The World Health Organization (WHO) has published its first-ever reports on fungal infections, highlighting the urgent need for advanced medicines, diagnostic tools, and R&D to tackle invasive fungal diseases.
As the fungal infections are increasing, they pose a significant threat to public health. Infections like candida, which cause oral and vaginal thrush, are becoming increasingly resistant to treatment and affecting severely ill patients and those with weakened immune systems, such as patients undergoing chemotherapy, living with HIV, or who’ve received organ transplants.
Dr. Yukiko Nakatani Assistant Director-General for Antimicrobial Resistance ad interim – WHO
“Invasive fungal infections threaten the lives of the most vulnerable but countries lack the treatments needed to save lives. Not only is the pipeline of new antifungal drugs and diagnostics insufficient, there is a void in fungal testing in low- and middle-income countries, even in district hospitals. This diagnostic gap means the cause of people’s suffering remains unknown, making it difficult to get them the right treatments.”
The fungi listed in the top ‘critical priority’ category of the WHO’s fungal priority pathogens list (FPPL) are deadly, with mortality rates up to 88 percent. As medical treatments advance, more people are surviving conditions or undergoing therapies (like chemotherapy or organ transplants) that weaken their immune systems. This weakened immunity makes them more vulnerable to infections, especially invasive fungal diseases.
These infections are challenging for various reasons such as inaccessibility of diagnostic tools, limited availability of antifungal medicines, and a slow and complex R&D process for new treatments.
In the past decade, only four new antifungal medicines have been approved by regulatory bodies in the USA, EU, or China. Currently, nine antifungal drugs are in clinical development aimed at addressing the most dangerous fungi.
Current antifungal treatments have issues such as severe side effects, frequent drug interactions, limited dosage options, and prolonged hospital stays. WHO’s report highlights the urgent need for safer antifungal drugs that reduce the need for constant drug monitoring. Additionally, there’s a need for Antifungal medicines, which work against an array of severe infections caused by fungal priority pathogens.
WHO suggests investing in global surveillance, expanding financial incentives for drug discovery and development, funding basic research to help identify new and unexploited targets on fungi for medicines, and investigating treatments that work by enhancing patients’ immune responses.
The newly issued report unveils that although there are tests for fungal priority pathogens, they require well-equipped labs and trained personnel, limiting access in low- and middle-income countries (LMICs). There is a demand for faster, more accurate, affordable, and user-friendly tests, especially in LMICs.
Existing antifungal diagnostics face several challenges: they are effective for only a limited range of fungi, lack accuracy, and take long time for result. Additionally, many tests are unsuitable for primary and secondary health facilities, as they require stable electricity and well-equipped laboratories.
Furthermore, health workers are not completely aware about the impact of infections, leading to inability to perform the testing needed to determine the appropriate treatment. WHO also calls for enhancing the global response against invasive fungal diseases and antifungal resistance, and is also developing an implementation blueprint for the FPPL.
