One of the biggest challenges to fungal disease preparedness is that they are underdiagnosed, which makes research, surveillance, and response more difficult.

“If we don’t have good diagnostic tests, these diseases don’t exist because we don’t know who has them,” said Tom Chiller, MD, former chief of the Mycotic Diseases Branch at the Centers for Disease Control and Prevention.

He adds that diagnosing fungal disease is inherently difficult because fungal cells look similar to human cells, making it challenging to get a diagnostic test that’s sensitive enough to tell the difference. Fungi are also everywhere around us, billions of them—exposure is “near universal,” and it’s hard to distinguish the colonies that are causing disease from those that are harmless.

Further, because fungal cells are so similar to human cells, it remains very challenging to kill one type of cell without also killing the other, making treatment toxicity a major issue. And with only three major classes of antifungal drugs—azoles, echinocandins, and polyenes—resistance is a larger problem because we don’t have as many tools in our toolbox when a fungal pathogen becomes resistant.

Fortunately, new antifungal drugs that are currently in various stages of development and investigation may help with resistance. Oteseconazole and rezafungin received US Food and Drug Administration approval in recent years, building on the existing antifungal classes and expanding our arsenal. Two even newer antifungal treatments, olorofim and fosmanogepix, represent new classes and will hopefully be approved in the coming years.

While millions of fungi exist, only a few hundred of them can cause human disease. Some of the most common and well-known fungal diseases include ringworm, vaginal yeast infections, athlete’s foot, skin infections like sporotrichosis, and mold infections like aspergillosis, as well as invasive infections like cryptococcal meningitis and candidiasis. The most dangerous fungal disease is multidrug-resistant Candida auris, which was first identified in a Japanese hospital in 2009 and has been found fatal in 29% to 62% of cases.

Without surveying when these conditions are diagnosed and treated, we can’t have accurate knowledge of which diseases are the most prevalent and when they become resistant to the available antifungal treatments. What’s more, stewardship programs to protect against resistance remain weak and limited in their scope, especially in underresourced countries.

Recognizing this gap, the WHO released a new blueprint in June 2026 to help countries begin to create uniform tools to respond to the growing public health threat around fungal disease and antifungal resistance. The report provides a framework with recommendations to guide the implementation of efforts to increase awareness and strengthen public health initiatives; build laboratory networks and surveillance systems; stimulate research and improve access to diagnosis and treatment; and address factors that contribute to disease and resistance. It aims to support countries in their disease response and to make more fungal diseases reportable to public health officials. Across the United States, for example, while reporting priorities vary across different states, the only fungal diseases that have been prioritized as legally reportable nationally are coccidioidomycosis (Valley fever) and Candida auris—which are only a small portion of those that can impact human health.

Chiller said that he hopes the report will bring more attention to the prevalence and also morbidity of these infections to improve available funding. Increasing resources will be particularly useful for investing in new treatments to stave off antifungal resistance.

Additionally, Australian researchers are in the final stages of launching an automated fungal infection surveillance platform that will help digitally survey fungal disease across the continent.

The digital platform, called the Design Thinking Framework, was built from a review of multiple sources of clinical information across a wide array of health care settings in Melbourne. It extracts information from electronic medical records (EMRs) using AI that’s trained to detect episodes of fungal disease even when it’s not explicitly mentioned. The tool will also provide a web-based platform accessible to physicians so that they can properly report future episodes of fungal disease and resistance.

Vlada Rozova, PhD, a senior lecturer in AI in Health at Monash University who originally headed up the project at the University of Melbourne, said the Design Thinking Framework will be helpful in monitoring what is being prescribed for fungal diseases across a range of hospitals to know when this leads to resistance and what can be done to reduce it, while also learning which treatments are most effective in helping patients.

“It will help clinicians to better evaluate the therapies that they’re providing their patients to know what’s necessary and in what particular types of patients certain antifungal agents are most effective,” said Rozova.

The biggest challenge for Rozova and her colleagues has been standardizing clinical annotations to ensure that reports are consistent across the platform. Getting clinicians to agree on which notes within EMRs indicate fungal disease and which indicate resistance has been and will continue to be a complex task because humans, unlike machines, aren’t standardized.

“If we can’t get humans to agree on what a fungal disease is, we can’t train a machine to look for it,” said Rozova.

Increased awareness will hopefully bring increased agreement and, with guidance from global bodies like the WHO and new digital surveillance platforms like this, will help to strengthen the global response to fungal infections and antifungal resistance.