The World Health Organization lists the main health risks of fungi.

The World Health Organization (WHO) has developed a classification of fungi that pose a threat to human health as a result of a major effort to address the growing number of neglected pathogens that are becoming increasingly resistant to treatment and causing death.

The health agency lists 19 invasive fungal diseases, including four that collectively kill 1.3 million people and contribute to five million deaths each year. Many of these deaths occur in people with HIV, cancer, tuberculosis and other underlying medical conditions that make them vulnerable to infection.

Many hospitals and clinics, especially in poor countries, do not have the diagnostic equipment to detect the disease, and health officials say the death toll from the fungus could be much higher.

Dr. Carmen El Pessoa-Silva, who specializes in disease surveillance and control, said: “The bottom line is that invasive fungal infections are becoming more common, but they are often not recognized in patients and are not properly treated.” Tuesday news conference. “We don’t have a real understanding of the scale of the problem.”

The WHO framed the report as a call to action, which officials hope will help create a greater sense of urgency among governments, drug developers, doctors and health policy experts.

Climate change has helped increase the geographic range and spread of some infections, according to the World Health Organization. The coronavirus pandemic has led to a spike in fungal infections among covid patients, who are admitted to intensive care units, where stubborn pathogens such as Candida auris sometimes grow, then invade their bodies through airways and veins.

Mucormycosis, often called the “black fungus” in India, has infected thousands of Covid patients, some of whom have required facial surgery to remove the infection.

Just as dangerous bacteria have become resistant and resistant to antibiotics due to their overuse in humans and agriculture, antifungals have been losing their healing punch in recent years. Scientists say the rise in resistance to Aspergillus fumigatus, a common mold that can be fatal to people with weak immune systems, is linked to the use of fungicides on cash crops such as grapes, corn and cotton.

Once a fungal infection enters the bloodstream, treatment becomes more difficult: bloodstream infections with fungi in the Candida family, for example, have a 30 percent mortality rate. This figure is significantly higher in patients with Candida auris, one of the four “critical priority” fungi reported by the World Health Organization. In the year The fungus, first identified in Japan in 2009, has spread to four dozen countries and is often resistant to more than one drug.

“There are very few new drugs in the pipeline,” said Dr. Hatim Sati, another WHO official who helped write the report. Many existing drugs are so toxic that some patients cannot safely take them, he said.

Doctors and researchers said they were encouraged by the World Health Organization’s decision to focus on fungal infections. “This is long overdue because fungal infections have been neglected for so long,” said Dr. Cornelius J. Clancy, an infectious diseases physician at the VA Pittsburgh Health Care System, who did not contribute to the report. .

Dr. David Denning, chief executive of the advocacy group Global Action for Fungal Infections, says poor surveillance is partly to blame for that neglect.

Failure to diagnose fungal infections means patients often go untreated, he said, citing a Kenyan study that found better surveillance for fungal meningitis could save 5,000 lives each year among HIV-infected people.

He said the annual cost for the expanded test would be around $50,000.

Dr. Denning said the lack of testing has other unseen consequences. He presented a hypothetical example of a leukemia patient who developed a fatal fungal infection. “If that person dies of fungal disease, their relatives may want to donate money to a leukemia charity,” he said. “They don’t give it to a fungal disease charity because leukemia is something they know about.”

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