By: Henrietta Afful
The World Health Organisation, WHO, has released its first ever list of health threatening fungi in the world.
Contained in a release published on October 25, 2022, the report highlights the first-ever list of fungal “priority pathogens” which is a catalogue of 19 fungi that “represent the greatest threat to public health.”
The 19 fungi are categorised into three priority groups namely; critical, high and medium and this is based on their level of threat to public health.
The fungi of greatest concern on the list are the four ‘critical priority’ pathogens, ranked highest due to their public health impact and risk of antifungal resistance.
The release further says the invasive forms of these fungal infections often affect severely ill patients and those with significant underlying immune system related conditions.
WHO says those with cancer, HIV/AIDS, chronic respiratory diseases, organ transplants and post-primary tuberculosis infection, are the population at the greatest risk of invasive fungal infections.
“Most fungal pathogens lack rapid and sensitive diagnostics and those that exist are not widely available or affordable globally” the release said.
Emerging evidence according to the release indicates that the incidence and geographic range of fungal diseases are both expanding worldwide due to global warming and the increase of international travel and trade, the release said.
It indicates that reported incidence of invasive fungal infections increased significantly among hospitalized patients during the COVID-19 pandemic.
“Emerging from the shadows of the bacterial antimicrobial resistance pandemic, fungal infections are growing, and are ever more resistant to treatments, becoming a public health concern worldwide” said Dr Hanan Balkhy, WHO Assistant Director-General, Antimicrobial Resistance (AMR).”
‘CRITICAL PRIORITY’
Among fungi in the critical priority group is Candida auris, the multidrug-resistant yeast that was first-discovered in Japan in 2009 and since then has spread worldwide.
Invasive infections caused by C auris, which spreads easily in healthcare settings and in some cases is resistant to all classes of antifungal medication, are fatal in as many as 53% of patients.
Another Candida species given critical priority is Candida Albicans, which is common in the mouth, throat, gut, vagina, and skin but can cause severe disease when it invades other tissue.
Also in the critical priority group is Crytptococcus neoformans, a pathogenic yeast that lives in the environment and can cause severe infections after being inhaled.
The last in the critical priority is Aspergillus fumigatus, an environmental mold that can cause severe lung infections and is a particular threat to cystic fibrosis, flu, and COVID-19 patients.
‘HIGH PRIORITY’
Among fungi listed as ‘high priority’ are three more Candida species Candida glabrata, Candida tropicalis, and Candida parapsilosis. The others are; Histoplasma spp., and Mucorales – a large group of fungi consisting of different genera.
‘MEDIUM PRIORITY’
The medium priority group includes Scedosporium spp., Candida krusei and Coccidioides spp., which causes valley fever.
Expert are hoping that the fungal priority pathogens list could have a similar impact as the document on which it was modeled—the 2017 WHO list of bacterial priority pathogens.
“We want this report to catalyze research and development on new antifungals and new diagnostics on fungal disease,” Haileyesus Getahun, MD, MPH, PhD, director of AMR Global Coordination at the WHO, said in a press briefing.
The report urges “strengthening laboratory capacity and surveillance; sustainable investments in research, development, and innovation; and public health interventions” as actions for policy makers, public health professionals and other stakeholders to improve overall response to these priority fungal pathogens.
