Antifungal Policy and Practice Across Five Countries: A Qualitative Review

Summary

This study examines how well five different countries handle invasive fungal infections through their healthcare policies and systems. Researchers found that while these infections affect millions of people globally, most countries lack comprehensive policies to diagnose, treat, and manage them effectively. Major issues include inadequate healthcare provider training, limited access to rapid diagnostic tests, and insufficient antifungal medications in some regions. The study recommends that countries develop better national strategies for preventing, diagnosing, and treating these serious infections.

Background

Invasive fungal infections (IFIs) affect an estimated 150 million people annually with over 2.5 million deaths per year, yet there is a lack of clarity and recognition about the global burden of IFIs. Few countries have comprehensive health policies covering antifungal prescribing, diagnosis, monitoring, prevention, treatment, education, and stewardship. This assessment examines the current state of antifungal policies across representative countries with varying economic systems and IFI burdens.

Objective

To assess and identify gaps in national and global antifungal policies by evaluating the strengths and weaknesses of IFI-related policy landscapes from five example countries: the Netherlands, Italy, South Korea, China, and India. The review aimed to raise awareness of key needs and issues in IFI prevention, diagnosis, and management across different health systems.

Results

None of the five countries demonstrated robust IFI policies with formal governmental recognition. Substantial gaps were identified including: low prioritization of IFI diagnostics, omission of fungal pathogens from antimicrobial resistance policies, general lack of awareness and healthcare professional training on IFI management, limited prevention and surveillance strategies, and minimal support for diagnostic and treatment innovation. Access to advanced diagnostics varied significantly, being most developed in the Netherlands, Italy, and South Korea.

Conclusion

Despite increasing IFI burden worldwide, there are significant policy gaps across all assessed countries requiring urgent action. Healthcare systems need to develop comprehensive fungal disease policies including diagnostic capacity, surveillance, stewardship, education, and treatment access. Countries should consider national, regional, and hospital-level policies addressing prevention, diagnosis, therapeutic management, and professional education to reduce IFI burden.
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