United States: Amidst a profound public health crisis, the world confronts the accelerating specter of antibiotic resistance, which claims nearly 5 million lives each year. Yet, while bacteria have garnered much of the spotlight, they are not the sole microbial adversaries evolving beyond our pharmacological reach.
Fungal infections, too, are adapting at an alarming rate, spurring what some experts describe as an unspoken pandemic—an issue that demands urgent redress.
“Despite its escalating global implications, the peril posed by fungal pathogens and their burgeoning resistance to treatment remains conspicuously absent from prominent discourse,” asserted Norman van Rhijn, a molecular biologist affiliated with the University of Manchester, UK.
This coming September, as the United Nations convenes in New York City to address antimicrobial resistance, the agenda will encompass discussions on resilient strains of bacteria, fungi, viruses, and parasites, as per reports by sciencealert.com.
In anticipation of this critical assembly, van Rhijn, alongside a consortium of international researchers, is calling upon global governments, the scientific fraternity, and pharmaceutical industries to broaden their focus beyond just bacterial threats.
In their correspondence to The Lancet, these scholars argue that initiatives tackling antimicrobial resistance often overlook fungal infections. Without swift and decisive intervention, infections that currently afflict 6.5 million people annually and claim 3.8 million lives could become even deadlier.
“The disproportionate emphasis on bacterial resistance is troubling, especially considering that over recent decades, numerous drug resistance challenges have stemmed from invasive fungal diseases, which remain largely underappreciated by both the scientific community and policymakers,” write van Rhijn and his colleagues, who represent institutions from China, the Netherlands, Austria, Australia, Spain, the UK, Brazil, the US, India, Türkiye, and Uganda.
In 2022, the World Health Organization unveiled the inaugural Fungal Priority Pathogen List—a pioneering global effort to systematically identify and prioritize fungal threats to human health.
Among the most formidable pathogens are Aspergillus fumigatus, a mold that targets the respiratory system; Candida, responsible for yeast infections; Nakaseomyces glabratus, which can affect the urogenital tract or bloodstream; and Trichophyton indotineae, an agent of skin, hair, and nail infections.
Those most vulnerable to these fungal assaults include the elderly and immunocompromised individuals.
Fungi, unlike bacteria or viruses, are complex organisms, sharing structural similarities with animals. This complicates the development of antifungal treatments, as scientists must devise medicines that eradicate fungal cells without harming essential human cells.
“To combat severe or invasive fungal infections, only four classes of systemic antifungals exist, and resistance to these treatments is now the norm, rather than the exception,” the correspondence laments, according to the reports by sciencealert.com.
Although recent decades have seen the emergence of promising antifungal drugs, the ever-quickening arms race between medicine and pathogens is further exacerbated by the agrochemical sector.
“Before many of these treatments reach the market, after years of development and clinical trials, fungicides with comparable modes of action are formulated by the agrochemical industry, leading to cross-resistance in critical priority pathogens,” the researchers elaborate.
“Fungal protection is vital for food security, but this raises a pivotal question: how do we reconcile the need for agricultural security with the imperative to treat resistant fungal infections now and in the future?”
This dilemma mirrors longstanding discussions regarding antibiotic use but has received far less attention in the antifungal context. Van Rhijn and his co-authors propose a global agreement that would restrict certain antifungal medications to specific uses, alongside collaborative international regulations to balance agricultural and health priorities, as per the reports by sciencealert.com.
The forthcoming UN summit must serve as the catalyst for a coordinated, multifaceted response to antimicrobial resistance, they urge.
No pathogen, whether microbe, bacterium, or fungus, should be neglected.
The study appears in The Lancet.