By Bunmi Yekini
The World Health Organization (WHO) has raised alarm over a critical shortage of medicines and diagnostic tools to combat invasive fungal infections, warning that the gap could be costing lives, especially among the most vulnerable.
In its first-ever reports on fungal diseases released today, the WHO called for urgent investment in research and development, citing an “insufficient pipeline” of antifungal treatments and a troubling lack of testing facilities, particularly in low- and middle-income countries (LMICs).
“Invasive fungal infections threaten the lives of the most vulnerable but countries lack the treatments needed to save lives,” said Dr. Yukiko Nakatani, WHO Assistant Director-General for Antimicrobial Resistance ad interim. “Not only is the pipeline of new antifungal drugs and diagnostics insufficient, there is a void in fungal testing in low- and middle-income countries, even in district hospitals.”
The WHO noted that infections like candida, which causes oral and vaginal thrush, are becoming increasingly resistant to treatment. These infections most commonly afflict patients undergoing chemotherapy, those living with HIV, or individuals who have received organ transplants.
The fungi listed in WHO’s top ‘critical priority’ category carry mortality rates as high as 88%. Yet, according to the report, the development of new antifungal drugs remains sluggish. Only four new antifungal medications have been approved globally in the last decade, and just three are currently in phase 3 clinical trials.
“There are serious side effects and drug interactions with current antifungals,” the WHO stated. “What’s urgently needed are safer medicines that reduce the need for prolonged hospital stays and continuous drug monitoring.”
Children are particularly underserved, the report added, with few clinical trials focused on pediatric formulations.
WHO’s companion report on diagnostics paints an equally grim picture. While tests do exist for many dangerous fungi, they depend on sophisticated laboratory infrastructure rarely available in lower-income countries. Most health facilities in these regions lack the resources to detect fungal infections early enough for life-saving intervention.
“There are many challenges with existing antifungal diagnostics; they work only for a limited range of fungi, are insufficiently accurate and take a long time to obtain results,” the report noted.
Health workers’ limited training on fungal infections and growing resistance also contribute to delayed or incorrect treatment.
To address the crisis, the WHO recommends ramping up global surveillance, expanding funding for antifungal R&D, and developing easy-to-use diagnostics that work even in low-resource settings. The organization is also working on an implementation blueprint to help countries better respond to fungal threats.
“Without urgent and coordinated action,” Dr. Nakatani warned, “we will continue to see preventable deaths caused by fungal infections that go undetected and untreated.”