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1rem

The latest fungal-focused edition of the CDC's Emerging Infectious Diseases highlights the global spread of antifungal resistance, Aspergillus infections, and Histoplasma detection in Spain.



New Insights into Fungal Infections: Resistance, Mortality, and Environmental Risks

This week, the CDC ACIP's endorsement of meningococcal, RSV, and chikungunya vaccines, the need to expand automated CD4 testing for improved HIV/AIDS care, and more.

Candida auris Epidemiology and Resistance Mechanisms Challenge Antifungal Treatment

Jane E. Sykes, BVSc (Hons), PhD, MPH, MBA, discussed how her study revealed a wider geographic distribution of valley fever, highlighting the need for improved human surveillance.

Canine Serology Sheds Light on Underreported Human Coccidioidomycosis Spread

Study uncovers the role of ploidy plasticity in fungal adaptation to fungicides, highlighting risks for human health and agricultural systems.

Environmental Fungicides Drive Genetic Shifts in Candida tropicalis, Promoting Azole Resistance

Scynexis developed its investigational fungal compound, SCY247, which is in phase 1 clinical trials and the company expects to share topline data this year.

Second Generation Antifungal Aims to Address Invasive Fungal Disease 

Late last year, Scynexis announced it had begun its phase 1 trial for its investigational fungal compound, SCY-247, which is a second-generation antifungal compound, from a novel class of structurally-distinct glucan synthase inhibitors, triterpenoids (fungerps).

“The reality is that there are not too many antifungal agents, or families of compounds, that are really tailored to the adequate treatment for systemic fungal diseases,” Scynexis CEO David Angulo, MD, said. “There are actually only 3 other families of compounds. This is very different from antibiotics.“

The company previously brought its first-generation antifungal, ibrexafungerp, to market. 

 in June 2021, for its first indication in vulvovaginal candidiasis (VVC), followed by a second indication in November 2022, for reduction in the incidence of recurrent VVC. At the time, it represented the first approved treatment in a novel antifungal class in more than 20 years.

For this new compound, the company would like to see it address the significant threat posed by antimicrobial resistance (AMR) in systemic fungal diseases with high mortality. Scynexis reports that SCY-247 has demonstrated 

 broad-spectrum antifungal activity against multidrug resistant fungal pathogens.

The phase 1 trial is a randomized, double-blind, placebo-controlled study of single and multiple ascending doses of oral SCY-247 in approximately 100 healthy subjects. The primary endpoint is safety and tolerability, and the secondary endpoint is pharmacokinetics.

In terms of indications, Angelo points out the company is looking to assess the properties of the compound and complete the phase 1 trial, and then look at specific fungal targets. However, he does see candidiasis as a likely target they will study for treatment with SCY-247.

“SCY-247 is a glucan synthesis inhibitor. The glucan synthesis inhibition is a mechanism that is a fungicidal against 

 infections are a logical target,” Angelo said.

However, he also wants to explore the utility of the investigational treatment against 

 as well as infections that affect immunocompromised patients, patients with bone marrow transplants or hematological malignancies.

Angulo says the company is expecting to have the initial results of the phase 1 trial in the third quarter of this year.




References
1. Scynexis Initiates Dosing in Phase 1 Trial of SCY-247, a Second-Generation Fungerp Candidate for Invasive Fungal Infections. Scynexis press release. December 18, 2024. Accessed April 22, 2025.
https://ir.scynexis.com/news-events/press-releases/detail/342/scynexis-initiates-dosing-in-phase-1-trial-of-scy-247-a
2. Parkinson J. FDA Approves Ibrexafungerp. Contagion. June 2, 2021. Accessed April 22, 20025.
https://www.contagionlive.com/view/fda-approves-ibrexafungerp




Scynexis developed its investigational fungal compound, SCY-247, which is in phase 1 clinical trials, and the company expects to share top-line data this year.

Second-Generation Antifungal Aims to Address Invasive Fungal Disease 

Sharmeen Roy discusses the role of Bayesian dosing in optimizing antimicrobial therapy, therapeutic drug monitoring, and hospital resource allocation.

Bayesian Dosing in Antimicrobial Therapy: Impact on Patient Safety and Hospital Efficiency

The shift toward Bayesian dosing is transforming how hospitals manage antimicrobial therapy, particularly for medications requiring therapeutic drug monitoring (TDM). As clinicians grapple with increasing patient loads and limited resources, precision dosing offers a safer, more efficient approach to optimizing treatment.

Sharmeen Roy, PharmD, BCPS, chief strategy and science officer at DoseMe, explains that vancomycin remains the most commonly used antimicrobial within their software, followed closely by aminoglycosides. 

“Bayesian dosing has shown significant benefits for medications with a narrow therapeutic window, where they are most effective and least toxic within a small range,” said Roy. “It improves target attainment because these medications require close monitoring, and it also addresses resource allocation challenges hospitals are facing today.”

By automating complex pharmacokinetic calculations, Bayesian dosing individualizes therapy for each patient, allowing clinicians to focus on clinical judgment rather than time-consuming manual calculations. This approach has led to measurable improvements, including shorter hospital stays, reduced adverse events, and lower toxicity risks, such as acute kidney injury.

Beyond improving patient safety, Bayesian dosing also streamlines hospital operations and reduces costs. The software enables limited sampling, meaning fewer lab draws are required while still achieving optimal dosing. This reduces the workload for clinical pharmacists, nurses, and laboratory staff, leading to greater efficiency across multiple departments. “It’s not just about making dosing more precise,” Roy noted, “but also about reducing lab and nursing resource use, making the entire system more sustainable.”

Challenges in Implementing Precision Dosing for Antimicrobials

While Bayesian dosing has become widely accepted for vancomycin, expanding this approach to other antimicrobials, such as β-lactams and antifungal,s presents new challenges.

Roy explained that despite vancomycin being in use for over 50 years, dosing strategies are still evolving. The 2020 AUC-guided dosing guidelines accelerated the shift toward Bayesian dosing, providing strong evidence-based support for its adoption. “Having guidelines in place makes it easier for clinicians to present the case to hospital leadership for why this approach is necessary,” she said.

“One of the biggest barriers is simply getting buy-in from leadership. Hospitals are juggling so many initiatives, and precision dosing has to compete for attention.” Fortunately, as more institutions experience the benefits of Bayesian dosing, adoption is steadily increasing.

Interestingly, the need for precision dosing is not necessarily driven by new antimicrobials, but rather by the need to rethink how older medications are dosed. Many antimicrobials were originally studied decades ago, under very different methodologies. As scientific understanding has advanced, researchers now recognize the importance of optimizing exposure levels to minimize adverse effects and improve patient outcomes.

For β-lactams, recent evidence suggests that therapeutic drug monitoring (TDM) enhances treatment efficacy by ensuring more precise dosing. “We now have better data on lab breakpoints, bacterial targets, and optimal dosing strategies,” Roy explained. “This allows us to fine-tune how we use these drugs, making treatment more effective and safer for patients.”

Stay tuned for part 2 coming soon where we continue this conversation and discuss AI.

Sharmeen Roy, PharmD, BCPS, discusses the role of Bayesian dosing, therapeutic drug monitoring, and hospital resource allocation.

Researcher Ashraf S. Ibrahim, PhD, discusses ongoing studies to ensure the safety of a novel monoclonal antibody and the growing need for rare disease awareness.

Advancing Mucormycosis Treatment: Investigating the Safety of VX-01

Researchers are advancing the development of a novel immunotherapy for mucormycosis, a rare and often fatal fungal infection primarily affecting immunocompromised individuals. Ashraf S. Ibrahim, PhD, senior investigator at the Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, discussed ongoing research efforts to establish the safety and efficacy of this potential treatment.

“What we're doing right now is we're trying to establish whether the treatment is safe,” Ibrahim explained. “So we've done something called tissue cross-reactivity studies with human tissues. We don't see a huge amount of binding, so cut it, I should say, is unique to the mucoralis fungi, which is the fungi that cause mucormycosis. You see a little bit of binding, cytoplasmic binding, which is not on the cell surface. For antibodies to be toxic, they have to bind to cell membrane proteins. So there is no cell membrane protein binding at all.”

Mucormycosis, caused by Mucorales fungi, presents a severe threat to individuals with weakened immune systems, such as those with uncontrolled diabetes or undergoing organ transplants. Traditional antifungal therapies have limited efficacy, underscoring the need for novel approaches like monoclonal antibodies.

The research is supported by funding from the National Institutes of Allergy and Infectious Diseases (NIAID) through an SBIR grant awarded to Vital X Biosciences, a company founded by Ibrahim. “We’ll be able to do GLP toxicity studies in rats, and we would basically try to obtain further funding to do GMP production and go into phase one clinical trial,” he stated. However, additional financial backing is required to move forward. “We still haven't gotten funds for that, but we've just submitted a grant in response to the broad agency announcement to try to obtain funds to take it into two different phase one clinical trials—one in adults and the other one in seniors. If we get awarded, then we probably can be in humans within two, two and a half years, including maybe two to three years, and then concluding the phase one clinical trials within four and a half to five years.”

Mucormycosis is becoming increasingly recognized due to rising case numbers worldwide. “The most important thing in rare diseases is that we basically have a good spotlight on them because these are really ignored diseases,” Ibrahim emphasized. “The problem is, you know, it is not as rare as it used to be. I've known a couple of people who had mucormycosis—friends, daughters, or sons of friends. When you get to that stage, then it is not as rare as you think. It is rare, meaning probably you see one case in a lifetime, but there are increasing numbers.”

Current estimates suggest approximately 4,000 cases occur annually in the United States, with a comparable burden in Western Europe. However, in endemic regions such as India, the numbers are significantly higher. “India in particular is endemic to the disease—200,000 cases per year at least,” Ibrahim noted. “I'm hearing Vietnam is also probably going to be in that region as well, not necessarily 200,000, but definitely in the thousands of cases. One tertiary hospital in Vietnam has seen, in the last year, 70 cases. That's a lot. We usually see in transplant centers between 10 to 15, maybe 20 cases per year. When you have 70 cases in one hospital that is not necessarily transplant-related, mainly diabetics, then you know that the burden of the disease is very high.”

Raising awareness and advancing new treatments remain crucial steps in addressing mucormycosis. “Trying to have a spotlight on the disease is probably helpful, at least, to try to get this treatment to be FDA-approved, hopefully, and available for patients to benefit from,” Ibrahim concluded.

As research progresses, this novel monoclonal antibody therapy could offer a significant breakthrough in the fight against mucormycosis, providing a much-needed option for patients with limited treatment alternatives.

Gu Y, Singh S, Alqarihi A, et al. A humanized antibody against mucormycosis targets angioinvasion and augments the host immune response. Sci Transl Med. 2025;17(789):eads7369. doi:10.1126/scitranslmed.ads7369

Ashraf S. Ibrahim, PhD, outlines safety studies and the potential of this antibody therapy for treating this rare fungal infection, which is seemingly becoming less rare.

Rising Mucormycosis Cases Drive Efforts for Spotlight on Treatment Research

Ashraf S. Ibrahim, PhD, details over 20 years of research on a spore coating protein and the development of VX-01 to block fungal tissue invasion.

Humanized VX-01 Monoclonal Antibody Targets Mucormycosis Invasion

Researchers have developed VX-01, a humanized monoclonal antibody designed to target mucormycosis, a severe fungal infection predominantly affecting immunocompromised individuals. VX-01 enhances the host's immune response and prevents fungal angioinvasion, offering a promising adjunctive treatment for this often fatal disease.

Mucormycosis, caused by Mucorales fungi, poses significant risks, especially to those with weakened immune systems. In the second part of our conversation with researcher Ashraf S. Ibrahim, PhD, senior investigator at the Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, he discusses over 20 years of research on mucormycosis, focusing on a key cell surface protein that facilitates the organism's aggressive tissue invasion.

“Basically, what we did is we've done a lot of work, and this is really the result of more than 20 years of research at the bench side trying to understand how the infection happens. So we've identified a cell surface protein that is expressed on the cell surface of the spores and the hyphae form of the organism. So you inhale the organism as spores. But what happens is they basically start germinating, forming hyphae. And that hyphae is really extremely aggressive in invading tissues, including blood vessels.”

The research identified a 16-amino acid peptide within this protein, which, when targeted with antibodies, could potentially block the organism's binding to mammalian cells.

“We've identified a protein called a spore coating protein. These proteins are professional invasins. In other words, their task is for the hyphae and the spores to bind the host cells, mammalian cells, human cells, and allow the organism to enter into the cell, embedding it and continuing to invade,” Ibrahim explains. “Within the protein itself, we've identified a 16-amino acid peptide that is highly immunogenic, surface exposed, and really resides in the binding facet of the spore coating protein to its receptor. The idea was to raise antibodies against that 16-amino acid peptide and see whether we can block the ability of the protein binding to its receptor, and as a result, prevent the organism from binding to the mammalian cell.”

Animal studies demonstrated efficacy, particularly when the antibody was combined with antifungal drugs.

“So in animal studies, we see actually very good efficacy of the antibody by itself given to mice. But then when you combine it with antifungals, the synergy is enormous. It's much better than either the antibody or the antifungal drug alone,” Ibrahim says.

However, the development of VX-01 faced challenges, particularly in the transition from murine to human antibodies.

“The difficulty was taking a mouse-derived monoclonal antibody and trying to give it to humans. In order for us to do this, we have to humanize it, because you can't give a mouse antibody to a human. One of two things would happen: either the antibody would be recognized as a foreign component and get destroyed by the human immune system, or you would have a severe allergic reaction, potentially leading to anaphylactic shock that might kill the patient,” Ibrahim notes.

Advances in humanization allowed for successful back mutations, improving the antibody's binding capability tenfold.

“We've done the humanization, and when we did this full humanization, we lost the activity of the antibody. It was no longer able to bind to the target protein. We had to go back and do back mutations—changing certain amino acids from the human frame back into the mouse frame. And we were able to do this with around 10 amino acids, which is acceptable by the FDA,” Ibrahim explains. “And then, all of a sudden, we not only restored the binding capability of the antibody, but we actually improved it by tenfold. We went from approximately 50 nanomolar to five nanomolar, which is really acceptable by the FDA for therapeutic antibodies.”

Production posed another challenge, particularly with Chinese hamster ovary (CHO) cells, the standard cell line for producing biologics.

“The only problem we've had in humanization was really production in CHO cells, which is the standard cell line for producing therapeutics. We were able to produce commercially viable quantities of approximately two to three grams per liter. What also helps us is that we don't have to go into high amounts of production because we don't have to give a huge amount of the antibody to see efficacy,” Ibrahim says. “So we see efficacy, on the basis of a human being, at approximately 100 milligrams total, which is considered to be a very low dose.”

VX-01 Monoclonal Antibody Targets Mucormycosis by Blocking Angioinvasion

Ashraf S. Ibrahim, PhD, details over 20 years of research on a spore-coating protein and the development of VX-01 to block fungal tissue invasion.

Humanizing Monoclonal Antibodies for Mucormycosis Treatment

Ashraf S Ibrahim, PhD, discusses how VX-01 prevents fungal invasion of blood vessels and enhances immune response in immunocompromised patients.

Mucormycosis, caused by Mucorales fungi, poses significant risks, especially to those with weakened immune systems. In the first part of our conversation with researcher Ashraf S Ibrahim, PhD, senior investigator at the Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, he explains, “Mucormycosis is a lethal fungal infection that became more prevalent during the COVID pandemic. Many patients treated with high doses of corticosteroids, especially those with diabetes and hyperglycemia, became infected with the fungus.” The infection occurs when individuals inhale spores that are commonly found in the environment. “You can inhale it all the time,” Ibrahim adds.

People with poorly controlled diabetes and those who are neutropenic or have leukemia are at higher risk of infection. “The classic patients at high risk in the West are neutropenic or leukemic patients, and those undergoing transplants, especially bone marrow transplants,” notes Ibrahim. He emphasizes the grave nature of the disease: “The lethality is extremely high; it's a very aggressive infection that targets blood vessels.” This process, known as angioinvasion, leads to severe tissue necrosis and infarction.

Traditional antifungal therapies have limitations, which underscores the need for innovative treatments. VX-01 is the result of humanizing a murine monoclonal antibody, C2, that targets CotH proteins—key fungal invasins that help the fungus invade host cells. “Rather than just trying to kill the organism, we focused on preventing it from invading host tissues, particularly blood vessels,” explains Ibrahim. Preclinical studies have shown that VX-01 is ten times more effective in binding to these proteins than its predecessor, C2.

VX-01 does not directly kill the fungus, but instead blocks its ability to infiltrate vital tissues. “This approach reduces the ability of the infection to be angioinvasive,” Ibrahim adds. When used in combination with antifungal drugs, VX-01 has shown the best outcomes in animal models, offering a new potential strategy for treating the disease.

Safety evaluations of VX-01 reveal no detectable damage to host cells in vitro, and minimal binding to cytoplasmic proteins in human tissue cross-reactivity studies. These findings suggest that VX-01 may offer a safer alternative to existing treatments. Ibrahim shares, “In our studies, we found no detectable damage to host cells in vitro, and minimal binding to cytoplasmic proteins in human tissue cross-reactivity studies.” This is encouraging as VX-01 progresses toward clinical trials.

The rise in mucormycosis cases is due, in part, to the global diabetes epidemic and advancements in treatments for cancer and transplants, both of which can weaken the immune system. “It’s not a surprise that mucormycosis cases are increasing,” Ibrahim says. “As medical advancements improve survival rates for other diseases, we’re seeing more infections. But we need to think outside the box to tackle this issue.”

VX-01 represents a significant step forward in the development of immunotherapies for mucormycosis, which continues to be a major challenge for immunocompromised patients. As new strategies for treating this aggressive and deadly infection are explored, VX-01 could emerge as an effective adjunctive treatment.

Gu Y, Singh S, Alqarihi A, et al. A humanized antibody against mucormycosis targets angioinvasion and augments the host immune response. 

2025;17(789):eads7369. doi:10.1126/scitranslmed.ads7369

Ashraf S. Ibrahim, PhD, discusses how VX-01 prevents fungal invasion of blood vessels and enhances immune response in immunocompromised patients.

Professor Gordon Ramage, BSc, PhD discusses the growing impact of fungal biofilms, emerging treatment options, and the need for improved detection methods.

Fungal Biofilm-Related Diseases: Diagnosis, Treatment, and Emerging Challenges

Fungal biofilm-related diseases are becoming more common due to increased use of implanted medical devices, immunosuppressants, and an aging population. The WHO has classified many fungi as critical or high-priority organisms due to their ability to form biofilms. These biofilms, which consist of interconnected cells on surfaces like catheters or within sinuses, pose challenges in diagnosis and treatment. They are difficult to detect, remove, and resistant to most antifungal agents, leading to higher risks for patients, including morbidity, mortality, surgeries, and extended hospital stays. Understanding biofilm formation mechanisms is key to improving diagnostic and therapeutic approaches.

In our interview with Gordon Ramage, BSc, PhD, a professor of infection prevention and control at Glasgow Caledonian University, we discussed the concern surrounding fungal biofilms and the challenges clinicians face when diagnosing and treating these infections.

Ramage explained the challenge of diagnosing and treating fungal biofilms, "Fungal biofilms are very difficult to differentiate from bacterial biofilms," he said. "Clinically, the signs—such as elevated temperature and other clinical parameters—are often indistinguishable. So, we don’t really know if someone has a fungal biofilm unless we can see it directly or have a definitive diagnostic test."

The Role of Medical Devices and Immunosuppressants

The rising incidence of fungal biofilm-related diseases can be attributed to the increased use of implanted medical devices and the use of immunosuppressants. “Fungi tend to affect people who are more immunocompromised. So, if you're on immunosuppressants, the likelihood of fungal pathogens growing on a surface is increased," Ramage said. "With the growing use of implanted medical devices globally, each new device presents an opportunity for a pathogen. So, when you're immunocompromised and have an implanted device, the likelihood of fungal biofilm formation increases."

When asked about the most promising therapeutic strategies for fungal biofilms, Ramage highlighted a few existing treatments and emerging drugs. "Drugs like liposomal Amphotericin B and the echinocandins have been shown to be useful, and they’re already used in clinical practice." He also pointed to newer antifungal drugs in development, "Drugs like Abrex, Fungoz, Resfungi, a new echinocandin, and Fim. These drugs are currently in Phase 2 and Phase 3 trials. From a biofilm perspective, they’ve shown effectiveness, particularly in lab settings."

Importance of Better Detection and Diagnosis

Ramage also discussed the importance of improving detection methods for fungal biofilms, "Diagnostics take time and money, and for some patients, it’s hard to respond quickly. Ideally, you would remove a device, then perhaps use microscopy or other forms of diagnostics like galactomannan or beta-glucan testing. But these methods are inherently expensive and may not provide more useful information than existing diagnostics."

"The approach is different depending on the type of biofilm," he said. "For example, in implanted devices, the device can be removed. But with conditions like vulvovaginal candidiasis or wound infections, the situation is more complex."

As fungal pathogens continue to emerge as a global threat, Ramage shared insights on the growing body of research in this area, noting that the article he co-authored is the culmination of years of work. "This article is probably the culmination of 25 years of work, starting when I was a postdoc in the United States," he explained. "There’s a lot of work being done in this field, and what we’re seeing now is that more and more fungal pathogens are being identified. Candida is a prime example—we didn’t really know much about it until 2009."

Ramage also highlighted the role of hospital environments in the spread of fungal infections. "It’s highly transmissible and can persist on surfaces," he said. "So, it’s not just about biofilms being on the person, it’s about the immediate surroundings, like the hospital environment, which is where a lot of the interest lies."

Future Directions for Research and Treatment

Looking ahead, Ramage expressed concern over the increasing prevalence of fungal infections, particularly in immunocompromised and elderly patients. "The more opportunities they have—such as in elderly patients or those who are immunocompromised—the more we’re going to see interesting things happen," he warned. "Unfortunately, those things aren’t necessarily good, but we will see more and more of them. We need to be mindful of that."

On the topic of antifungal drug development, he said "A lot of antifungal drug development is based on mycology. We take yeast cells or spores in low concentrations, test them against an antifungal, and say, 'Well, that’s sensitive,'" he explained. "But what we need to remember is that when we think about these organisms growing on surfaces—on a device, on a wound, or around a hospital—they’re not individual cells anymore. So, we should be thinking about developing biocides and new antifungals with this in mind, recognizing that, in some cases, these organisms form biofilms."

Ramage G, Kean R, Rautemaa-Richardson R, Williams C, Lopez-Ribot JL. Fungal biofilms in human health and disease. 

. Published online February 5, 2025. Accessed February 12, 2024. doi:10.1038/s41579-025-01147-0

Professor Gordon Ramage, BSc, PhD, discusses the increasing impact of fungal biofilms, new treatment options, and the need for enhanced detection methods.

GAFFI is working to address fungal diagnostic gaps in Africa by raising awareness, implementing successful models, and advocating for shifts in resources and collaboration, while facing challenges in funding, infrastructure, and political commitment.

GAFFI Continues Efforts to Raise Awareness and Improve Fungal Diagnostic Capabilities

Fungal infections affect over 1 billion people globally, causing an estimated 11.5 million life-threatening infections and more than 1.5 million deaths annually. Despite their impact, fungal diseases remain under-recognized and underfunded in global health. In response, the Global Action Fund for Fungal Infections (GAFFI) launched the "95-95 by 2025" initiative, aiming to diagnose and treat 95% of serious fungal infections by the end of 2025.

David W Denning, FRCP, FRCPath, FMedSci, professor of infectious diseases and global health at the University of Manchester, and a key figure in GAFFI, discussed the organization's ongoing efforts to address gaps in fungal diagnostics, particularly in Africa, where many countries lack adequate testing infrastructure.

"As of 2025, GAFFI is continuing its journey in addressing global fungal diagnostic gaps," Denning said. "Surveys have documented the availability of fungal tests in different regions. For example, there was a good survey in South America, two surveys conducted in multiple centers across Asia, and a large survey in Africa in 2002. This survey looked at lab tests and sample collection procedures across all of Africa, including North Africa."

Denning explained that many countries, especially in Africa, face barriers to diagnosing fungal infections. One example he highlighted was testing for fungal eye infections, which can occur in regions with high contact lens use or ocular injuries. "The question is whether the country performs corneal scraping (as required) and whether they consider fungal infection as a potential cause, with the appropriate lab tests available."

GAFFI published the findings of this survey in a report in 2002 and presented it at the African Centers for Disease Control’s public health meeting in Kigali that December. The results showed significant diagnostic gaps across Africa. “Morocco and Tunisia are doing well with testing, and South Africa has a good setup except for Aspergillus disease, which isn’t well recognized there,” Denning explained. “Some countries have patchwork testing, and places like South Sudan and Equatorial Guinea have virtually no testing available at all—no pathology for cancer diagnosis, let alone fungal testing.”

To raise awareness of these gaps, GAFFI sent the report to every medical school in Africa, addressing the deans, in the hopes of improving education and training in this area. "I don’t know whether they’ve done anything with it, but we hope that they at least could see that their country had a problem," Denning said. "We’ve worked with Africa CDC to raise awareness and also with the industry to help them understand where the gaps are and provide links to these countries. We’ve conducted numerous webinars and educational sessions as well."

Looking ahead, Denning shared GAFFI’s goal of replicating its model from Guatemala in an African setting. "One of our future goals is to replicate the successful model we implemented in Guatemala in an African setting," Denning noted. "While we may not focus solely on HIV, a possible area of focus could be HIV and lung disease. However, implementing this in larger, less organized countries like Kenya, Tanzania, and Mozambique presents challenges."

He stressed that this initiative will take time and resources. "This initiative will take two to three years and is not a trivial task. It's not just about diagnostics; we need to provide education, monitor the progress, and collect data as well."

A key factor in improving fungal diagnostic capabilities, according to Denning, is shifting how resources are allocated. "Currently, in Africa, most diagnostics are paid for by the patients or their families, except for HIV or TB testing. But fungal tests are not covered, which poses a problem," Denning explained.

Denning concluded by noting that GAFFI cannot tackle this issue alone. "GAFFI alone can’t tackle these issues. Collaboration with other stakeholders is essential to drive these changes forward."

Listen to the first part of our conversation with Denning about the "95-95 by 2025" initiative, which aims to diagnose and treat 95% of serious fungal infections globally by 2025. The discussion highlights efforts to improve access in underserved regions and the impact of the campaign, with successes in countries like Uzbekistan and Guatemala, where improvements in diagnostic tools have helped address fungal infection challenges.

GAFFI is addressing fungal diagnostic gaps by raising awareness, implementing models, and advocating for resource shifts, despite challenges in funding, infrastructure, and political support.

Fungal Infections

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