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China’s innovative national plan to combat fungal diseases and antifungal resistance

Summary

China has created a comprehensive national system to fight fungal infections and drug resistance. The system monitors fungal diseases across hundreds of hospitals throughout the country to track which infections are most common and which antifungal medicines are becoming less effective. Early findings show that many hospitals lack proper facilities for testing fungal infections, and some fungi are developing resistance to commonly used antifungal drugs, particularly fluconazole.

Background

Fungal diseases affect over 6.5 million people worldwide and contribute to more than 2.5 million deaths annually, yet remain underrecognized globally. China has established comprehensive policies including the Biosecurity Law and National Action Plans to address fungal diseases and antifungal resistance. The China Fungal Disease Surveillance System (CFDSS) was established in May 2019 as a milestone in implementing these strategic initiatives.

Objective

To describe China’s innovative national plan and surveillance system for combating fungal diseases and antifungal resistance, including the CFDSS organizational structure, investigations, and implementation strategies.

Results

The 2020 baseline investigation across 769 institutions found that while 97% of tertiary hospitals offer mycology services, only 41% have dedicated independent mycology workspaces. The retrospective surveillance analyzed 252,811 fungal strains revealing high prevalence of non-Candida albicans species (>66%) and fluconazole-resistant C. tropicalis (>41%). Active surveillance of 303 hospitals identified 1,355 fungemia cases with 16.1% all-cause 30-day mortality.

Conclusion

China is leading global efforts to address fungal diseases through comprehensive surveillance, research support, practitioner training programs, and rational antifungal stewardship. The CFDSS represents a major achievement in strengthening prevention, diagnosis, treatment, and control of fungal diseases with potential for international collaboration and knowledge sharing.
  • Published in:Innovation (Camb),
  • Study Type:Policy Review and Surveillance Report,
  • Source: PMID: 39872483, DOI: 10.1016/j.xinn.2024.100741
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