Millions deprived of life-saving antifungal medicines

The world is in the grip of a global crisis that kills the equivalent of the populations of Philadelphia, Kampala or Prague, – around 1.6 million each year. A new report published today in the Journal of Antimicrobial Chemotherapy, documents how many countries do not have life-saving antifungal therapies. Professor David Denning of The University of Manchester & President of GAFFI and the paper’s lead author says it beggars believe that hundreds of millions of people cannot access the optimal therapy for fungal meningitis and fungal lung infections globally.
GAFFI (The Global Action Fund for Fungal Infections) has today published the largest survey ever undertaken from 159 countries and found that a pair of critical antifungal medicines for AIDS patients are not available in over 95 countries. One of these antifungals has been available since the 1950’s and the other since the 1970’s.
The article studied the registration, availability, price and EML status of four key antifungal drugs globally.
The key findings are:
One of the critical drugs for fungal meningitis (amphotericin B) is not available in 42 countries.
The other key drug for fungal meningitis, flucytosine is not licensed in and is unavailable in 89 of 125 (71.2%) and 95 of 125 (76.0%) countries, respectively, representing an unserved population of 2898 million. The daily price of flucytosine varied from $4.60 to $1409.
Yet both Amphotericin B and flucytosine have been available in Europe and the US for over 40 years. The World Health Organisation recommends they are used together to bring down mortality from 100% to 25%.( Fungal meningitis is the commonest form of meningitis in sub-sarahan Africa because of AIDS).
The 25 year old drug, fluconazole is available in all countries and itraconazole is unavailable in just five countries. However, being available is not enough – cost matters as patients pay for their care in many countries. The daily cost of fluconazole varied from In South Africa, which has the largest AIDS burden in the world and a massive TB problem, itraconazole costs about £11.60 per day – unaffordable for most people there.

Full press release:
Article published in Journal of Antimicrobial Chemotherapy,
REF:Global access to antifungal therapy and its variable cost, Matthew Kneale; Jennifer S. Bartholomew; Emma Davies; David W. Denning
Journal of Antimicrobial Chemotherapy 2016; doi: 10.1093/jac/dkw325

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