Syphilis Outbreak Devastates Native American Communities in the Great Plains, But Federal Help Remains Stalled

In partnership with

Natalie Holt, a physician and chief medical officer for the Great Plains Area Indian Health Service in Aberdeen, South Dakota, is on the frontlines of a devastating syphilis outbreak that has severely impacted Native American communities in the region. Holt, along with other health officials, is working tirelessly to curb the spread of the disease, but they are facing a serious challenge: a lack of resources and no federal public health emergency declaration.

How to Meal Prep in 30 Seconds

Huel Black Edition is the ultimate solution for anyone looking for complete nutrition, fast.

At just $2.50 per serving, you’ll get 40g of protein and 27 essential vitamins—all in just 30 seconds. Whether you’re rushing out the door or need a quick meal at home, Huel makes nutrition easy and affordable.

The cherry on top? New customers get a bundle of savings to kickstart their Huel journey. Use code HUELBE15 for 15% off your first order, plus a FREE t-shirt and shaker.

Get 15% Off Today

The syphilis outbreak in the Great Plains has reached alarming levels, particularly among Native Americans. According to the Great Plains Tribal Epidemiology Center, syphilis rates among Native Americans surged by 1,865% from 2020 to 2022—far exceeding the national rise of 154% during the same period. In addition, 1 in 40 Native American and Alaska Native babies born in the region in 2022 were born with syphilis, a disease that can be transmitted from mother to child during pregnancy, often with deadly consequences.

In South Dakota alone, there have been 577 documented cases of syphilis in 2023, with 430 of those cases—more than 75%—affecting Native Americans, who represent only 9% of the state's population. Despite the clear disparity, public health leaders are still waiting for a federal public health emergency declaration, which would provide the resources needed to better address the crisis.

"We know how to address this, but we do need extra support and resources in order to do it," said Meghan Curry O’Connell, the chief public health officer for the Great Plains Tribal Leaders’ Health Board. In February, O’Connell and other tribal leaders sent a formal request to the Department of Health and Human Services (HHS) to declare a public health emergency. The agency has responded by offering some training and resources, but has not taken the necessary step of declaring an emergency or providing the funding tribal leaders are asking for.

Despite the lack of federal action, Holt remains cautiously optimistic. Indian Health Service facilities in the region have been conducting over 1,300 syphilis tests per month, and while new cases have declined slightly in recent months—from 92 in January to 29 in September—Holt acknowledges that much more needs to be done. "The decline in new cases is promising, but there has been a lot of damage done over the past few years," Holt said.

The challenges extend beyond simply providing tests and treatments. Public health officials are also working to encourage people without symptoms to get tested. To make it easier, no appointments are required, and educational flyers are distributed at pharmacies with information about where and when to get tested. Even with these efforts, Holt knows there are still many people who may fall through the cracks, especially those who are not frequent users of healthcare services.

This ongoing outbreak highlights a broader issue: tribal health systems need greater federal investment to respond to public health threats effectively. "Our requests have been specific to this outbreak, but they’re needed as a foundation for whatever comes next," said O'Connell. "Because something will come next."

Syphilis is a dangerous sexually transmitted infection that, if left untreated, can cause serious complications, including damage to the heart, brain, and other organs. Pregnant women with syphilis can pass the disease to their babies, leading to congenital syphilis, which is a leading cause of stillbirth and infant death. Nationwide, congenital syphilis cases have tripled in recent years, with the CDC reporting over 3,700 cases in 2022—the highest number since 1994.

As public health leaders continue to battle the outbreak, they stress that more resources and a formal public health emergency declaration are needed to curb the spread of syphilis and protect the health of Native American communities. Holt remains hopeful, fueled by the support of her team and the community. "Cancer can be tough. But so am I," she says, channeling her own resilience in the face of an ongoing crisis. "We know what we need to do; we just need the resources to do it."