Syphilis rates across the motu have risen by 45% since 2022, with wāhine, rangatahi and pēpi Māori among the most affected. Advocates say urgent action is needed, calling for more testing and more open conversations about sexual health.

“It’s a simple bacterial infection that can be treated. And the harmful damage can be picked up early and be treated,” says Tamara Karu, midwife and general manager of Ngā Maia Trust.

Syphilis is a sexually transmitted disease that has escalated over the past decade. Early signs can be subtle-including painless sores, while long-term untreated infections can lead to severe complications.

“2012 we saw about 50 nationally, we now have 5000 diagnosed cases,” Karu says.

“[We have] seen syphilis [grow] in numbers exponentially.”

She says that early in her career, syphilis was so rare and undetected that there were even discussions about removing it from routine testing.

Despite being a sexual transmitted infection, syphilis can also be passed on to babies.

“[Syphilis] be transmitted across the placenta to the unborn pēpi,” says Dr Beth Messenger of Sexual Wellbeing Aotearoa.

More data from FHP Science shows that six pēpi were born with congenital syphilis in 2024 - more than double last year’s number. This number continues to rise despite routine antenatal testing.

“Some of them don’t survive,” she adds.

“It’s a cause of stillbirth a [in] that first few weeks and months of life.”

She says early symptoms are often missed, but can be dangerous if left untreated.

“Usually it’s a painless ulcer, usually that’s in the genital region, sometimes it’s in the mouth.”

“Years later, it can damage other things like big blood vessels, damage the brain.”

Health workers say that rising case numbers reflect barriers to care, particularly for Māori and Pasifika.

“There’s a stigma our whānau and rangatahi are quite embarrassed to access health,” says Ashleigh Hesseltine, a registered nurse at Kahungunu Health Services.

Hesseltine says there is a lack of education around sexual health within her rohe.

“A lot of our young ones aren’t telling anyone that they are sexually active. So they’re often relying on friends to bring them into clinic. [Many] of them have infections and not know.”

Te hītori o te pākewakewa i Aotearoa

Syphilis is believed to have first entered Aotearoa through early European settlers, spreading through ports and patterns of movement.

“I understand that it was commonly traveled throughout the ports. And our current rates are reflective of our transience, of how much we’re moving, whether that’s globally or ā-motu nei,” Karu says.

“The first thing with wahine [and] rangatahi, [is that] they were not the groups most at risk in the past. So they’re probably not the ones where we’ve necessarily gonna make that offer in a way that makes them go, ‘I should be accepting this test’,” says Dr Messenger.

“Syphilis rates and its impact on whānau Māori is not necessarily a clinical issue,” Karu adds.

“The source of the problem is around getting our early interventions, our health promotion, our public health campaigns promoting, and really growing our awareness around sexual health.”

Arataua’s Let’s Talk About Ai series is helping spark kōrero for rangatahi.

Kahurangi Milne says, “I whakaaro ake mātau, me āta tuku i ētahi kōrero haumaru ki a tātau rangatahi, kia kaua rātau e haere ki ērā kiriata kikorangi nei, ki te ako, me pēhea te tiaki te tinana.”

Chey Milne notes sexual health education is not a new concept in te ao Māori.

“I ngā wā o ngā tūpuna ko te haka, ko te mōteatea tērā nē - Rūaumoko? Mahi ai tērā.”

Back in the clinic, Hesseltine says they meet rangatahi where they are - often outside school.

“They come to the desk quite embarrassed and then they leave with a big weight off their shoulders and it’s so rewarding to see. [We] know that we our clients return is is quite good,” she says.

Dr Messenger says screening as simple.

“People within fairly new infection would get just one dose of penicillin as an injection. If somebody’s hard syphilis and we don’t know how long that’s four, then they would get three injections to make sure it’s gone.”