WHEREAS, the National Indian Health Board (NIHB), established in 1972, serves all Federally recognized American Indian/Alaska Native (AI/AN) Tribal governments by advocating for the improvement of health care delivery to AI/ANs, as well as upholding the Federal government’s trust responsibility to AI/AN Tribal governments; and

WHEREAS, the Great Plains Tribal Leaders Health Board (GPTLHB), established in 1986, is comprised of the seventeen (17) Tribes and one (1) Indian Health Service Unit in the four-state region of South Dakota, North Dakota, Nebraska, and Iowa, and addresses the health concerns and need of the Indian Tribes in the Great Plains Indian Health Service Area; and

WHEREAS, federally recognized Indian tribes have a right to health care from the federal government based on Treaties, congressional acts, federal court decisions, and on the federal government’s trust responsibility to Indian Tribes; and

WHEREAS, since the COVID-19 pandemic, rates of sexually transmitted infections (STIs) have been increasing across the United States; and

WHEREAS, Indian country, and specifically the four states of the Great Plains Area, have all seen significant increases in STI rates, especially syphilis, and have issued health alerts recommending enhanced testing, treatment, and other measures; and

WHEREAS, The Centers for Disease Control and Prevention (CDC) Sexually Transmitted Infections Surveillance 2022 report indicated that AN/ANs experience the highest rate of primary and secondary syphilis cases (67.0/100,000), nearly four times higher than the national rate (17.7/100,000); and

WHEREAS, the national AI/AN congenital syphilis rate was 644.7/100,000, resulting in 1 in every 155 AI/An infants diagnosed with congenital syphilis, much higher than the average rate of 102.5/100,000, representing 1 out of every 975 U.S. births; and

WHEREAS, from 2021 to 2022, the greatest increase in the rate of reported primary and secondary syphilis cases per 100,000 persons was among AI/AN persons (46.7 to 67.0; 43.5% increase), and AI/AN persons also had the greatest five-year increase in the rate of reported primary and secondary syphilis (15.4 to 67.0; 335.1% increase from 2018); and