More than just an infection: Whole person approaches to congenital syphilis prevention

Congenital syphilis remains a significant global public health challenge, despite effective tools for screening, diagnosis, and treatment. Pregnant people and their infants continue to experience preventable illness and death, highlighting gaps not only in clinical care, but also in the systems and conditions that determine whether people can access and remain connected to care. Preventing congenital syphilis requires more than treating an infection-it requires health systems that can reach people early, respond to their needs, and address the social and structural factors that shape health. The Association of State and Territorial Health Officials (ASTHO) works with public health leaders across the United States to strengthen systems and advance approaches that can reduce congenital syphilis and improve health outcomes. This session will explore how lessons from public health practice can inform a whole-person approach to congenital syphilis prevention across diverse settings and health systems. A whole-person approach recognizes that clinical care is only one part of prevention. Access to antenatal care, continuity of care, transportation, housing stability, stigma, substance use, poverty, migration, and other social and structural factors can influence whether pregnant people are able to access testing, receive timely treatment, and remain connected to care. Effective prevention therefore depends on collaboration across public health, clinical care, community organizations, social services, and other sectors. Participants will explore practical strategies for identifying missed opportunities for prevention, strengthening coordination across services, using surveillance and other data to guide action, and engaging communities in the design and delivery of interventions. The session will also consider how public health agencies can serve as conveners and catalysts for systems change, helping partners move from fragmented, disease-specific responses toward coordinated approaches centered on the needs and experiences of people and families. Although health systems and resources differ across countries and communities, the underlying challenge is shared: Ensuring that every pregnant person has equitable access to the information, testing, treatment, and supportive services needed to prevent congenital syphilis. Preventing congenital syphilis is not only about eliminating a pathogen. It is about building health systems capable of reaching people with the right care, at the right time, in ways that reflect their lived realities. A whole-person approach can help transform congenital syphilis prevention from a series of clinical interventions into a coordinated strategy for healthier pregnancies, healthier infants, and healthier communities.