The World Health Organization (WHO) have released a report highlighting fungal pathogens that pose a great threat to public health.
The WHO fungal priority pathogens list (FPPL) is the world’s first effort to prioritise fungal pathogens, considering the unmet research and development needs and the perceived public health importance. The WHO FPPL will focus on and drive research and policy interventions to improve the response to fungal infections and antifungal resistance.
Fungal pathogens are becoming increasingly common and becoming a global health threat. These pathogens are quickly becoming resistant to treatment as there are only four antifungal medicines available and few candidates in the clinical pipeline. Most fungal pathogens lack rapid diagnostics and those that exist are unaffordable and not widely available.
Fungal pathogens are affecting severely ill patients
The invasive fungal pathogens are affecting severely ill patients and those with underlying immune system-related conditions. Affected population groups include those with cancer, HIV/AIDS, organ transplants, chronic respiratory disease, and post-primary tuberculosis infection.
New evidence has shown the incidence and geographic range of fungal diseases are expanding worldwide due to global warming and the increase in international travel and trade. Especially during the COVID-19 pandemic, cases of fungal pathogens infect hospitalised patients. As fungi such as candida oral and vaginal thrush become more resistant to treatment, risks for the development of more invasive forms of infections in the general population are also growing.
“Emerging from the shadows of the bacterial antimicrobial resistance pandemic, fungal infections are growing, and are ever more resistant to treatments, becoming a public health concern worldwide,” said Dr Hanan Balkhy, WHO Assistant Director-General, Antimicrobial Resistance (AMR).
Despite growing concerns about fungal infections, they continue to receive little attention and resources. This leads to a rising burden of fungal diseases and antifungal resistance.
Creating three priority categories for fungi
The WHO FPPL is divided into three categories: critical, high and medium priority. The fungal pathogens in each category are ranked by their public health impact and their emerging antifungal resistance risk.
WHO emphasises that the FPPL must be interpreted carefully, as some endemic pathogens could be more concerned in their respective region or local contexts.
The authors stress that more evidence is required to inform the response to fungal pathogens and to understand the burden. The report also highlights that coordinated action is needed to address the impact of antifungal use on resistance across the One Health spectrum and calls for expanding access to quality diagnostics and treatments.
“We need more data and evidence on fungal infections and antifungal resistance to inform and improve response to these priority fungal pathogens,” said Dr Haileyesus Getahun, WHO Director, AMR Global Coordination Department.
Furthermore, the report outlines strategies to improve fungal pathogen research and development. The primary actions include strengthening laboratory capacity and surveillance, sustaining investments in research, development and innovation, and enhancing public health interventions for prevention and control.
