There is a worldwide crisis of antibiotic resistance, which causes approximately 5 million deaths each year. However, bacteria are not the only concern.

Fungal infections are also evolving and becoming resistant to the drugs used to treat them, leading some researchers to call it a “silent epidemic.”

Fungal infections and antifungal resistance are being overlooked in global health discussions, according to molecular biologist Norman van Rijn of the University of Manchester. “The threat of fungal pathogens and antifungal resistance, even though it is a growing global issue, is being left out of the debate,” he explained.

In September, the United Nations will hold a meeting in New York City to discuss antimicrobial resistance. The meeting will focus on resistant bacteria, fungi, viruses, and parasites.

Norman van Rijn, along with an international group of scientists, is urging governments, researchers and the pharmaceutical industry not to limit their focus just to bacteria.

In their comments in The Lancet study, van Rijn and colleagues emphasize that fungal infections should not be overlooked in efforts to combat antimicrobial resistance.

Without immediate action, fungal infections can become even more dangerous. Currently, these infections affect 6.5 million people each year and cause 3.8 million deaths.

Fungal infections such as Aspergillus fumigatus, which affects the lungs, and Candida, which causes yeast infections, are considered the most dangerous.

People with weakened immune systems and the elderly are most at risk. The World Health Organization (WHO) has already listed these and other fungal pathogens as top priorities for global health.

“Most people agree that resistant bacterial infections are a significant part of the AMR (antimicrobial resistance) problem. However, many drug resistance problems over the past decades have also been the result of invasive fungal diseases, which have gone largely under-recognised by scientists, governments, clinicians and pharmaceutical companies. The threat of fungal pathogens and antifungal resistance, even though it is a growing global issue, is being left out of the debate,” said Dr van Rijn.

Fungi are particularly challenging to treat because their structure more closely resembles that of animals than bacteria, making it more difficult to create drugs that kill fungi without harming human cells.

Currently, there are only four classes of antifungal drugs, and resistance to them is increasing.

Van Rijn’s team worries that agricultural practices are contributing to this problem. Fungicides used in farming can cause cross-resistance in fungi that affect humans. They suggest that the world needs a balance between protecting crops and treating fungal infections.

The upcoming UN meeting is being seen as a pivotal moment to launch a global approach to combat antimicrobial resistance, including fungi in the fight. “No microbe should be left behind,” the researchers concluded.