WHO Releases First-Ever Report on Fungal Tests & Treatments

April 4, 2025

The World Health Organization (WHO) has released its first-ever reports about the serious shortage of medicines and tests for dangerous fungal infections. This concern is particularly pressing in low- and middle-income countries (LMICs). The reports highlight the urgent need for new research and development to fix these problems.

Fungal Infections

Fungal infections are becoming a public health concern. Common ones like candida—which causes mouth and vaginal infections—are getting harder to treat because antifungal resistance. These infections mostly affect people who are already very sick or have weak immune systems, such as those getting cancer treatment, living with HIV, or who have had organ transplants. Fungal infections range from superficial to invasive diseases. Invasive fungal diseases (IFDs) account for over 6.5 million infections and approximately 3.8 million deaths worldwide each year. The mortality rate for IFDs can exceed 50% despite treatment.

Antifungal Treatment Landscape

New Drug Approvals (Past Decade):

Only 4 new antifungal drugs have been approved in the last 10 years in the USA, EU, or China.
These drugs are Isavuconazole, Ibrexafungerp, Oteseconazole, and Rezafungin.

Current Drug Pipeline:

Historically, only three new classes of antifungal drugs have been approved in the past 30 years.
9 antifungal drugs are in clinical trials for high-priority fungal infections.
Only 3 are in Phase 3 (the final stage), so very few new drugs are expected in the next 10 years.
22 drugs are in preclinical stage, but this is not enough due to high failure rates in early development.

Problems with Existing Antifungal Treatments:

Serious side effects
Frequent interactions with other medicines
Limited dosage options
Require long hospital stays

Need for Safer and Better Treatments:

Urgent need for safer antifungals with fewer side effects and less monitoring.
Need drugs effective against a broad range of dangerous fungal infections.
Children are especially underserved – very few trials for pediatric doses or child-friendly formulations.

WHO Recommendations:

Boost global monitoring of fungal infections.
Increase financial support for drug development.
Invest in basic research to find new drug targets in fungi.
Explore treatments that boost the body’s immune system to fight fungi.

Antifungal Testing Landscape

Current Situation with Fungal Tests:

Tests are available for detecting priority fungal pathogens.
But they need advanced labs and trained staff, which most low- and middle-income countries (LMICs) lack.
So, many people in LMICs don’t benefit from these tests.

Urgent Need:

All countries, especially LMICs, need faster, cheaper, and more accurate fungal tests.
WHO recommends point-of-care diagnostics (tests that can be used at or near the patient, even in remote areas).

Problems with Existing Tests:

Limited coverage – current tests detect only a few types of fungi.
Often inaccurate and take too long to give results.
Not suitable for primary or secondary health centres because they need stable electricity and special lab equipment.

Knowledge Gaps

Many doctors and health workers lack awareness about fungal infections and growing drug resistance.
This leads to delays or errors in diagnosis and treatment.

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