WHO galvanises action plans to address lethal fungi species that cause millions of deaths a year.
The World Health Organization today issued its first 'Fungal Pathogen Priority List' with 19 different fungal species highlighted, with the aim to focus and drive further research and policy interventions and strengthen the global response to lethal or serious disease causing fungal infections and antifungal resistance.
The global leader in fungal disease advocacy, Global Action for Fungal infections (GAFFI) has been working with WHO for several years to list all the key antifungals and diagnostics onto the WHO's Essential Diagnostic and Essential Medicines Lists. GAFFI celebrates this report with Chief Executive Professor David Denning saying:
"It has been a privilege to assist this insightful exercise with colleagues from across the world. Fungal diseases are a global threat, with gross inequity of access to life-saving diagnostics and antifungal drugs. The engagement of public health, with integration of diagnostics in routine care, has the potential to save countless lives each year. WHO's engagement is critical to global health improvements and addressing the growing spectre of antifungal resistance.'
Fungal diseases kill over 1.6 million people each year and cause long term disease in hundreds of millions more. The fungi at the top of the WHO list – so-called 'Critical' – were the common Candida albicans and Aspergillus fumigatus, together with Cryptococcus neoformans which causes meningitis and the multi-drug resistant Candida auris. Antifungal resistance is becoming an increasing problem in these 'Critical' fungi, but also in many others on the 'High' and 'Medium' priority lists.
The WHO FPPL scope is: "focused on fungal pathogens responsible for acute and subacute systemic fungal infections for which drug resistance or other treatability and management challenges exist. The pathogens included are all associated with serious risks of mortality and/or morbidity." GAFFI's policy brief on antifungal resistance outlines the most pressing problems.
The report articulates a clear need for an evidence base to inform public health interventions – both in terms of disease impact and improved delivery of care. For many fungal diseases this is lacking or sketchy, especially in resource-limited countries where diagnostics are not always available.
The WHO recommends three key broad areas for action:
improved surveillance of fungal diseases (which requires regular access to diagnostics)
targeted support for R&D and innovation (new antifungal drugs, improved diagnostics)
enhanced health systems (to ensure access to diagnosis, resistance detection and therapy, including a major uplift in training).
The report calls for universal access of these tests and therapies.
The WHO AMR Division was responsible for co-ordinating and writing the report, with expert support from the University of Sydney and an international Expert Advisory Group led by Dr Ana Alastruey-Izquierdo (Instituto de Salud Carlos III, Spain). Funding was provided by the Governments of Austria and Germany and GARDP.
)About GAFFI: The high level objective of Global Action For Fungal Infections (GAFFI) is to ensure that WHO Essential Diagnostics and Antifungal drugs are accessible to all, aligned to Universal Health Coverage. Vulnerable people from countries in the global south are disproportionately affected and those afflicted with fungal disease live in misery due to morbidity, the inability to work and stigma. Limited diagnosis and poor measurement of disease morbidity means that the true scale of the problem is unknown. GAFFI has been a key global voice for fungal diseases in terms of public and global health since 2013.
Independently, GAFFI has engaged with professional colleagues in over 80 countries to provide a baseline estimate of numbers of people affected by serious fungal diseases; the general lack of robust data on fungal disease impact is emphasised by the WHO's report today.(