Edinburgh contributes to major WHO reports on fungal infections

Improved diagnostics are urgently needed in the fight against the rising threat of fungal infections and antifungal resistance. While facing multiple challenges in development, implementation and utilisation, antifungal diagnostics need to be especially accessible at the point of care in Low- and Middle-Income Countries (LMICs). It was a pleasure to contribute and I commend the WHO team to adding the diagnostics landscape report and antifungal drugs pipeline to the fungal priority pathogens list (FPPL) addressing a key unmet need in building a strong portfolio of tools against fungal AMR.

There is good evidence that the emergence of antifungal drug resistance in debilitating human fungal infections is linked to the use of related compounds in agriculture to combat the fungal destruction of major cereal crops such as wheat and rice.  The diagnosis and prevention of fungal infections which can greatly reduce global yields of cereals is therefore also of major importance to human wellbeing, as is the development of new medical and agricultural antifungal compounds whose modes of actions are distinct.

Fungal infections are causing increasing problems in medicine, particularly for the increasing numbers of people with weakened immune systems. The emergence of antifungal resistance accentuates this problem. Prompt diagnosis of infection and of antifungal resistance  is critical in order that appropriate treatments are initiated quickly. This prompt initiation of appropriate antifungal therapy is a major determinant of a good outcome and the focus on developing diagnostics and expanding therapeutic options that are accessible to all populations in need is most welcome.

I hope that this diagnostics report will direct efforts and resources to improve diagnosis of fungal keratitis – an infection of the cornea (most commonly caused by several of the WHO fungal priority pathogens) that causes blindness to over 600,000 people, and the results in the removal of an estimated 84,000-167,000 eyes annually – primarily affecting rural communities of LMICs. Delayed access to diagnosis and initiation of appropriate treatment worsens outcomes for these patients. Developing tools for diagnosing fungal keratitis at the primary care level will help to reduce much of this needless blindness by allowing patients to be treated earlier, and with more appropriate medications.