Aspergillosis, lung and sinus disease caused by the fungus Aspergillus, affects around 15 million people and kills over 1 million each year.
Announced at the 8th biennial Advances against Aspergillosis international conference in Lisbon starting on February 1st 2018, are the 5 aspirational targets for aspergillosis to be achieved by 2030:
1.) Survival in invasive aspergillosis increased to 90% (up from under 50%)
2.) Plugging the major gaps in our understanding of the biological, immunological and genetic basis of aspergillosis
3.) Diagnostics (most countries, including all of Africa have no diagnostic capability at all)
• New widely available, standardized and clinically validated diagnostics techniques
• New simple screening tests developed
• New antifungal agents licensed for invasive, chronic and allergic aspergillosis and for all age groups (only 3 classes currently available)
5.) At least one vaccine against aspergillosis in clinical trials or approved (none currently).
At the conference opening session, Professor David Denning, President of the Global Action Fund for Fungal Diseases (GAFFI) and Professor of Infectious Diseases in Global Health at the University of Manchester spoke on behalf of patients, doctors and researchers in calling for radical improvements.
Because diagnostics are not available in so many countries, hundreds of thousands of people unknowingly die or are disabled by aspergillosis yet could be saved or cured. He said: “I have been looking after patients with aspergillosis for over 35 years, and yet we still lose patients and see too many people severely affected by this common fungus.
I contributed to many clinical studies bringing the first effective oral drugs to patients (itraconazole and voriconazole), and yet the burden and deaths remains huge. Nothing less than a concerted international effort is required to address huge disparities in aspergillosis frequency.”
2018 marks the 20th anniversary of The Aspergillus Website www.aspergillus.org..uk), which the Fungal Infection Trust has been supporting. It provides a truly encyclopedic resource (>100,000 pages) and news feed to the world at no cost to the user, thanks to its many supporters over decades.
Together with its sister Website for Patients (www.nacpatients.org.uk), they attract over 125.000 users per month, indicative of the need for information. In 2012, the Fungal Infection Trust launched a global educational website Life Worldwide (www.LIFE-Worldwide.org), in English and Spanish, which is also highly utilised.
The Advances in Aspergillosis conference series, held alternate years, is the premier forum for detailed and dedicated discussion of all aspects of aspergillosis, attracting over 350 delegates from 35+ countries.
Topical issues include: emergence of pan-azole and echinocandin resistance which requires unique approaches, new antifungal agents and immunotherapies for chronic and allergic aspergillosis, better molecular and low-cost strategies for diagnosis and publication of several recent clinical guidelines for clinicians offer detailed guidance.
Other major needs for health improvements in aspergillosis include:
• Improvement in the public’s awareness of fungal diseases and specifically aspergillosis
• Keeping homes free from excessive Aspergillus and other moulds related to dampness, which increases the number and severity of asthma episodes
• Stronger evidence base of antifungal therapy allergic aspergillosis to reduce the number and severity of asthma episodes, and probably asthma deaths
• Hospital environments for vulnerable patients free of Aspergillus
• Reduction in azole resistance with reduced use of azole fungicides in non-essential crops
• Prevention of a new epidemic of resistance with any new classes of antifungal used for aspergillosis by not allowing such chemical class to be used as a fungicide
• Need for better surveillance and detailed epidemiology data
• Development of immunotherapies as well as vaccines
Advances Against Aspergillosis (www.AAA2018.org)
Fungal Infection Trust (www.fungalinfectiontrust.org.uk)
Aspergillus Website (www.aspergillus.org.uk)
Aspergillosis Patients website (www.nacpatients.org.uk)
LIFE-Worldwide (Fungal disease education & awareness) (www.LIFE-Worldwide.org)
The Fungal Infection Trust (www.fungalinfectiontrust.org) is a UK Company limited by Guarantee approved as a charity by the Charity Commissioners. Since 1991, the Fungal Infection Trust (FIT) has made a unique contribution to advancing the science and medicine of fungal diseases, in the UK and internationally.
GAFFI is a registered International Foundation based in Geneva and UK Charity and is focused on 4 major tasks related to serious fungal infections. These are:
• Universal access to diagnostics for serious fungal disease
• Universal access to antifungal agents www.gaffi.org/why/burden-of-disease-maps/
• Accurate data on the number and severity of fungal infections
• Health professional education related to better recognition and care for patients with serious fungal disease
GAFFI issued its 10 year Roadmap ’95-95 by 2025’ in 2015 calling on all governments and international health agencies to ensure 95% of the global population have access to fungal diagnostics and antifungal therapies by 2025: http://www.gaffi.org/roadmap/ GAFFI has enabled several antifungal drugs to be listed on the World Health Organisation’s Essential Medicine List, including those used for aspergillosis.
The Aspergillus Website (www.aspergillus.org.uk) was set up in 1998 by the Fungal Infection Trust. It is the most comprehensive source of information about Aspergillus and the diseases it causes available on the internet. An estimated 100,000 distinct IP addresses log on monthly and over 200,000 other websites link to the Aspergillus Website.
Users are in over 140 countries. Over 1000 patients are currently registered with the support discussion group on Yahoo! and another 150 on Facebook with 280 LinkedIn members (Aspergillus and Aspergillosis Group). The Website for Patients supports the patient and carer community (www.nacpatients.org.uk),
LIFE is the international health professional education brainchild of the Fungal Infection Trust. LIFE’s goal is to improve the health of patients suffering from serious fungal infections primarily through health professional education and increased awareness internationally (www.LIFE-Worldwide.org). Summary information on fungi, fungal diseases, diagnostic tests and treatments are provided free in English and in Spanish.