The World Health Organization (WHO) has published its first ever reports on diagnostic and treatment gaps in the treatment of invasive fungal infections. The reports highlight grave concerns regarding drug resistance, insufficient access to diagnostics in low-income countries, and a poor global pipeline of antifungal medicines.

Key Highlights

Growing threat of invasive fungal infections

• Fungal infections such as oral/vaginal thrush (candida) are developing resistance to treatment.

• Immunocompromised and seriously ill patients, such as cancer patients, HIV-positive patients, and organ transplant recipients, are most vulnerable.

Extreme shortage of medicines and diagnostics

• WHO indicates that diagnostic facilities in low- and middle-income countries (LMICs) are extremely under-resourced.

• Only 4 new antifungal medicines have been licensed around the world over the last decade.

• Nine antifungal medicines are in clinical development, of which only three are in Phase 3 trials.

High mortality and inadequate treatment

• Fungal infections included in WHO's list of critical priority pathogens have up to 88% mortality.

• Existing treatments have severe side effects, few dosage forms, and involve long hospital stays.

• Children are especially underserved because of unavailability of age-appropriate formulations.

WHO recommendations

• Invest in global fungal surveillance systems.

• Increase funding for antifungal R&D.

• Create faster, less expensive, point-of-care diagnostics that can be used in LMIC environments.

• Educate health workers in fungal infection diagnosis and resistance patterns.

Quotes from Leaders or Officials
"Invasive fungal infections put the lives of the most vulnerable at risk, but treatments to save lives are not available in countries," said Dr Yukiko Nakatani, WHO Assistant Director-General for Antimicrobial Resistance ad interim. She highlighted the need for low-cost diagnostics and safer antifungal treatments as a matter of urgency.The WHO's historic reports point to a call-to-action by the world as a whole towards pharmaceutical innovation, policy reform, and training the healthcare workforce. With increasing resistance to antifungals and diagnostic capacity being outpaced, the global community needs to respond urgently to prepare accessible, safe, and effective tools to combat invasive fungal disease.