The impact of COVID-19 pandemic on invasive fungal infections in Africa: What have we learned?

Abstract

Invasive fungal infections (IFIs) have been described as diseases of the poor. The mortality rate of the infections is comparable to that of malaria, HIV, and TB, yet the infections remain poorly funded, neglected in research, and policy at all levels of human resources. The Coronavirus Disease 2019 (COVID-19) pandemic has further worsened the current state of management for IFIs. At the same time, response to COVID-19 has stirred and boosted vaccine production, vaccine substance manufacturing, and building of next-generation sequencing capacity and genomics data sharing network in the continent. Through collaboration and transdisciplinary research effort, these network and technology can be extended to encourage fungal research to address health issues of existing and emerging fungal pathogens.

Fig 1. Lessons learned from COVID-19 pandemic influence on IFIs.

In endemic regions, IFIs, malaria, HIV, and TB are common due to poverty. However, due to limited awareness, and low research funding, limited rapid and accurate diagnostics, and effective therapeutic options, compared to malaria, HIV, and TB, IFIs have not received adequate priority despite their high prevalence. (1) Negative effects of COVID-19 on IFIs: The emergence of COVID-19 pandemic attracted all medical attention, resources and funding for emergency response and containment, and research; thereby, it is assumed to exacerbate the existing conditions of IFIs and increase burden. (2) Positive effects of COVID-19 response: Through sheer ambition and strategic investment including contributions from donors such as Illumina, Oxford Nanopore, Microsoft, and Gates Foundation, African governments have pledged to expand vaccine production and strengthen vaccine substance manufacturing capacity to meet with up to 60% of local vaccine needs in the next 2 decades. The response to COVID-19 also stimulated expansion of capacity and expertise in next-generation sequencing technology and deepened collaboration in genomic data sharing networks through African Pathogen Genomics Initiative. (3) Feedback effects: These technologies and networks are now used in surveillance of SARS-CoV-2 evolution to tackle new threats. (4) Benefits: The virus-driven development in genome sequencing and vaccine manufacturing technologies and genomic data sharing network have wide application and can be used to drive research in IFIs and other neglected infections through collaborative efforts. COVID-19, Coronavirus Disease 2019; FNTD, fungal neglected tropical disease; IFI, invasive fungal infection; SARS-CoV-2, Severe Acute Respiratory Syndrome Coronavirus 2; TB, tuberculosis.