With rising resistance and limited access to treatment, fungal infections are becoming an overlooked but growing global health threat
The World Health Organization (WHO) has released its first-ever reports addressing the severe lack of medicines and diagnostic tools to treat invasive fungal infections. The findings underscore a pressing need for innovation and investment in research and development (R&D) to bridge these critical gaps and strengthen global health responses.
Fungal diseases are becoming a growing public health concern, particularly among vulnerable populations such as cancer patients, people living with HIV, and those who have undergone organ transplants. Common infections, such as Candida, are showing increasing resistance to treatment. In many low and middle-income countries (LMICs), diagnostic capabilities remain limited, even in district hospitals—making timely and accurate treatment difficult.
Critical Shortage of Antifungal Treatments
According to WHO, the development pipeline for antifungal medicines is severely limited. Over the last decade, only four antifungal drugs have been approved by regulatory bodies in the US, European Union or China. Currently, nine antifungal agents are in clinical development. Still, only three are in phase 3—the final stage before regulatory approval—meaning few new treatments will likely become available within the next ten years. Additionally, 22 antifungal compounds are in preclinical stages, an insufficient number given the high dropout rates typically seen in drug development.
Current antifungal treatments present several challenges, including serious side effects, drug-drug interactions, limited dosage forms, and prolonged hospitalisation. WHO highlights the need for safer, broad-spectrum antifungal medicines and paediatric formulations, as children remain significantly underserved.
Lack of Accessible Diagnostics in LMICs
The WHO diagnostics report reveals that although tests for fungal pathogens are commercially available, they largely depend on well-equipped laboratories and trained personnel. As a result, most people in LMICs do not benefit from timely or accurate diagnoses. Existing diagnostics cover only a limited range of fungal infections, often lack precision, and are time-consuming. Many are unsuitable for use in primary or secondary healthcare settings due to the need for reliable electricity and controlled laboratory conditions.
Healthcare providers often lack awareness and training in recognising fungal infections and antifungal resistance. This further reduces the likelihood of appropriate testing and timely intervention. WHO calls for the development of affordable, point-of-care diagnostic tools and improved training for health professionals to close these gaps.
WHO is also developing an implementation blueprint for its Fungal Priority Pathogens List (FPPL) and recommends greater investment in global surveillance systems, financial incentives for drug development, and basic scientific research to identify new treatment targets. Strengthening the global response to fungal diseases and antifungal resistance is crucial to reducing the health burden among the world’s most vulnerable populations.
