There has been a significant rise in syphilis cases across the Great Plains region, causing concern among tribal officials representing nations from North Dakota, South Dakota, Nebraska, and Iowa. They have decided to appeal to Health and Human Services (HHS) Secretary, Xavier Bacerra, to declare a formal public health emergency. The Great Plains Tribal Leaders Health Board’s CEO, Jerilyn Church, based in Rapid City, SD, sent a letter to Secretary Bacerra on Tuesday to convey this urgent message.
“The elected leaders from each of the Great Plains Area tribal nations implore you to issue a Public Health Emergency Declaration under Section 319 of the Public Health Service Act, acknowledging the significant outbreak of syphilis and congenital syphilis affecting American Indian and Alaska Native communities in our region,” Church wrote.
Great Plains Tribal Leaders Health Board (GPTLHB) is the official representative body for 17 tribal nations and one service unit in the Great Plains area, addressing health issues since 1986.
“The syphilis rate among American Indians and Alaska Natives in the Great Plains now surpasses any recorded rate in the United States since 1941, predating the availability of penicillin for infection treatment,” Church emphasized.
Section 319 of the Public Health Service Act grants the Secretary of Health and Human Services the authority to implement measures to prevent the spread and transmission of communicable diseases. This includes creating and enforcing regulations, as well as mobilizing resources for this purpose.
Data from the Great Plains Tribal Epidemiology Center reveals concerning trends – in 2020, syphilis rates among American Indians and Alaska Natives in the Great Plains were similar to the national average. However, by 2022, these rates had surged by 1,865%, far outpacing the 154% increase seen nationwide. Congenital syphilis cases have also sharply risen, with some areas seeing rates where over one in every 40 American Indian and Alaska Native babies born in 2022 were diagnosed with the condition, accounting for 2.5% of all Native births in those communities.
Despite this unprecedented crisis, public health resources have not kept up with the scale of the problem. According to the Great Plains Tribal Epidemiology Center, frontline health workers have faced nearly a 19-fold increase in syphilis cases between 2020 and 2023 without a corresponding increase in funding or workforce capacity.
The Health Board is calling for urgent action, including emergency access to data from the Indian Health Service and other relevant department sources, the collaboration of credentialed staff from tribal public health agencies with the Indian Health Service to coordinate the syphilis response, sending at least 50 personnel from the Public Health Service to the Great Plains Area to strengthen syphilis and congenital syphilis diagnosis and treatment efforts, ensuring sufficient supplies for syphilis treatment, providing emergency funding, and developing a comprehensive plan to support and monitor children affected by congenital syphilis.
“Many of these hundreds of children will face significant long-term health challenges. It is imperative to commence planning for their care now to ensure they are not left behind,” Church emphasized.
