WHO / FUNGAL PRIORITY PATHOGENS LIST

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26-Oct-2022 00:04:16
WHO today published a report highlighting the first-ever list of fungal "priority pathogens" – a catalogue of the 19 fungi that represent the greatest threat to public health. WHO

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STORY: WHO / FUNGAL PRIORITY PATHOGENS LIST
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SOURCE: WHO
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DATELINE: 19 OCTOBER 2022, GENEVA, SWITZERLAND / FILE

SHOTLIST:

1. SOUNDBITE (English) Haileyesus Getahun, Director of AMR Global Coordination, WHO and the Quadripartite (FAO/OIE/UNEP/WHO) Joint Secretariat:
“The report we released today is the WHO priority fungal pathogen list. And this is the priority fungal pathogens for which we need intensified action and research and development, as well as investment that we want the world to galvanize its efforts in order to bring us into the next level of being prepared for any potential public health impact in the future. The list was a result of an extensive evidence evaluation and also in engagement with the experts all over the world where we have reached a global consensus that we our efforts should be intensified around this priority fungal pathogens.”
2. Close up, camera filming Haileyesus Getahun
3. SOUNDBITE (English) Haileyesus Getahun, Director of AMR Global Coordination, WHO and the Quadripartite (FAO/OIE/UNEP/WHO) Joint Secretariat:
“We know antibacterial drug resistant infection kills 1.3 million people every year, and it can contribute up to 5 million deaths every year. But it does. It means that within this backdrop of bacterial infection, we should ignore and neglect the emerging public health, perceived public health significance of these fungal infections. So, yes, they are ignored. But we have to also see in the broader context of addressing antimicrobial resistance where the resources are needed and where these efforts are critical.”
4. SOUNDBITE (English) Carmem L Pessoa-Silva, Unit Head, Surveillance, Evidence & Laboratory Strengthening Surveillance, Prevention and Control Department, WHO:
“I have to say that this is like a hidden problem because it is not yet properly diagnosed. So we need to look for the problem to better characterize and then address. In this, in order to achieve this, we need to strengthen laboratory capacities in all countries because fungal, invasive fungal infections are not happening only in few countries, these, as for other types of antimicrobial resistance, the antimicrobial restistance, also invasive fungal infections are happening everywhere, in all parts of the world. And we should not leave any country behind.”
5. Close up, camera
6. SOUNDBITE (English) Carmem L Pessoa-Silva, Unit Head, Surveillance, Evidence & Laboratory Strengthening Surveillance, Prevention and Control Department, WHO:
“Because of this lack of proper access to quality diagnostics, patients that could survive, they are dying. Therefore, we need better diagnostics. And with better diagnosis, this hidden, somehow, public health issue will start to appear to be more evident and will inform surveillance to then inform all other actions such as the public awareness, the prevention, the control, the treatment, and the research and development for new diagnostics and treatment.”
7. SOUNDBITE (English) Hatim Sati, Project And Report Technical Lead, And Technical Officer, AMR Global Coordination, WHO:
“During the COVID 19 pandemic, there has been an increase in the reports of COVID associated fungal infections that are invasive coming almost from all WHO regions. Most reports refer to invasive fungal infections in acutely ill patients who are admitted to the hospital with COVID and are then diagnosed with secondary infections. This was, of course, of concern, and it adds to the urgency in terms of trying to address these priority pathogens and understanding how they behave, understanding their epidemiology in-depth, understanding the impact of external factors such as global warming, other pandemic, other diseases.”
8. Close up, Hatim Sati moves his hands
9. SOUNDBITE (English) Hatim Sati, Project And Report Technical Lead, And Technical Officer, AMR Global Coordination, WHO:
“In light of the expansion of the immunocompromised or at risk populations globally in terms of their number, but also in terms of the new at risk groups that researchers are finding, And all of this collectively makes it important to act, to generate evidence, to generate data, to understand the extent of the problem, understand the burden of disease, and strengthen the capacity, especially in low and middle income countries, for diagnosing and managing these infections.”

STORYLINE:

WHO today published a report highlighting the first-ever list of fungal "priority pathogens" – a catalogue of the 19 fungi that represent the greatest threat to public health.

The WHO fungal priority pathogens list (FPPL) is the first global effort to systematically prioritize fungal pathogens, considering the unmet research and development (R&D) needs and the perceived public health importance.

The WHO FPPL aims to focus and drive further research and policy interventions to strengthen the global response to fungal infections and antifungal resistance.

Fungal pathogens are a major threat to public health as they are becoming increasingly common and resistant to treatment with only four classes of antifungal medicines currently available, and few candidates in the clinical pipeline. Most fungal pathogens lack rapid and sensitive diagnostics and those that exist are not widely available or affordable globally.

The invasive forms of these fungal infections often affect severely ill patients and those with significant underlying immune system related conditions. Populations at greatest risk of invasive fungal infections include those with cancer, HIV/AIDS, organ transplants, chronic respiratory disease, and post-primary tuberculosis infection.

Emerging evidence 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. During the COVID-19 pandemic, the reported incidence of invasive fungal infections increased significantly among hospitalized patients. As the fungi that cause common infections (such as candida oral and vaginal thrush) become increasingly resistant to treatment, risks for the development of more invasive forms of infections in the general population are also growing.

“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).

Despite the growing concern, fungal infections receive very little attention and resources, leading to a scarcity of quality data on fungal disease distribution and antifungal resistance patterns. As a result, the exact burden of fungal diseases and antifungal resistance, are unknown, and the response is therefore undermined.

The WHO FPPL list is divided into three categories: critical, high and medium priority. The fungal pathogens of in each priority category are so ranked primarily due to their public health impact and/or emerging antifungal resistance risk. While recognizing these critical pathogens as of public health concern globally, WHO emphases that the FPPL must be interpreted and contextualized carefully, as some endemic pathogens could be of more concern in their respective regional or local contexts.

The authors of the report stress the need for more evidence to inform the response to this growing threat and to better understand the burden – both of disease and antifungal resistance. The report also highlights the urgent need for coordinated action to address the impact of antifungal use on resistance across the One Health spectrum and calls for expanding equitable access to quality diagnostics and treatments.
“We need more data and evidence on fungal infections and antifungal resistance to inform and improve response to these priority fungal pathogens” said Dr Haileyesus Getahun, WHO Director, AMR Global Coordination Department.

The FPPL report underscores strategies for policymakers, public health professionals and other stakeholders. The strategies proposed in the report are collectively aimed at generating evidence and improving response to these fungal priority pathogens including preventing the development of antifungal drug resistance. The primary recommended actions are focused on: (1) strengthening laboratory capacity and surveillance; (2) sustaining investments in research, development, and innovation; and (3) enhancing public health interventions for prevention and control.

“Countries are encouraged to follow a stepwise approach, starting with strengthening their fungal disease laboratory and surveillance capacities, and ensuring equitable access to existing quality therapeutics and diagnostics, globally” added Dr Haileyesus Getahun.

Resistance to antifungal medicines is partly driven by inappropriate antifungal use across the One Health spectrum. For example, injudicious use of antifungals in agriculture was linked to the rising rates of azole-resistant Aspergillus fumigatus infections.

The report also calls for fostering WHO’s collaborative effort with the Quadripartite organizations and other partners, to address the impact of antifungal use on resistance across the One Health spectrum.
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