Germany will allow the use of photos in medical diagnoses from 2019, a move that is expected to mean stricter use of the tests that identify so-called congenital syphilis.
Germany’s current standards require doctors to use a separate technique that also uses microscopic samples of the blood and semen of patients.
Supporters say it is too costly to test patients every two years for congenital syphilis, a sexually transmitted disease that can be lifelong, but critics argue it is inappropriate to give different treatment to men who have sex with men and straight people.
The proposal, which is awaiting legislative approval, would allow the use of what are known as unilateral syphilis cytogenetic tests, which also can identify other sexually transmitted diseases, in public health campaigns.
Germany’s medical regulator, Geri Müller-Kohli, said in September the testing of all patients would no longer be obligatory.
Ranging from up to €1,900 ($1,995) – a comparable cost to a regular routine blood test – the testing is the subject of heated debates in Germany.
Doctors have argued that the cytogenetic tests are most effective at identifying new cases. Those that are not evidence-based do not accurately reflect patients’ risk of acquiring a sexual disease and may unintentionally label healthy people as carriers, they say.
Patients have objected to being asked to give an anatomical sample of their genitalia for screening, fearing that it might be used to cause uncomfortable psychological trauma.
“This solution is both pragmatically and morally compatible,” said Dr Georg Rodi, head of infectious diseases at the Heinrich Boell institute of neonatology.
The Germans’ case has been supported by the European Union’s health commissioner, Vytenis Andriukaitis, in a paper published on Tuesday.
“It is high time for harmonisation of national competences in relation to this crucial health issue,” he wrote in the 16-page paper.
In 2016, Germany was the only country in the EU to opt out of a mandatory screening programme agreed by member states last year.
The legislation is part of a bid to get the number of infected people in Germany down to about 1% by 2020.
In 2012, there were more than 20,000 diagnoses of congenital syphilis, which can be transmitted between mother and child during sex and between mother and man via dirty needles.
The majority of cases in Germany are reported among people who have sex with men, according to the German federal public health office.
Leading German politicians say syphilis cases among men who have sex with men have fallen to 25% from 55% in 2012. Some activists say more could have been achieved without tighter curbs on syphilis.