The World Health Organization has released its first reports on the status of diagnosis and treatment of priority invasive fungal infections and outlined their key findings in a press release. The documents highlight the critical inadequacy of existing analytical systems and drugs, highlighting the need for urgent research in this area.
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Fungal infections pose a growing public health threat, particularly affecting the seriously ill and immunocompromised, particularly those undergoing chemotherapy for cancer, HIV infection, and organ transplants. Moreover, even the most common fungal infections, such as candidiasis, are becoming increasingly resistant to available treatments. Meanwhile, pathogens from the critical category of the WHO Fungal Pathogen Priority List (FPPL) are extremely dangerous, with mortality rates reaching up to 88 percent.
According to a report on the treatment of fungal infections, over the past decade, regulatory agencies in the US, EU, and China have approved only a handful of antifungal agents. Currently, nine drugs against the most serious FPPL infections are in clinical development, with only three of them having reached Phase III clinical trials. Twenty-two drugs are undergoing preclinical trials, which is woefully inadequate given the high attrition rate at various stages of testing.
In addition to the development of resistance, problems with existing antifungal medications include serious side effects, a wide range of drug interactions, a limited range of forms and dosages, and the need for prolonged hospitalization for their administration. Treating fungal infections in children is particularly challenging, as very few clinical trials have been conducted to determine indications and contraindications, age-appropriate dosages, and formulations.
Data from the diagnostics report show that analytical tests for priority fungal pathogens are available on the market, but they are designed for well-equipped laboratories and trained personnel. This means that most people in low- and middle-income countries lack access to them. Furthermore, existing diagnostic systems suffer from limitations such as coverage of only a small number of pathogenic fungi, insufficient accuracy, and long wait times for results.
Yukiko Nakatani, WHO Assistant Director-General for Antifungal Resistance, emphasized that invasive fungal infections pose the greatest threat to vulnerable populations, and it is for them that diagnostics and treatments are least accessible. Furthermore, the development and production of such treatments is fundamentally inadequate globally and requires increased research and funding.
A previous meta-analysis of data from 204 countries showed that antibiotic resistance rose to third place in overall mortality in 2019. Moreover, the WHO estimates that an adequate vaccination campaign against the 24 most significant pathogens could reduce the use of these medications by 2.5 billion daily doses annually.
