Fungal infections are growing deadlier — and our treatments are running out

Fungal infections are growing deadlier — and our treatments are running out

This week, the World Health Organization (WHO) released its first-ever reports on diagnostics and treatments for fungal infections. The findings are sobering: invasive fungal diseases are becoming increasingly common, particularly among people with weakened immune systems, and we are dangerously unprepared.

Infections like Candida auris and Aspergillus fumigatus — both listed as ‘critical priority pathogens’ by the WHO — are claiming millions of lives every year. Globally, an estimated 6.5 million people suffer from invasive fungal infections annually, contributing to 3.8 million deaths, with 2.5 million of these directly attributed to fungal disease. These numbers are likely underestimates, due to a lack of proper diagnostic tools in many parts of the world.

The WHO’s latest analysis reveals a stark reality: our arsenal of antifungal medicines is critically thin. Currently, there are just nine antifungal agents in clinical development globally. Even more concerning, only three of these candidates have reached Phase 3 trials — the final hurdle before regulatory approval. Over the past decade, just four antifungal agents have received regulatory approval worldwide.

Here in Australia, this issue of slow development and limited incentives is already on the radar. Our report Fighting Superbugs: Ensuring Australia is ready to combat the rise of drug resistant infections highlights the urgent need for policy reform to tackle market failures in antimicrobial development. Solutions like expanding R&D incentives and piloting new funding models could help stimulate investment in antifungal treatments — and ensure Australia stays ahead of this growing threat. These measures have also been noted for action in the recent HTA review recommendations.

What’s more, these few treatments are not enough to keep pace with rising resistance. Some strains of Candida auris are resistant to all three major classes of antifungals, leaving clinicians with few options. Mortality rates for bloodstream infections caused by this fungus can reach up to 66%, a chilling statistic that underscores the urgency of the problem.

Children are especially underserved. The WHO report highlights the lack of child-friendly formulations, clinical trials, and dosing information for paediatric populations, exposing a vulnerable group to even greater risk.

The diagnostics landscape is just as concerning. While some tests for fungal infections are available, they largely depend on well-equipped laboratories and trained staff. For many lower-income countries, this remains out of reach. Without fast, accurate, and affordable diagnostics, infections go undetected, spreading silently and limiting access to life-saving treatment.

The WHO warns that the slow and complex process of antifungal R&D is a major barrier to progress. Current treatments have significant drawbacks: serious side effects, complex drug interactions, and often, the need for prolonged hospital stays. To change this trajectory, WHO calls for increased investment in drug discovery, streamlined development pathways, and better integration of fungal testing into healthcare systems worldwide.

This report is a wake-up call. Without urgent, coordinated action, we risk seeing fungal infections take an even greater toll on global health. WHO is urging governments, funders, researchers, and the pharmaceutical industry to prioritise fungal disease research, improve access to diagnostics and treatments, and accelerate the development of new tools to tackle this growing crisis.

Without it, the rise of drug-resistant fungi will continue unchecked, leaving the most vulnerable at deadly risk.