The World Health Organization (WHO) today published a new blueprint to help countries respond to the increasing burden of fungal disease and antifungal resistance – one of global health’s most underestimated and neglected threats.
Fungal diseases affect more than 300 million people each year, and are associated with high mortality, long-term illnesses, and major losses in health and productivity worldwide. Antifungal resistance is a growing threat, driven in part by the widespread use of antifungals and their analogues across human, animal and plant health, as well as environmental exposure to antifungal chemicals. Responsible use of antifungals is essential to preserve their effectiveness while continuing to protect human and plant health.
Despite their profound human and economic toll, fungal diseases remain largely absent from national health plans, global burden-of-disease estimates, and the majority of antimicrobial resistance (AMR), universal health coverage, and One Health strategies.
The new Blueprint for strengthening responses to fungal disease and antifungal resistance: implementation guidance builds on the WHO fungal priority pathogens list and existing WHO work on neglected tropical diseases, HIV, and antimicrobial resistance, providing countries with practical guidance to strengthen national and regional responses to fungal disease and antifungal resistance.
“The Updated Global Action Plan on AMR approved by the Seventy-ninth World Health Assembly recognized that antifungal resistance is an integral part of the AMR challenge – and one we can no longer afford to overlook. This Blueprint gives countries a concrete path forward,” said Dr Jean Pierre Nyemazi, Director a.i. of the Department of Antimicrobial Resistance at WHO.
Developed through a structured, multi-stage process and consultations with over 150 experts from all WHO regions – spanning clinical mycology, diagnostics, antifungal stewardship, surveillance, regulatory policy, public health, and patient advocacy – the Blueprint aims to help countries address critical gaps in knowledge, diagnosis, treatment, surveillance, research, and workforce capacities, particularly in low-resource settings.
Aligned with the updated WHO Global action plan on antimicrobial resistance and the universal health coverage agenda, the Blueprint prioritizes interventions under four interlinked domains:
Domain 1: Public health and health system interventions focuses on strengthening awareness and health system readiness, including through antifungal stewardship programmes, workforce training, and infection prevention and control.
Domain 2: Advancement of therapies, tools and innovation seeks to expand equitable access to quality-assured antifungal medicines and diagnostics, while driving research, innovation, and market incentives through coordinated regulatory and financing mechanisms.
Domain 3: Laboratory systems, surveillance and outbreak preparedness focuses on building resilient laboratory networks and integrated surveillance systems to enhance diagnostics, detection, data quality, and evidence-informed management and policy.
Domain 4: Social and environmental drivers addresses the agricultural, environmental, and social determinants of fungal disease and antifungal resistance through cross-sectoral One Health approaches to reduce risk.
The Blueprint also provides an implementation logic framework and identifies 12 catalytic entry points to guide national and regional prioritization of interventions and investments to achieve measurable outcomes.
“Fungal disease and antifungal resistance remain an under addressed priority across national health plans, AMR strategies, and surveillance systems. This Blueprint provides countries with a practical framework to strengthen their response,” said Hatim Sati, Technical Officer in the Department of Antimicrobial Resistance at WHO, who led the development of the Blueprint.
The implementation guidance is intended for national policy-makers and programme managers working on communicable diseases and AMR, researchers and developers of antifungal medicines and diagnostics, donors and public–private partnerships supporting antimicrobial research and development, as well as global decision-makers, health providers, and patient advocates.
