Preface

The control of sexually transmitted diseases (STDs) is critical to the global improvement of the reproductive health of all people. The serious impact of STDs on women and children in particular, and the linkage between STD and HIV prevention are of profound concern to public health professionals worldwide.

Indeed, several studies have now validated the important role that STDs play in the spread of HIV, as well as the impact of STD treatment in HIV prevention. I believe that the lessons learned should now be applied globally.

Although various types of preventive behavioral interventions need to be greatly expanded, and work has to continue on challenging and important issues such as AIDS vaccines and drugs for those who are HIV-infected, STDs provide an available target of opportunity. There is already advanced knowledge about treatment and prevention, and success in this area is limited more by service issues than by a lack of scientific understanding. Better STD services also will mean improvements in reproductive health, including HIV prevention. Therefore, public health program managers and clinicians must seize on this without delay.

The publication of this book, Control of Sexually Transmitted Diseases: A Handbook for the Design and Management of Programs, is timely. It grew out of the recognition that STD control programs are multifaceted, and that managers should be well versed in all aspects of programming. Unlike most other books about STDs, this one provides a comprehensive account of STD management and prevention. It addresses the full spectrum of issues that STD managers at the national and local levels must consider when designing and implementing STD programs.

The handbook is not intended to be a clinical text, even though it contains technical material. Rather, for the people who design and/or manage STD programs, it provides an overview of the topics most salient to their programs. These include training, surveillance, curative and preventive services, evaluation and more.

Developed primarily for managers in resource-poor settings, the book starts with the assumption that health care providers in most societies operate under financial constraints. Often, this has meant that STD control efforts are seriously compromised.

The publication also should prove valuable to others who have an investment in STD control–family planners, child survival workers, donor groups and the like.

It is my hope that the use of the handbook will lead to an improvement in funding decisions, training, service design and delivery, and community education. This will lead to gains in STD and HIV prevention and care worldwide, and contribute to the ultimate goal of high-level reproductive health for women, men and children.

Peter Piot
Executive Director
Joint United Nations Programme on HIV/AIDS
(UNAIDS)