Moving the Global STI Response Forward: Insights from Advocacy Partners

_{By Grace Tettah, Program Manager, AVAC}

With so much innovation in research on display, hallway conversations often circled back to the big questions: “What’s next?” and “Where do we go from here?”. Bridging the gap between research and real-world impact takes collaboration and meaningful engagement with advocates and civil society. AVAC connected with advocacy partners, Cleopatra Mpaso of Pangaea Zimbabwe, Mandisa Mdingi of The Foundation for Professional Development in South Africa, and Felix Mogaka of the Kenya Medical Research Institute during the conference to learn more about their perspectives on the challenges facing the global STI response, and how advocacy can help move the needle.  

Funding: The elephant in the room 

Cleopatra Mpaso characterizes the question of funding, saying “Everyone keeps mentioning it, but nobody is talking about what to do about it”. In Impact Global Health’s report, Is this the new era? Funding for sexual & reproductive health R&D 2018-2023, data showed a steady increase in global funding for STI research and development (R&D) since 2018. However, sustaining momentum for STI R&D will require governments, funders, researchers, and advocates to step up, especially considering funding disruptions caused by sweeping U.S. cuts to global health budgets.  

Francis Ndowa from Skin & Genito-Urinary Medicine Clinic in Zimbabwe issued a message to governments in a plenary presentation stating: “We’ve created the guidelines, we’ve created the strategies based on evidence, you have also created your own national strategies and guidelines. Now let’s implement them, and here are the support mechanisms that we can use”.  

This call to action offers just one response to the funding challenge. Evidence shows that advocacy can play a critical role in influencing governments to reallocate resources, turning commitments on paper into impact in communities.  

The availability of good, clear data is a barrier 

“Good, clear evidence and data that makes the case about why STIs are important to everybody” is urgently needed, said the Gates Foundation’s Lori Newman in a session. Felix Mogaka shared his vision of leveraging his credibility as a researcher to collect such evidence to advocate, for instance, for governments to move away from syndromic management to diagnostic testing. He also described standardizing point-of-care screening and collecting diverse patient data as an efficient way to collect information within communities, highlighting the value of supporting community-led monitoring efforts to generate data that supports successful advocacy. Mogaka’s approach would begin with “a tool that collects these [diverse] types of data, and it includes both data that’s relevant to research, but also includes outcomes that are relevant to someone who has an STI… but always just collect data, regardless of whether it’s in a research setting, or in a program setting, or in a routine health care setting.” 

Stigma continues to discourage care-seeking behavior 

Normalizing STI testing, treatment, and care is an ongoing advocacy priority, requiring consistent public messaging and education to shift the broader narrative about sexual health. “We need to start thinking around how we can normalize STI testing and treatment through storytelling,” Mpaso said. For example, leveraging social media to share testimonial videos of people openly discussing their experience with STI testing and treatment. This openness helps reduce stigma, showing that STIs are treatable and common, rather than shameful. She also explained the critical role of advocates in translating complex research into pieces of information that people can understand and feel empowered to act on. Advocacy turns evidence into messages that normalize STIs, creating environments where people feel safe to seek services. 

Community voices are going unheard 

Understanding what people affected by STIs want and need is the key to developing solutions that work and improve livelihoods. “We have a lot of data that’s generated by researchers in terms of what researchers are interested in, but we don’t have a lot of data on what matters to people who are affected by STIs,” said Mogaka. This is where advocacy is critical; amplifying community voices to shape a research agenda that reflects lived experiences. Mandisa Mdingi highlighted the success of clinic committees in South Africa where community representatives advocate for patient priorities and shape local clinical programming and practices, bridging the communication gap between clinicians and the patients they serve. Her take on the role of advocacy stresses the need to push for collaboration: “We collaborate, we include the decision makers, and, most importantly, the community.” 

Moving Forward Together 

Collaboration is key to sustain momentum in the global STI response and to address the challenges outlined above. When researchers, implementers, donors, community members, and advocates work together, solutions grounded in inclusivity and equity are possible, echoing AVAC’s Alison Footman, “over the next couple of years it is going to be incredibly important for all of us to take our skills and work together and think about the best collaboration”.   

Advocacy influences policy and funding decisions, challenges stigma, and translates research into accessible information. This is critical to ensure that innovations reach the people that need them most. To meet this moment, AVAC plans to work in partnership with civil society partners to build regional advocacy capacity in South Africa, Kenya, and Zimbabwe, to advance innovation, access, and equity in the global STI response. As Mdingi stated, advocacy is about “driving the principle of equity, where everyone should be able to access services.” 

For more STI resources and information about AVAC’s STI work, visit STIwatch.org