Call for global action on fungal infection

A global project calling on national governments and public health agencies to reduce the death and blindness toll from fungal diseases was launched in Australia on 5 May 2015.

The ‘95–95 by 2025’ project was launched by the Global Action Fund for Fungal Infections (GAFFI) with the target of 95% of patients with life- or sight-threatening fungal disease being diagnosed and 95% treated by 2025. Currently the figures are somewhere between 33 and 50%.

Significant advances in diagnostics for fungal pneumonia and meningitis have been made over the past 15 years, but are not available in most countries. Amphotericin B, for example, was first used in 1959 but is still not available in 76 countries despite being critical in the treatment of fungal meningitis.

GAFFI claims that the importance of chronic and allergic fungal infections has been overlooked for years, and are likely to be responsible for over 500,000 deaths each year. Likewise, AIDS-related fungal infections are responsible for up to 700,000 deaths (nearly half the total deaths from AIDS), and could be halved rapidly if diagnosis and treatment were made available immediately.

At the project launch, David Denning, president of GAFFI and professor of infectious diseases in global health at the University of Manchester, said: “We propose a systematic approach to greatly reducing deaths and disease from fungal disease, using tried and tested rapid diagnosis and antifungal therapy. We recognise that health ministers in all countries have many demands, but the loss of life and sight of some of the most productive and active members of society is economically and socially disastrous.”

Over 300 million people around the world of all ages suffer from serious fungal infections every year, resulting in 1,350,000 deaths. Most serious fungal infections are ‘hidden’, occurring as a consequence of other health problems such as asthma, AIDS, cancer, organ transplant and corticosteroid therapies. Tens of thousands lose their eyesight every year from fungal keratitis yet the condition is rarely diagnosed and treated.

Denning describes fungal disease as “the Trojan horse – the silent, unappreciated global catastrophe on a scale no one has grasped until recently”. For example, up to 20% of patients (1.2m worldwide) develop a fungal lung infection after tuberculosis that slowly progresses to death over five years unless arrested with treatment.

Around 10,000 people in the UK contract a fungal infection every year. Most survive, but many suffer debilitating symptoms and long-term problems.