Continued rise in STDs highlights bipartisan attack on American healthcare system

By Erik Schreiber
17 October 2019

The incidence of sexually transmitted diseases (STDs) increased sharply in 2018, according to an annual report by the Centers for Disease Control and Prevention (CDC). The increase continues a trend that has persisted for at least a decade and is the result of a conscious, bipartisan attack on the health of the working class.

The CDC report “is a cause for deep concern about dangerous gaps in our public health infrastructure,” according to a press release from the Infectious Diseases Society of America and the HIV Medicine Association. The data indicate “neglect of critical public health investments” that has “damaging impacts to public, as well as individual, health,” the groups said.

The transmission STDs is entirely avoidable if individuals have knowledge of and access to the appropriate preventive measures. If an infected person goes without treatment, however, STDs can cause infertility, facilitate HIV transmission, and create stigma. The CDC report mainly focuses on three STDs: chlamydia, gonorrhea, and syphilis.

Chlamydia was the most common of the three in 2018, when 1,758,668 cases were reported to the CDC. “This case count corresponds to a rate of 539.9 cases per 100,000 population, an increase of 2.9 percent, compared with the rate in 2017,” according to the report. In fact, the rates of reported cases have increased over each of the last five years.

Chlamydia incidence is highest among teenagers and young adults. In 2018, the overall rate of reported cases among females between ages 15 and 24 increased 1.0 percent over the 2017 level and 11.8 percent over the 2014 level. Similarly, rates among men increased 37.8 percent from 2014 to 2018.

Reports of chlamydial infection have been increasing since at least 2000. “During 2000–2011, the rate of reported chlamydial infection increased from 251.4 to 453.4 cases per 100,000 population,” according to the report. This represents a staggering 80 percent increase during this period.

Gonorrhea was the second most common STD in 2018. “Rates of reported gonorrhea have increased 82.6 percent since the historic low in 2009,” the report notes. From 2017 to 2018 alone, the rate of infection increased 5.0 percent (6.0 percent among men and 3.6 percent among women).

The increase in gonorrhea infection is particularly alarming, since N. gonorrhoeae, the bacterium that causes it, can develop resistance to antibiotics quickly. According to the report “In 2018, more than half of all infections were estimated to be resistant to at least one antibiotic.” The CDC has recommended various cephalosporins (a class of antibiotics) to treat gonorrhea infection, but the bacterium is developing resistance to these medications.

In its investigation of syphilis, the report examines all stages of the disease, including primary and secondary syphilis (i.e., the most infectious stages) and congenital syphilis (i.e., infection transmitted to a baby from its mother). In 2018, the total case count of reported syphilis in all stages was the highest recorded since 1991. The number of reported cases increased 13.3 percent from 2017 to 2018. Furthermore, incidence has increased almost every year since its historic low in 2001, when the disease had been on the brink of eradication.

The rate of congenital syphilis has been rising each year since 2013. In 2018, 41 states reported at least one case of congenital syphilis. The national rate in 2018 was 39.7 percent higher than it was in 2017 and 185.3 percent higher than it was in 2014. “During 2017–2018, the number of syphilitic stillbirths increased (from 64 to 78 stillbirths), as did the number of congenital syphilis-related infant deaths (from 13 to 16 deaths),” according to the report. “The resurgence of syphilis, and particularly congenital syphilis, is not an arbitrary event, but rather a symptom of a deteriorating public health infrastructure and lack of access to health care.”

As the CDC itself implies, the continuing increase in STD incidence is a scandal and an indictment of both capitalist parties. President Donald Trump and the Republicans in Congress have cut the CDC’s budget during every year of his presidency. The budget was reduced from $6.4 billion in 2017 to $6.3 billion in 2018 and to $5.6 billion in 2019.

After cynically declaring a national emergency on the border with Mexico last year, Trump directed the Treasury and the Department of Defense to reallocate $6.7 billion in funds—more than the CDC’s 2019 budget—to pay for building a border wall. These funds already had been appropriated by Congress for other purposes, and Trump’s action violated the Constitutional separation of powers. Nevertheless, the Senate approved the impeachable offense by voting to “back-fill” the money.

President Barack Obama and the Democrats also did their best to make workers, rather than the federal government, foot the bill for health care. Obama’s signature domestic initiative, the Affordable Care Act (ACA), required that people without insurance from their employer or a government program buy insurance from a private insurance company. Rather than challenging the for-profit health care industry, the ACA has guaranteed it a continuous flow of profits.

The Democrats and Republicans are as united in their support for war spending as they are in their attacks on workers’ health. Both parties collaborated to provide a historic $738 billion for the military in fiscal year 2020 while allotting only $632 billion for all other discretionary spending categories combined.

The CDC report, together with the bipartisan budgets, show that there is no constituency in the ruling class that will guarantee the fundamental right of the working class to healthcare. If it is to secure its most basic needs, the working class must organize independently of both capitalist parties on the basis of socialist program fighting to reorganize society to meet human need and rather than the interests of private profit.