State and local health departments in the US are facing significant budget cuts for their sexually transmitted disease (STD) prevention programs. The cancellation of a $1 billion investment has led to reduced funding for STD programs, hindering efforts to combat the rapid increase in syphilis cases. The loss of funding has impacted disease intervention specialist workforce expansion and the ability to provide timely care and prevention for pregnant women and their babies. Mississippi, Nevada, and Arizona are among the states facing challenges in addressing the spread of syphilis.