Fungal infections are evolving, outpacing medical solutions and sparking a “silent pandemic.” Researchers emphasize the urgency of addressing this global health crisis.
Norman van Rhijn, a molecular biologist at the University of Manchester, underscores the lack of focus on fungal pathogens. “The threat of antifungal resistance is being neglected in the broader antimicrobial resistance discussion,” he states.
A CALL FOR COMPREHENSIVE ACTION
Ahead of this pivotal event, van Rhijn and an international team of scientists urge stakeholders to expand their focus. Their correspondence in The Lancet stresses that fungal infections are often overlooked in initiatives tackling antimicrobial resistance.
“Without urgent action, some dangerous fungal infections could become even deadlier,” they warn. Currently, 6.5 million people are infected by these fungi each year, leading to 3.8 million deaths.
THE DISPROPORTIONATE FOCUS ON BACTERIA
The researchers point out that the disproportionate focus on bacterial infections is alarming. Many drug resistance issues in recent decades stem from invasive fungal diseases, which remain largely unrecognized.
The team, comprising experts from around the globe—including China, the Netherlands, and the US—calls for a shift in attention.
WHO’S FUNGAL PRIORITY PATHOGEN LIST
In 2022, the World Health Organization (WHO) released the Fungal Priority Pathogen List. This marked the first global effort to prioritize fungal pathogens systematically.
Notable threats include:
- Aspergillus fumigatus: A mold that infects the respiratory system.
- Candida: A yeast that causes infections.
- Nakaseomyces glabratus: Can infect the urogenital tract or bloodstream.
- Trichophyton indotineae: Infects skin, hair, and nails.
Older adults and immunocompromised individuals are particularly vulnerable to these infections.
THE COMPLEXITY OF FUNGI
Fungi are more complex organisms than bacteria or viruses, making treatment challenging. Their cellular structure is more similar to animals, complicating drug development.
Currently, only four systemic antifungal classes exist. Unfortunately, resistance to these treatments has become the norm rather than the exception.
THE ROLE OF AGROCHEMICALS
In recent decades, promising new antifungals have emerged. However, the agrochemical industry accelerates the arms race between pathogens and medicine.
Fungicides developed for agriculture often share modes of action with antifungals, leading to cross-resistance in critical pathogens.
BALANCING FOOD SECURITY AND HEALTH
“Antifungal protection is crucial for food security,” the researchers highlight. They pose a critical question: How do we balance food security with treating resistant fungal pathogens?
This conundrum mirrors discussions on antibiotics, but similar discourse around antifungals is limited.
RECOMMENDATIONS FOR ACTION
Van Rhijn and his team propose a global agreement to restrict specific antifungal drugs for targeted use. They also advocate for collaborative regulations to harmonize food security with health needs.
