challenges we’re faced with.
We can move on some actions immediately and quickly. But the reality is that this is not going to be a quick fix.
Community groups, peak bodies, health professionals and governments all have invaluable experience, knowledge and tools. Combining and coordinating these – so that we’re all moving in the same direction – will be incredibly powerful. It will help us to maintain momentum over the next few years. Having syphilis as a CDINS makes our collaborative path forward clearer and smoother.
I look forward to working with you in the coming months and years to stop the spread and dire health outcomes of syphilis.
Thank you for all you are doing, and will be doing in the future.
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