A collective of global scientists has raised an urgent alarm regarding the rising resistance to fungal diseases. They emphasize the need for immediate action in a commentary published in The Lancet this week, led by researchers from The University of Manchester, the Westerdijk Institute, and the University of Amsterdam. Their report highlights that many fungal pathogens recognized by the World Health Organization, which lead to approximately 3.8 million fatalities annually, are either already resistant or quickly developing resistance to antifungal treatments.
The researchers contend that the focus on bacteria is too narrow and will not adequately address the issue of antimicrobial resistance (AMR). They insist that the upcoming United Nations meeting on AMR in September must also consider the resistance emerging in various fungal pathogens.
Severe health consequences
Currently, resistance is a common occurrence for the four available classes of antifungal medications, complicating, if not hindering, the treatment of several invasive fungal infections. Infections resistant to fungicides include Aspergillus, Candida, Nakaseomyces glabratus, and Trichophyton indotineae, which can have serious health repercussions, particularly for the elderly or those with weakened immune systems.
Dr. Norman van Rhijn from The University of Manchester, who coordinated the commentary with Professor Ferry Hagen from the University of Amsterdam and the Westerdijk Institute, stated: “While many recognize that resistant bacterial infections are a major aspect of the AMR dilemma, the problems of drug resistance stemming from invasive fungal diseases have largely been overlooked by scientists, governments, clinicians, and drug companies. The rising threat of fungal diseases and antifungal resistance, despite being an expanding global concern, is absent from the discussion.”
Experts note that, unlike bacteria, the close resemblance between fungal cells and human cells makes it challenging to discover treatments that can effectively target fungi while causing minimal harm to patients.
Back to the beginning
Professor Ferry Hagen stated: “Although developing new antifungals is incredibly challenging, there have been some promising new agents, including entirely new classes of molecules, that have entered clinical trials in recent years. However, even before these reach the market after extensive development periods, the agricultural sector often develops fungicides with similar mechanisms of action, leading to cross-resistance. This brings us back to square one. It is important to note that fungal issues significantly impact many vital crops, so antifungal measures are essential for food security, but the critical question remains—at what cost?”
The scientists propose the following recommendations:
- Establishing a global consensus to limit the use of specific classes of antifungal agents to designated applications.
- Encouraging collaboration on solutions and regulations that promote food security and the health of animals, plants, and humans.
- Elevating the issue of antifungal resistance in the UN’s agenda for the September meeting.
