"Fungal One Health and Antimicrobial Resistance Network"

Fungal infections are a growing problem, now killing more people than tuberculosis or malaria globally. Unfortunately fungi are also becoming resistant to the main anti fungal drugs we use to treat them. We have show that this is due to mass use of antifungals in agriculture. These are needed because fungi are the main pathogens that destroy crops. Furthermore global warming is increasing the threat of fungi across plant, animal and human health.

To combat this, new types of antifungal therapies are coming into medical use, however we are already seeing equivalent antifungals being used in agriculture, known as "dual-use". We urgently need a holistic framework to ensure that we don't lose the efficacy of anti fungal drugs, both as medicines and as fungicides, whilst ensuring that we can continue to ensure that our food supplies are protected.

In order to address the issue of antifungal resistance we have developed a Fungal One Health and Antimicrobial Resistance Network. One health refers to approaches that seek to balance and optimise the health of people, animals and ecosystems.

The key challenges we face our to be able to understand the specific reasons why emergence of anti fungal resistance occurs within a one health context, to develop early warning systems that allow us to know when resistance in occurring or spreading, to identify the key hot-spots in the environment where anti fungal resistance is occurring, and have better understanding of where antifungals are being used most across one health.

This will allow us to identify appropriate countermeasures that allow us to deliver judicious stewardship of antifungals so they can be used appropriately to enable food security and animal and human health, whilst ensuring that the risk of anti fungal resistance is minimised. In order to address these challenges and deliver appropriate countermeasures we have brought together a diverse range of scientists from across the relevant disciplines, as well as key stakeholders from relevant government departments, healthcare, agrochemical and pharmaceutical industries and end users such as farmers and patients. They will contribute to 4 working groups that focus on

1: the underlying causes of dual use anti fungal resistance, 2: surveillance of anti fungal resistance, 3: understanding the role of agricultural waste streams and water as hotspots for antifungal resistance, and

4: developing countermeasures such as anti fungal stewardship and other interventions to mitigate the risk of antifungal resistance.

Our key aims will be to advance our knowledge of the underlying drivers of dual use antifungal resistance, how this occurs within the ecosystem, to develop surveillance systems and antifungal stewardship toolkits. We will develop policy documents and white papers, undertake outreach with end users, the public, governmental bodies and NGOs. The Network will train the next generation of multidisciplinary researchers in this area and develop pragmatic research proposals to enable us to fight the spread of anti-fungal resistance.