Writing in PLoS Neglected Tropical Diseases, Marcio Rodrigues and Joshua Nosanchuk highlight the numerous reasons why fungal diseases are so neglected. They point to a science failure – including inadequate funding. They detail research funding for different diseases by numbers of deaths: malaria $1,315 , tuberculosis $334, diarrhoeal diseases $276, compared with $31 for cryptococcal meningitis. Research articles published were similarly low for fungal infections.
Outbreaks of fungal disease still surprise and demand continued investment in the topic. The fungal meningitis outbreak due to Exserohilum rostratum and the recent spread of Candida auris underline this need. Fungal outbreaks are surprising common, but rarely hit the headlines.
They also highlight market failures, as has GAFFI – many antifungals are simply not available or affordable for millions of people (see GAFFI’s maps of WHO Essential medicines). The last new class of antifungal to be launched (echinocandins) was in 2002, and these are narrow spectrum agents.
The lack of engagement by public health is also problematic – the stories and community and medical impact of fungal diseases are infrequently told to students of public health. Yet they are as compelling and much more addressable with the recent introduction of sensitive, quick and inexpensive diagnostic tests.
Rodrigues and Nosanchuk have issued a call to action – will it be heard?