Life-threatening fungal infections affect 3.2 million Pakistanis, moot told

The faculty at Aga Khan University has launched a comprehensive medical atlas aimed at improving the diagnosis and treatment of fungal infections which are becoming a growing public health concern in Pakistan.
The new book titled ‘Practical Guide and Atlas of the Diagnosis of Fungal Infections’ was launched on Monday at the 1st International Collaborative Mycology Conference at AKU. The event had been jointly organised by the global research and advocacy body, Global Action Fund for Fungal Infections (GAFFI), the Medical Microbiology and Infectious Diseases Society of Pakistan and AKU.
The book contains high-resolution microscopic images of more than 20 types of fungal infections caused by more than 60 fungal species that have been reported at the country’s healthcare institutions. Compiled over a period of six years and through a series of eight intensive workshops, the publication also contains detailed instructions to guide medical professionals and students in diagnosing these infections.
Visiting skin specialists from across Pakistan told the conference that common fungal infections affecting the skin are now the leading cause of patients visiting dermatology clinics and hospitals. Despite the prevalence of such illnesses and the fact that 3.2 million Pakistanis are living with infections such as keratitis, which can cause vision loss, and Candida auris infection, which can be potentially fatal, there is no specific national policy on fungal disease, the experts noted.
“Fungal disease is an area almost forgotten by public health professionals and policymakers,” said Dr Kausar Jabeen, associate professor in the department of pathology and laboratory medicine at AKU and chair of the conference. “Since treatment options for these diseases are already limited, this policy oversight has dangerous implications. Fungal infections also represent a growing threat to the livelihood of our animals and plants which harms the country’s food security and biodiversity.”
Sessions at the conference also focused on the key concern about the growing fungal resistance to medicines which was narrowing treatment options and leaving patients little choice beyond highly expensive drugs.
Commenting on the challenges of treating Candida auris, a serious yeast infection which can trigger sepsis, a life-threatening condition, speakers noted that poor availability of medicines was leading to delays in treatment. Even when medicines were present, the prohibitive cost of using second-line drugs, which can cost around Rs13,000 per day, limited the availability of treatment, they said.
Every year, fungal infections claim 1.6 million lives across the world, which is higher than the death toll of malaria, said Professor David Denning, the president of GAFFI. Similarly, fungi and fungi-like microorganisms, oomycetes (commonly known as water mould), destroy a third of all food crops around the world which would have fed 600 million people.
Denning said that the World Health Organization has no funded programmes specifically targeting fungal diseases. There are fewer than 10 countries which have a national surveillance programme for fungal infections and fewer than 20 which have fungal reference diagnostic laboratories, he added.
“Many of the diagnostic tests that do exist are not available in developing countries, and well-established antifungal drugs that would cure disease are not reaching people that need them,” he said.

Experts from various disciplines of medicine, veterinary medicine, agriculture, food and pharmaceutical industry attended the two-day event. The conference was followed by a day of workshops at AKU’s Centre for Innovation in Medical Education.