10 year Roadmap 95-95 by 2025 David W. Denning President GAFFI The University of Manchester

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10 year Roadmap 95-95 by 2025David W.
DenningPresident GAFFIThe University of
Manchester
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• GAFFI is calling for
• By 2025, ensure that 95 of people with serious
  fungal disease are diagnosed and 95 treated

www.GAFFI.org
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Deaths from fungal infection need to fall
Fungal Infection TB (2013) Malaria (2013)
gt1,350,000 1,500,000 627,000
www.GAFFI.org
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1.5 million deaths from AIDS in 2013330,000 due
to TB700,000 due to fungal disease?
www.GAFFI.org
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Diagnosis
Ensure that affordable diagnostic tests for all
common and uncommon fungal infections are made
available and focused on rapid, non-culture
testing.
www.GAFFI.org
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GAFFI is calling for
At least one expert in fungal disease
diagnostics in each country. The focus should be
on non-culture-based tests. Strong clinical links
are very important.
www.GAFFI.org
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Core tests for mycology reference laboratories
www.GAFFI.org
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Treatment GAFFIs aim
Ensure distribution of antifungal agents on the
WHO Essential Medicine List to reach all those
who need them.
www.GAFFI.org
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WHO Essential Medicines List
Griseofulvin Fluconazole Amphotericin
B Flucytosine Topicals GAFFI has applied for
itraconazole to be added
www.GAFFI.org
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www.gaffi.org/why/burden-of-disease-maps/
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www.gaffi.org/why/burden-of-disease-maps/
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• GAFFI is calling for
• a network of expert clinicians and train the
  trainer programs, supported by clinical
  guidelines, in each country and region

www.GAFFI.org
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www.LIFE-Worldwide.org
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• ISHAM members and mycology experts need to grasp
  these issues and try and impact on clinical
  practice across the world and in each part of
  each country

www.GAFFI.org
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• Public health

Public health mycology is a non-existent
discipline, which needs fostering by Schools of
Public Health, scholarship programs, development
of surveillance networks and incorporation into
mainstream global health institutions.
www.GAFFI.org
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• Global public health and fungal diseases

• WHO Cryptococcal/HIV guidelines (2013/5)
• Amphotericin B and flucytosine placed on WHO
  Essential Medicine List (2013)
• Mycetoma accepted as Neglected Tropical Disease
  (2013)
• WHO skin and oral health in HIV guidelines (2014)

www.GAFFI.org
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• Global public health and fungal diseases

• WHO Cryptococcal/HIV guidelines (2013/5)
• Amphotericin B and flucytosine placed on WHO
  Essential Medicine List (2013)
• Mycetoma accepted as Neglected Tropical Disease
  (2013)
• WHO skin and oral health in HIV guidelines (2014)
• Very few national surveillance programs
• DALYs and QALYs only for cryptococcal meningitis
• GBD/IHME efforts have ignored all fungal diseases
• Economic modelling only for invasive mycoses in
  high income countries

www.GAFFI.org
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• A major goal is to reduce AIDS deaths due to
  fungal infections

Support 90-90-90 Reduce AIDS deaths to lt500,000
by 2020 Focus on the commonest lethal fungal
infections - cryptococcal meningitis,
Pneumocystis pneumonia, disseminated
histoplasmosis and chronic pulmonary
aspergillosis after tuberculosis
www.GAFFI.org
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• Reducing AIDS deaths due to fungal infections

www.GAFFI.org
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Friends of GAFFI - our 4 tasks

• Universal access to diagnostics for serious
  fungal disease
• Universal access to antifungal agents
• Accurate data on the number and severity of
  fungal infections
• Health professional education related to better
  recognition and care for patients with serious
  fungal disease

www.GAFFI.org
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• Leave no one behind

Too many people have no access to life-saving
diagnostics and antifungal medicine This has to
change
www.GAFFI.org