More than 40 percent of pregnant women who delivered a baby with congenital syphilis in 2023 did not receive a syphilis test in time to be adequately treated before delivery, a gap the federal government is now spending $4 million to close.
The Department of Health and Human Services announced the initiative on August 12, 2026. It directs approximately $3.25 million in supplemental awards to recipients of the CDC's Strengthening STD Prevention and Control for Health Departments cooperative agreement, expanding access to point-of-care syphilis testing and linking patients to care from August 2026 through February 2027. Remaining funds support national partners who provide technical assistance and implementation support.
The figure driving the spending is stark because congenital syphilis is preventable. Testing and treatment during pregnancy stop transmission to the fetus. An estimated 83 percent of congenital syphilis cases in 2023 could have been prevented with timely testing and treatment.
"Congenital syphilis is preventable, yet too many mothers and babies are still suffering," said HHS Secretary Robert F. Kennedy Jr. in the department's announcement, adding that the aim is to put rapid tests where women receive care so infections are detected earlier and treated faster.
The Numbers Behind a Twelve-Year Climb
Congenital syphilis has risen for 12 consecutive years, moving in the opposite direction from most sexually transmitted infections.
Nearly 4,000 cases were reported in 2024, an increase of nearly 700 percent over the past decade. In 2023, congenital syphilis contributed to 279 stillbirths and infant deaths. Syphilis during pregnancy can cause miscarriage, stillbirth, infant death, and lifelong medical complications in surviving infants.
That trajectory is unusual. MedicalDaily reported this week on new research into the deep history of this family of infections, at a moment when newborn cases are climbing even as adult diagnoses of several other sexually transmitted infections decline. A newborn infection rate rising while adult transmission falls points at the prevention step rather than at the underlying epidemic.
The precise nature of the gap matters and is easy to misstate. The 40 percent figure describes women who did not receive a test in time for adequate treatment before delivery. That includes women never tested at all and women tested too late for treatment to work, which are different failures requiring different fixes. A CDC Vital Signs analysis of 2022 cases found that lack of timely testing and adequate treatment during pregnancy contributed to 88 percent of the 3,761 congenital syphilis cases reported that year, which included 231 stillbirths and 51 infant deaths.
Testing Where People Already Are
The design of this initiative reflects a specific diagnosis of why testing fails, and it is not primarily about obstetric practice.
Standard prenatal care already includes syphilis screening at the first visit. The women who fall through are largely those with limited or no prenatal care. The American College of Obstetricians and Gynecologists, citing CDC data, notes that two in five infants with congenital syphilis were born to people who received no prenatal care at all. Adding another recommendation to a prenatal schedule does not reach someone who never attends one.
HHS says the initiative will promote syphilis screening and treatment beyond traditional health care settings. The department names emergency departments, maternal and child health programs, correctional intake settings, and substance use treatment programs as places that can provide additional opportunities to identify and treat syphilis, including during pregnancy.
Point-of-care tests are what make that possible. They provide rapid results, allowing providers to begin treatment immediately rather than waiting for traditional laboratory testing. For a population that may not have a stable address, phone, or transportation, the gap between test and result is often where the intervention is lost.
Awarded jurisdictions were identified as experiencing a high burden of syphilis and congenital syphilis, so the funding is targeted rather than distributed evenly, as CIDRAP reported.
The Question Pregnant Patients Should Ask
For a household, the useful step is simple and specific.
Anyone who is pregnant should ask their clinician when they were tested for syphilis and whether they will be tested again later in pregnancy. Recommendations from major professional bodies include screening at the first prenatal visit, with repeat testing in the third trimester and at delivery for people at increased risk or in areas with high syphilis rates. Rates are high enough in much of the United States that repeat testing is frequently warranted.
Timing is the part patients can influence. Treatment is highly effective throughout most of pregnancy but works less reliably when the diagnosis comes very late, particularly after 36 weeks, because there is less time between treatment and delivery. A test in the first trimester and another later cover infections acquired after the first visit, which a single early test cannot.
Anyone who has had limited prenatal care, or who is seeking care in an emergency department, urgent care, correctional facility, or substance use treatment program while pregnant, can ask for a syphilis test at that visit. That request is the entire point of this initiative, and a patient can make it without waiting for a program to reach their site.
Treatment during pregnancy uses penicillin, and patients with a reported penicillin allergy should raise it early, since the standard approach involves allergy evaluation rather than substitution.
The Limits of a Seven-Month Program
Several things about this initiative should be stated plainly rather than assumed.
The funding period runs from August 2026 through February 2027, which is roughly seven months. That is shorter than a full pregnancy and shorter than the time needed to measure an effect on congenital syphilis cases, which are counted at birth. Whether the program is extended has not been announced.
The dollar figure is also modest against the scale of the problem. Approximately $3.25 million distributed across high-burden jurisdictions funds testing capacity, not a national screening infrastructure. Cost and coverage pressures on the households most affected remain, a picture MedicalDaily has tracked in reporting on marketplace enrollment and deductibles.
HHS has not published which jurisdictions received awards, how many tests the funding is expected to support, or what outcome measures will determine whether it worked.
The next meaningful data point will be CDC's finalized congenital syphilis figures for 2025 and provisional numbers for 2026, which will show whether the twelve-year climb has broken. Readers should watch for those releases and for any announcement extending the funding beyond February.
Key Questions Answered
What did HHS announce? A $4 million initiative to expand rapid point-of-care syphilis testing, including about $3.25 million in supplemental awards through a CDC cooperative agreement, running August 2026 through February 2027.
What is the 40 percent figure? More than 40 percent of pregnant women who delivered a baby with congenital syphilis in 2023 did not receive a syphilis test in time to be adequately treated before delivery.
How common is congenital syphilis? Nearly 4,000 cases were reported in 2024, a nearly 700 percent increase over the past decade and the twelfth consecutive annual rise.
Is it preventable? Yes. An estimated 83 percent of 2023 cases could have been prevented with timely testing and treatment during pregnancy.
Where will the new testing happen? Beyond traditional clinical settings, including emergency departments, maternal and child health programs, correctional intake settings, and substance use treatment programs.
What should a pregnant person ask? When they were tested for syphilis and whether they would be retested later in pregnancy. Repeat testing is recommended for people at increased risk or in high-rate areas.
Why does timing matter so much? Treatment is effective throughout most of pregnancy but less reliable when diagnosis comes very late, because less time remains between treatment and delivery.
