The World Health Organization has issued for the first time reports on the status of diagnosis and treatment of priority invasive fungal infections and outlined their main provisions in a press release. The documents highlight the critical inadequacy of existing analytical systems and drugs, which indicates the need for urgent developments in this area.
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Fungal infections are a growing public health threat, particularly affecting the seriously ill and immunocompromised, particularly those undergoing cancer chemotherapy, HIV infection, and organ transplantation. Even the most common fungal infections, such as candidiasis, are becoming increasingly resistant to available drugs. In turn, pathogens in the critical category of the WHO Fungal Priority Pathogen List (FPPL) are extremely dangerous, with mortality rates reaching up to 88 percent.
According to the report on the treatment of fungal infections, only a few antifungal drugs have been approved for use by regulators in the United States, the European Union, and China over the past decade. Currently, nine drugs are in clinical development against the most dangerous FPPL infections, and only three of them have reached phase III clinical trials. Twenty-two drugs are in preclinical studies, which is far from enough, given the high dropout rate at various stages of testing.
Problems with existing antifungal drugs, in addition to resistance, 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. Treatment of fungal infections in children is particularly problematic, as very few clinical trials are conducted to determine indications and contraindications, age-specific dosages, and dosage forms.
Data from the diagnostics report show that assays for priority fungal pathogens are available on the market, but they are limited to well-equipped laboratories and trained personnel. This means that most people in low- and middle-income countries do not have access to them. In addition, existing diagnostic systems have limitations such as coverage of only a small number of fungal pathogens, insufficient accuracy, and long wait times for results.
Yukiko Nakatani, WHO Assistant Director-General for Antifungal Resistance, stressed that invasive fungal infections pose the greatest threat to vulnerable populations, and it is for them that diagnostics and treatments are least accessible. At the same time, the development and production of such tools is fundamentally insufficient worldwide and requires increased research and funding.
An earlier meta-analysis of data from 204 countries showed that in 2019, bacterial resistance to antibiotics rose to third place in the structure of overall mortality. At the same time, according to WHO estimates, an adequate vaccination campaign against 24 most significant pathogens could reduce the use of these drugs by 2.5 billion daily doses annually.