In a first-of-its-kind report, the World Health Organization (WHO) has published a list highlighting fungal ‘priority pathogens’, comprising of 19 fungi that represent a serious threat to public health.
The list – referred to as WHO’s fungal priority pathogens list (FPPL) – is the first worldwide effort to systematically prioritise fungal pathogens, given the unmet R&D needs and the perceived public health importance. Moreover, its authors underscore the need for a coordinated global effort, while offering future strategies for policymakers, public health professionals and other stakeholders.
Strategies put forward in the report are collectively aimed at producing evidence and improving response to these fungal priority pathogens.
At the centre of the recommendations is a call for strengthened laboratory capacity and surveillance, as well as sustained investments in research, development and innovation. The authors also call for leaders to enhance public health interventions for prevention and control.
The FPPL is focused on accelerating further research and policy interventions as a means of reinforcing the global response to fungal infections and antifungal resistance. This follows grave health concerns raised by the rise in antimicrobial resistance (AMR).
Fungal pathogens present a major threat to public health challenge as they are gradually becoming more common and resistant to treatments with only four classes of antifungal medicines currently available, alongside a selection of candidates in the clinical pipeline.
Invasive types of fungal infections can affect severely ill patients and those with underlying immune system related conditions, while people who are placed at the highest risk of invasive fungal infections include cancer patients, those living with HIV/AIDS, organ transplant patients, chronic respiratory disease patients and those diagnosed with post-primary tuberculosis infection.
Further evidence signals that the incidence and geographic spread of fungal diseases are both expanding worldwide as a result of global warming and with the increase of international travel and trade.
It was noted that during the COVID-19 pandemic, reported incidences of invasive fungal infections increased considerably among hospitalised patients.
Although concern continues to grow around the subject, fungal infections actually receive little attention and resources, resulting in a scarcity of quality data on fungal disease distribution and antifungal resistance patterns.
The WHO FPPL list is split into three categories: critical, high and medium priority. The fungal pathogens of in each category are put in order primarily due to their public health impact and/or emerging antifungal resistance risk.
“Countries are encouraged to follow a stepwise approach, starting with strengthening their fungal disease laboratory and surveillance capacities, and ensuring equitable access to existing quality therapeutics and diagnostics, globally,” said Dr Haileyesus Getahun, WHO director, AMR Global Coordination Department.