Addressing the dual-use of antifungals and fungal antimicrobial resistance (fAMR) through a One Health approach
Year: 2026
Type: article
Abstract: Fungal antimicrobial resistance (fAMR) is accelerating, driven in part by the dual-use of antifungal modes of action in agriculture and medicine, threatening therapy. Addressing this challenge requires a unified One Health response that balances agricultural productivity, economic stability, and human and animal health. By focusing on the United Kingdom's policy approach, we argue that current efforts are constrained by fragmented governance, surveillance and regulation. To resolve this, we propose three policy recommendations: 1. a cross-government fAMR body, 2. mandatory environmental and clinical surveillance, and 3. for fungicide approvals to look beyond crop pathogens and integrate risk assessments for potential hotspots of resistance selection in human fungal pathogens. These measures will safeguard current and future antifungals while providing much-needed regulatory clarity and will be translatable to other national and regional contexts.
Institutions: British Society for Antimicrobial Chemotherapy, University of Manchester, University of Oxford, Royal Brompton & Harefield NHS Foundation Trust, Harefield Hospital, Imperial College London, Parliament of United Kingdom, F2G (United Kingdom), University of Exeter, UK Health Security Agency, MRC Centre for Medical Mycology, Agricultural Development Advisory Service (United Kingdom), Thames Water (United Kingdom), University of Nottingham, Public Health Wales, Cardiff University
Language: English
Subfield: Applied Microbiology and Biotechnology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $3,190
Funders: Canadian Institute for Advanced Research, Wellcome Trust, Department of Health and Social Care, University of Oxford, Directorate for Biological Sciences, Medical Research Council, Biotechnology and Biological Sciences Research Council, Natural Environment Research Council, St. John's College, University of Oxford
Awards: G1260009046, "Fungal One Health and Antimicrobial Resistance Network", Understanding the adaptability of Aspergillus fumigatus, Understanding and mitigating the impact of emerging antifungal resistance, Bridging the gap between environment and patient; investigating the risk and transmission of antifungal resistance in Aspergillus fumigatus, G4527599430, Mechanisms of Gene Flow in Pathogenic Fungi allowing Fungal Adaptation, MRC Centre for Global Infectious Disease Analysis (MRC GIDA), Understanding the eco-evolutionary drivers of emerging antifungal resistance, G6969331965, Understanding and mitigating the impact of emerging antifungal resistance
OpenAlex ID: W7162810797