High quality and representative gonococcal antimicrobial resistance (AMR) data is imperative to monitor AMR trends, identify emerging AMR, and inform refinements of global, international and national clinical management guidelines and public health policies. The WHO Global Gonococcal Antimicrobial Surveillance Program (GASP) has been documenting the emergence and spread of AMR in gonorrhea globally since 1992.

The GASP is a worldwide laboratory network coordinated by focal points and regional coordinating centres. Each designated regional focal point, in partnership with its WHO regional office, collates data on patterns of antimicrobial susceptibility in gonorrhoea in participating countries.

• To ensure adequate sentinel surveillance of antimicrobial resistance in order to inform treatment guidelines in all countries.
• To establish a strategy to rapidly detect patients with gonococcal infections, who experience a clinical and/or microbiological treatment failure following treatment with recommended cephalosporin therapy.
• To ensure the effective clinical management of infected patients and their sexual partners.

In order to have accurate and comparable data globally and detect emerging resistance, gonococcal culture-based AMR monitoring needs to be standardized and linked to clinical and epidemiological data. To address these needs, the Enhanced Gonococcal Antimicrobial Surveillance Program (EGASP) was initiated.

EGASP is a focused sentinel surveillance, where men presenting with urethral discharge are consecutively identified in sentinel sites and clinics. Demographic, clinical, and behavioral data are collected during routine clinical activities and urethral specimens are processed in selected reference laboratories using quality-assured culture techniques and MIC determination. Laboratory and epidemiological data are combined, validated, analyzed, and shared with WHO through a dedicated EGASP module in the GLASS-IT platform. Tools are available to facilitate the implementation and expansion of EGASP including the generic EGASP protocol.