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Call for global action on life-threatening fungal infections

August 01 2017

A ‘first of its kind’ series comprising of eight new authoritative papers has been published today in the prestigious journal The Lancet Infectious Diseases. The series gives new insights into the breadth of fungal diseases and a call to action for world health bodies to prevent millions of infections each year.

Killing over 1.5 million and affecting over a billion people, fungal diseases have been the most neglected topic by public health authorities. However, most deaths from fungal diseases are avoidable.

Most serious fungal infections are ‘hidden’, occurring as a consequence of other health problems such as asthma, AIDS, cancer, organ transplant and corticosteroid therapies. All require specialized testing for diagnosis, and delays or missed diagnosis often leads to death, serious chronic illness or blindness.

As a result the Journal has decided to signal an end to this neglect by commissioning an authoritative series of articles, covering almost all aspects of fungal diseases.

The series focuses on the global inequalities in treatment. Professors David Denning and Juan Luis Rodriguez Tudela from The University of Manchester and the Global Action Fund for Fungal Infections, coordinated the eight paper series commented:


Professors Juan Luis Rodriguez Tudela (L) and David W. Denning (R) at a GAFFI Board meeting, March 2017

Professor Denning said: The massive advances in fungal disease and understanding over the last two decades should have resulted in much better outcomes – but sadly not in many countries”.

Professor Juan Luis Rodriguez Tudela said: “Improvements in patient outcomes require changes in all part of the health care ‘ecosystem’, notably clinical training, access to and resource for fungal diagnostics, access to affordable antifungal therapy. A major public health response is called for.”

According to the researchers, there has been a complete absence of proposals or commentary on integration of fungal diseases into health care systems.

This is addressed by Professor Donald Cole of the Dalla Lana School of Public Health, University of Toronto who calls for a ‘combined health systems and public health approaches’ and provides examples from Mozambique, Kenya, India, and South Africa.

Authors of the papers in the series have been brought together from six continents. They tackle fungal infections in AIDS, in cancer, after TB, in asthma, after transplantation and major abdominal surgery, in critical care in the rare patients with immunodeficiencies and notably the WHO ‘neglected tropical fungal diseases’ mycetoma and chromoblastomycosis.

Outbreaks of fungal diseases occur frequently and these are highlighted in one article.

Another addresses antifungal resistance – like anti-bacterial resistance an increasing problem requiring many radical solutions and new antifungal drugs.

Professor Denning added: “The evidence gathered in this article series shows not only the scale of the global problem but also that hundreds of thousands of deaths a year could be avoided.

“The expertise is available, now it just needs government and international action to make it a reality.”

Lancet papers here

Fungal infections in HIV & AIDS  Limper et al

Candida and invasive mould diseases in non-neutropenic critically ill patients and patients with haematological cancer   Colombo et al

Pulmonary and sinus fungal diseases in non-immunocompromised patients  Denning et al

Neglected endemic mycoses  Queirox-Telles et al

The global problem of antifungal resistance: prevalence, mechanisms, and management  Perlin et al

Immunotherapeutic approaches to treatment of fungal diseases Armstrong-James et al

Emerging issues, challenges, and changing epidemiology of fungal disease outbreaks Benedict et al

Improvement of fungal disease identification and management: combined health systems and public health approaches Cole et al

Comment : Recovery from serious fungal infections should be realisable for everyone   JL Rodriguez -Tudela

Manchester University Press Release