WHO urges stronger action against rising fungal threat

Testing for antimicrobial resistance (AMR) is carried out at a laboratory in Buenos Aires, Argentina. Antifungal resistance is an integral part of the AMR challenge to global health and development.

The World Health Organization has issued new guidance urging countries to take stronger action against fungal diseases and antifungal resistance, warning that the growing threat remains largely neglected in national health strategies.

The new Blueprint for Strengthening Responses to Fungal Disease and Antifungal Resistance, released on Tuesday, outlines practical measures to improve prevention, diagnosis, treatment and surveillance.

According to WHO, fungal diseases affect more than 300 million people every year and are linked to high mortality, long-term illness and significant losses in health and productivity worldwide.

Fungal infections range from common conditions such as ringworm and nail infections to severe invasive diseases that can be life-threatening, particularly for people with weakened immune systems, intensive care patients, transplant recipients, cancer patients and people living with HIV.

WHO warned that antifungal resistance is also rising, driven partly by the widespread use of antifungal medicines and similar chemicals across human, animal and plant health, as well as environmental exposure.

Despite the growing burden, fungal diseases are often absent from national treatment policies, global disease burden estimates and major strategies addressing antimicrobial resistance (AMR), universal health coverage and One Health initiatives.

The blueprint comes about a month after the World Health Assembly adopted an updated Global Action Plan on AMR. Antimicrobial resistance occurs when bacteria, viruses, fungi and parasites evolve and become resistant to medicines, making infections harder to treat.

WHO said AMR remains one of the most serious global health and development challenges.

“The Updated Global Action Plan on AMR approved by the 79th World Health Assembly recognised that antifungal resistance is an integral part of the AMR challenge — and one we can no longer afford to overlook,” said Jean Pierre Nyemazi, interim Director of WHO’s Department of Antimicrobial Resistance.

He said the blueprint provides countries with “a concrete path forward.”

The guidance builds on WHO’s first Fungal Priority Pathogens List, published in 2022, which identified 19 fungal pathogens or pathogen groups requiring urgent research, development and public health action.

The blueprint was developed through a multi-stage consultation involving more than 150 experts from all WHO regions, including specialists in clinical mycology, diagnostics, surveillance, regulatory policy, public health and patient advocacy.

Its goal is to help countries address major gaps in knowledge, diagnosis, treatment, surveillance, research and workforce capacity, particularly in low-resource settings.

The blueprint identifies four priority areas for action.

The first focuses on strengthening public health systems through improved awareness, preparedness, antifungal stewardship, workforce training and infection prevention.

The second prioritises expanding equitable access to quality-assured antifungal medicines and diagnostics while supporting research, innovation and market development.

The third aims to strengthen laboratory systems and surveillance to improve clinical management, support public health decision-making and enhance outbreak preparedness.

The fourth addresses social and environmental drivers, including agricultural and environmental factors linked to fungal disease and antifungal resistance.

“Fungal disease and antifungal resistance remain an under-addressed priority across national health plans, AMR strategies and surveillance systems,” said Hatim Sati, who led development of the guidance.

“This blueprint provides countries with a practical framework to strengthen their response,” he added.