A dire warning has been issued by leading scientists worldwide about the looming crisis of antifungal resistance. A new commentary published in The Lancet highlights the urgent need for action to address the growing problem of resistance in fungal pathogens, which already claims around 3.8 million lives annually. Coordinated by researchers from The University of Manchester, the Westerdijk Institute, and the University of Amsterdam, the commentary reveals that many of the fungal pathogens identified by the World Health Organization are either resistant to or rapidly developing resistance to antifungal treatments.
The authors argue that the current focus on bacterial resistance is insufficient and that the upcoming United Nations meeting on antimicrobial resistance (AMR) must also address the issue of fungal resistance. They stress that resistance has become the norm for the four main classes of antifungal drugs, making it increasingly challenging to treat invasive fungal infections. Pathogens such as Aspergillus, Candida, Nakaseomyces glabratus, and Trichophyton indotineae, which can severely affect older adults and those with weakened immune systems, exemplify the devastating impact of this resistance.
Dr. Norman van Rhijn from The University of Manchester, who led the commentary alongside Professor Ferry Hagen from the University of Amsterdam and the Westerdijk Institute, commented, “Most people agree that resistant bacterial infections are a major component of the AMR crisis. However, many of the drug resistance issues we face today also stem from invasive fungal diseases, which have been underrecognized by scientists, governments, clinicians, and pharmaceutical companies. The growing threat of fungal pathogens and antifungal resistance is not being adequately addressed in the ongoing debate.”
Unlike bacteria, fungi have cell structures similar to human cells, complicating the development of treatments that specifically target fungi without harming patients. Professor Ferry Hagen added, “Although promising new antifungal agents, including entirely new classes of molecules, are in clinical trials, they often face setbacks. The development of similar fungicides by the agrochemical industry leads to cross-resistance, pushing us back to square one. While antifungal protection is crucial for crop health and food security, we must consider the broader implications and costs.”
To combat this escalating issue, the scientists recommend the following actions:
- Establishing a global agreement to limit the use of certain antifungal classes to specific applications.
- Promoting collaboration on solutions and regulations to ensure food security and universal health for animals, plants, and humans.
- Elevating the priority of fungal AMR at the UN’s upcoming meeting in September
