GAFFI Continues Efforts to Raise Awareness and Improve Fungal Diagnostic Capabilities
GAFFI is addressing fungal diagnostic gaps by raising awareness, implementing models, and advocating for resource shifts, despite challenges in funding, infrastructure, and political support.
Fungal infections affect over 1 billion people globally, causing an estimated 11.5 million life-threatening infections and more than 1.5 million deaths annually. Despite their impact, fungal diseases remain under-recognized and underfunded in global health. In response, the Global Action Fund for Fungal Infections (GAFFI) launched the "95-95 by 2025" initiative, aiming to diagnose and treat 95% of serious fungal infections by the end of 2025.1-2
David W Denning, FRCP, FRCPath, FMedSci, professor of infectious diseases and global health at the University of Manchester, and a key figure in GAFFI, discussed the organization's ongoing efforts to address gaps in fungal diagnostics, particularly in Africa, where many countries lack adequate testing infrastructure.
"As of 2025, GAFFI is continuing its journey in addressing global fungal diagnostic gaps," Denning said. "Surveys have documented the availability of fungal tests in different regions. For example, there was a good survey in South America, two surveys conducted in multiple centers across Asia, and a large survey in Africa in 2002. This survey looked at lab tests and sample collection procedures across all of Africa, including North Africa."
Denning explained that many countries, especially in Africa, face barriers to diagnosing fungal infections. One example he highlighted was testing for fungal eye infections, which can occur in regions with high contact lens use or ocular injuries. "The question is whether the country performs corneal scraping (as required) and whether they consider fungal infection as a potential cause, with the appropriate lab tests available."
GAFFI published the findings of this survey in a report in 2002 and presented it at the African Centers for Disease Control’s public health meeting in Kigali that December. The results showed significant diagnostic gaps across Africa. “Morocco and Tunisia are doing well with testing, and South Africa has a good setup except for Aspergillus disease, which isn’t well recognized there,” Denning explained. “Some countries have patchwork testing, and places like South Sudan and Equatorial Guinea have virtually no testing available at all—no pathology for cancer diagnosis, let alone fungal testing.”
To raise awareness of these gaps, GAFFI sent the report to every medical school in Africa, addressing the deans, in the hopes of improving education and training in this area. "I don’t know whether they’ve done anything with it, but we hope that they at least could see that their country had a problem," Denning said. "We’ve worked with Africa CDC to raise awareness and also with the industry to help them understand where the gaps are and provide links to these countries. We’ve conducted numerous webinars and educational sessions as well."
Looking ahead, Denning shared GAFFI’s goal of replicating its model from Guatemala in an African setting. "One of our future goals is to replicate the successful model we implemented in Guatemala in an African setting," Denning noted. "While we may not focus solely on HIV, a possible area of focus could be HIV and lung disease. However, implementing this in larger, less organized countries like Kenya, Tanzania, and Mozambique presents challenges."
He stressed that this initiative will take time and resources. "This initiative will take two to three years and is not a trivial task. It's not just about diagnostics; we need to provide education, monitor the progress, and collect data as well."
A key factor in improving fungal diagnostic capabilities, according to Denning, is shifting how resources are allocated. "Currently, in Africa, most diagnostics are paid for by the patients or their families, except for HIV or TB testing. But fungal tests are not covered, which poses a problem," Denning explained.
Denning concluded by noting that GAFFI cannot tackle this issue alone. "GAFFI alone can’t tackle these issues. Collaboration with other stakeholders is essential to drive these changes forward."
Listen to the first part of our conversation with Denning about the "95-95 by 2025" initiative, which aims to diagnose and treat 95% of serious fungal infections globally by 2025. The discussion highlights efforts to improve access in underserved regions and the impact of the campaign, with successes in countries like Uzbekistan and Guatemala, where improvements in diagnostic tools have helped address fungal infection challenges.
Part 1: https://www.contagionlive.com/view/fungal-infections-invisible-until-it-s-too-late
