News from the press

  • OVER A MILLION AIDS DEATHS PREVENTABLE BY 2020, SAYS GAFFI -  CALL ISSUED FOR IMPROVED DIAGNOSIS AND TREATMENT OF FUNGAL INFECTION

    GENEVA: [24th October 2016] Fungal infection causes around half of AIDS-related deaths, of which there were 1,100,000 in 20151.  A first of its kind analysis – ‘Modelling reduction in AIDS deaths’ by the University of Manchester’s Professor David W Denning2 and published today in Philosophical Transactions of the Royal Society B3 – suggests that the opportunity to save lives is being missed. 

    Using 2013 data of 1.5m deaths from AIDS, around 47% (700,000) were attributable to the four most common lethal fungal infections4 and 24% (360,000) to tuberculosis (TB).  Scenarios and projections to 2020 for the reduction of avoidable deaths were constructed based on published outcomes of the real-life impact of diagnostics and generic antifungal drugs.  The Global Action Fund for Fungal Infections (GAFFI) concluded that access to rapid diagnostics and antifungals could prevent just over 1,000,000 deaths by 2020.

    GAFFI analysis predicts that on the current trajectory there will be 740,000 AIDS-related deaths in 2020. GAFFI is calling for a global focus on identifying and treating fungal diseases which could reduce this figure by 42% to 426,000.

    Accelerating a reduction in AIDS-related deaths: With improved access to antiretroviral therapy and a focus on diagnosing TB co-infection, deaths from AIDS have been falling.  However, progress is slower than anticipated across the world.  The UNAIDS aspirational target of zero AIDS deaths by 2015 was not met5: however, on UNAIDS numbers, there was a 41% reduction in lives lost (from 2010 at 1.76 m to 1.1 m in 2015). 

    Continued failure to focus efforts on advanced HIV infection and the 47% with fungal infections means the current UNAIDS target of fewer than 500,000 annual deaths by 20206 will almost certainly be missed - as was the aspirational target of zero AIDS deaths by 2015.  Retention in care is a major factor but it is late presentation with overwhelming infection that is GAFFI’s primary concern. 

    On the third anniversary of GAFFI’s inception, the Foundation established to address access to fungal diagnostics and therapy worldwide, an urgent call is being made to focus attention on preventable opportunistic infections which account for most AIDS-related mortality, with a median age of death in the mid-30s. 

    Professor David Denning of GAFFI and the University of Manchester, comments: “Too many people die from AIDS, most of them adults in the prime of life.  Our analysis shows that diagnosing and treating fungal diseases complicating HIV infection will drive down AIDS deaths in the short term.  Action could and should be taken by donors, national and international public health agencies, non-governmental organisations and governments toward achieving the UNAIDS mortality reduction target and the recently announced 2030 Millennium Development Goals.”

    Denning continues, “Our projections reveal that by improving access to just 60% of those who need it, over 300,000 lives could be saved per year.  By 2020, a total of over a million lives could have been saved, helping to meet the UNAIDS mortality reduction target reducing AIDS deaths to 500,000 per year.”

    ”Dr Meg Doherty, Department of HIV and Global Hepatitis Programme, World Health Organisation, says: “The HIV/AIDS epidemic is one of the greatest global health challenges. We commend GAFFI’s call for global concerted action to address the large number of AIDS deaths caused by fungal infection. Widespread adoption of rapid tests for fungal disease and adoption of the WHO’s cryptococcal guidelines should reduce mortality.  Country-level integration of fungal disease interventions and treatment guidelines into existing HIV and TB programmes and national strategies would offer a leap forward in achieving everyone’s goal of reducing AIDS deaths.” 

     

    -Ends-

    Notes to editors

     

    References:

    11.1 million [940 000 – 1.3 million] people died from AIDS-related illnesses in 2015 (Fact sheet 2016 | UNAIDS (http://www.unaids.org/en/resources/fact-sheet) and 1,340,000 is the figure used in the GAFFI analysis.   The absence of accurate death registration in many countries precludes highly accurate mortality statistics.

     

    2 David W. Denning FRCP FRCPath FMedSci is the current President of GAFFI.  He is also Professor of Medicine and Medical Mycology, University of Manchester and the Director of the National Aspergillosis Centre (NAC), University Hospital of South Manchester, UK.

    The NAC has been commissioned by the Department of Health to provide long term care for patients with chronic pulmonary aspergillosis.

     

    3 Publication: Denning DW. How the UNAIDS target of reducing annual AIDS deaths below 500,000 by 2020 can be achieved. Phil Trans Roy Soc B, In press.  The analysis used a linear prediction scenario exercise, and compared the current slow downward trajectory of AIDS deaths with gradually increasing efforts to diagnose and treat fungal disease, as well as the benefits of increased ARVs. The HIV statistics used by GAFFI were based on 2013 deaths of 1.5 million, which were readjusted downwards in 2014 to 1.2 million, by UNAIDS, after the analysis was done. The absence of accurate death registration in many countries precludes highly accurate mortality statistics.

     

    4 The major fungal causes of death in AIDS patients are: cryptococcal meningitis, Pneumocystis pneumonia (PCP), disseminated histoplasmosis and aspergillosis. Rapid diagnostic tools and antifungal agents are available for these diseases, and the study found that with 60% coverage, annual deaths for cryptococcal disease could fall by 70,000, PCP by 162,500, disseminated histoplasmosis by 48,000 and chronic pulmonary aspergillosis by 33,500.

     

    5 UNAIDS 2011 – 2015 Strategy ‘Getting to Zero’

    http://www.unaids.org/sites/default/files/sub_landing/files/JC2034_UNAID...

     

    6 UNAIDS 2016 United Nations political declaration 2016: http://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2016/june/20160608_PS_HLM_PoliticalDeclaration

     

    The Global Action Fund for Fungal Infections (GAFFI www.gaffi.org): GAFFI’S vision is to reduce illness and death associated with fungal diseases worldwide. GAFFI works to improve the health of patients suffering from serious fungal infections through better patient care, improved access to diagnostics and treatment, and by provision of educational resources to health professionals. As a Geneva-based Foundation, GAFFI is the major advocacy and fund raising body for a number of implementing partners, including governments and both national and international global health agencies. GAFFI issued a 10 year Roadmap in 2015 entitled ’95-95 by 2025’ calling for 95% of the world’s population to have access to fungal diagnostics and antifungal therapy by 2025.

     

    For further information and interviews contact: Kat McCamley, Iona Cousland or Julie Flexen (tbc) at Munro & Forster Communications on 020 7089 6100 or [email protected]

  • LIVING WITH UK BURDEN OF FUNGAL ASTHMA GREATLY EXCEEDS PRIOR ESTIMATES NEW STUDY WARNS

    Experts at the National Aspergillosis Centre and Manchester Academic Health Science Centre are warning of a significant increase in the number of people in the UK who are living with invasive and serious fungal diseases that affect the lungs, bloodstream and brain and can sometimes lead to death.

    While invasive fungal infections were estimated by the Health Protection Agency in 20061 a new report published today* is the first comprehensive attempt to capture how many people in the UK suffer from fungal asthma.

    Asthma in adults is common in the UK with over 4 million reported cases, and researchers in Manchester believe as many as 300,000 of them are affected by fungal asthma.

    The research from the National Aspergillosis Centre and MAHSC (Manchester Academic Health Sciences Centre), based at The University of Manchester – is published by the British Infection Association.

    Fungal asthma is such a big problem because the UK has one of the highest rates of asthma internationally. The range of estimate reflects uncertainty as no community study has ever been done, despite the large number affected. Asthmatics allergic to and exposed to higher amounts of fungi that they breathe in usually have poor asthma control and require steroid boosters. Antifungal therapy benefits these people, and may prevent deaths from asthma, doctors believe.

    Invasive aspergillosis is the commonest missed infectious diagnosis in intensive care in the UK. It is always fatal without therapy and affects from 3,288 to 4,257 patients each year, most undiagnosed. Treated invasive aspergillosis has a 30-85 per cent mortality depending on the patient group.

    Dr Bradford Winters in 2012 analysed deaths in intensive care, and invasive aspergillosis was the commonest missed infectious diagnosis2.

    Pneumocystis pneumonia has been increasing, especially in the non-HIV group, and probably affects over 500 annually. 15-50 per cent of these patients die, even if treated.

    Although 1,700 cases of Candida bloodstream infections are reported annually, the actual estimate of tissue invasive cases in hospitalised and critically ill people is 5,124. This carries a ~45% mortality, if diagnosed and treated.

    A Health Protection Agency report from 2006 estimated that ~66 per cent of those who die of fungal infection could have been saved with faster recognition and rapid diagnosis.

    Experts believe rarer infections and antifungal resistant infections are probably on the increase, including Candida auris and multi-resistant Aspergillus fumigatus derived from the environment.

    Professor David Denning Director of the National Aspergillosis Centre at the University Hospital of South Manchester, explained: ‘While the UK is rich in data sources, there is a remarkable poverty of contemporary studies of fungal diseases. An accurate estimate of total burden will ultimately rely on improved diagnostic testing and laboratory reporting.

    “This report gets us closer to true burden of fungal diseases in the UK – necessary for improved diagnosis and reducing death. The scale of the ‘fungal asthma’ problem is staggering, and potentially remediable with antifungal therapy, as I know from treating hundreds of affected patients,” he added.

     

    For more in formation please contact Susan Osborne, Director of Communications at The Goodwork Organisation on 07836 229208.

    Note to Editors

    1.http://webarchive.nationalarchives.gov.uk/20140714084352/http://www.hpa.org.uk/webc/hpawebfile/hpaweb_c/1196942156347

    2. Winters B, Custer J, Galvagno SM Jr, Colantuoni E, Kapoor SG, Lee H, Goode V,  Robinson K, Nakhasi A, Pronovost P, Newman-Toker D. Diagnostic errors in the intensive care unit: a systematic review of autopsy studies. BMJ Qual Saf. 2012 Nov;21(11):894-902. Link http://qualitysafety.bmj.com/content/21/11/894

    Fungal asthma is an umbrella term for allergic bronchopulmonary aspergillosis (ABPA), severe asthma with fungal sensitization (SAFS) and fungal-associated airways disease. Almost all patients are adults, as these condictions are rare in children. Patients sensitized (ie allergic) to fungi have much worse asthma, attend and are admitted to hospital more often, need more corticosteroids and probably are more likely to die of asthma. About 197 million adults have asthma across the world and an estimated 4.8 million have ABPA and over 6.5 million (3%) have SAFS.

    Cases of fungal disease compared with other health problems in the UK:

    TB – 5,758 cases in 2015

    Malaria – 1,400 cases in 2015

    New HIV diagnoses - 6,151 in 2014

    Meningococcal (meningitis) disease – 805 cases in 2015/16

    Multiple sclerosis – 107,000 in 2016

    Breast cancer - 53,696 in 2013, with 11,433 deaths

    Rheumatoid arthritis 297,600 in 2002

  • F2G Ltd announces publication of initial F901318 data in scientific journal PNAS

    F901318 represents a novel class of antifungal drug, the orotomides

    Currently in clinical development for the treatment of invasive aspergillosis


    MANCHESTER, UK – 26 October 2016 - F2G Ltd, the UK-based antifungal drug discovery and development company, today announced the publication of the initial F901318 data in the prestigious scientific journal Proceedings of the National Academy of Sciences (PNAS), of their work in elucidating the mechanism of action of its novel orotomide antifungal - lead candidate F901318. The study entitled “F901318 represents a novel class of antifungal drug that inhibits dihydroorotate dehydrogenase” can be found here: http://www.pnas.org/content/early/2016/10/24/1608304113.abstract

    The identification of dihydroorotate dehydrogenase (DHODH) as the mechanism by which F901318 inhibits and kills Aspergillus fumigatus was a major breakthrough differentiating F901318 from all other systemic antifungal agents. DHODH represents one of only a handful of clinically validated antifungal drug targets. The paper describes the genetic and biochemical techniques used to identify and conclusively confirm DHODH as the target of F901318 and also the in vivo activity of the drug in severe infection models.

    Aspergillosis is a serious pulmonary infection caused by Aspergillus, a common fungus that affects people with weakened immune systems or lung diseases. Due to its novel mechanism of action, F901318 is active against drug resistant Aspergillus species and other rare moulds offering potentially life-saving therapy options.

    Dr Jason Oliver, Lead author and Head of Biochemistry, F2G Ltd said: “We are delighted that PNAS recognised the importance of our work in the identification and validation of DHODH as an antifungal target. New antifungal drugs that act via novel mechanisms are urgently needed to combat the high mortality of invasive fungal disease and the emergence of resistance to existing therapies. We are focussed on exploiting DHODH fully to develop the next generation of systemic antifungals.”
    Ian Nicholson, Chief Executive Officer, F2G Ltd added: “The antifungal pipeline has failed to produce new antifungal drugs with mechanisms of action different from those of existing classes in the past 15 years since caspofungin was licensed in 2001. F901318 is active against drug resistant Aspergillus species and other rare moulds offering potentially life-saving therapy options. We are thrilled that the hard work and dedication of Jason and his team has resulted in this publication in such a leading peer reviewed international journal.”

    F2G plans to advance its lead compound, F901318 to completion of a pivotal registration study, and to further develop earlier stage assets in its pipeline.
    About F2G Ltd: F2G is a world leading UK biotech company focused on the discovery and development of novel therapies to treat life threatening invasive fungal infections, with experienced management & board. F2G has discovered and developed a completely new class of antifungal agents called the orotomides. The orotomides are active against Aspergillus and other rare and resistant moulds and act via a completely different mechanism than currently marketed antifungal agents. Due to their new mechanism of action, orotomides are active against fungal infections resistant to current therapies, a growing problem globally. A limited Phase II study for F901318 is planned imminently with pivotal registration trials in Invasive Aspergillosis planned for 2017 based on an accelerated regulatory pathway agreed with the relevant agencies. F901318 is being developed both as IV and oral formulations and promises to have a safe and well-tolerated profile. The company recently announced a $60 million financing to develop its pipeline of novel therapies to treat life threatening invasive fungal infections.

    Contact:
    F2G Ltd
    Ian Nicholson | Chief Executive Officer
    [email protected] | +44 (0)161 785 1271 | www.f2g.com
    Hume Brophy
    Mary Clark, Supriya Mathur, Alex Protsenko
    [email protected] | +44 (0)207 862 6475

  • OVER A MILLION AIDS DEATHS PREVENTABLE BY 2020 SAYS GAFFI

    October 24 2016

    Call issued for improved diagnosis and treatment of fungal infection.

    Geneva: 24th October 2016

    Fungal infection causes around half of AIDS-related deaths, of which there were 1,100,000 in 20151.  A first of its kind analysis – ‘Modelling reduction in AIDS deaths’ by the University of Manchester’s Professor David W Denning2 and published today in Philosophical Transactions of the Royal Society B3 – suggests that the opportunity to save lives is being missed. 

    Using 2013 data of 1.5m deaths from AIDS, around 47% (700,000) were attributable to the four most common lethal fungal infections4 and 24% (360,000) to tuberculosis (TB).  Scenarios and projections to 2020 for the reduction of avoidable deaths were constructed based on published outcomes of the real-life impact of diagnostics and generic antifungal drugs.  The Global Action Fund for Fungal Infections (GAFFI) concluded that access to rapid diagnostics and antifungals could prevent just over 1,000,000 deaths by 2020.

    GAFFI analysis predicts that on the current trajectory there will be 740,000 AIDS-related deaths in 2020. GAFFI is calling for a global focus on identifying and treating fungal diseases which could reduce this figure by 42% to 426,000.

    Accelerating a reduction in AIDS-related deaths: With improved access to antiretroviral therapy and a focus on diagnosing TB co-infection, deaths from AIDS have been falling.  However, progress is slower than anticipated across the world.  The UNAIDS aspirational target of zero AIDS deaths by 2015 was not met5: however, on UNAIDS numbers, there was a 41% reduction in lives lost (from 2010 at 1.76 m to 1.1 m in 2015). 

    Continued failure to focus efforts on advanced HIV infection and the 47% with fungal infections means the current UNAIDS target of fewer than 500,000 annual deaths by 20206 will almost certainly be missed - as was the aspirational target of zero AIDS deaths by 2015.  Retention in care is a major factor but it is late presentation with overwhelming infection that is GAFFI’s primary concern. 

    On the third anniversary of GAFFI’s inception, the Foundation established to address access to fungal diagnostics and therapy worldwide, an urgent call is being made to focus attention on preventable opportunistic infections which account for most AIDS-related mortality, with a median age of death in the mid-30s. 

    Professor David Denning of GAFFI and the University of Manchester, comments: “Too many people die from AIDS, most of them adults in the prime of life.  Our analysis shows that diagnosing and treating fungal diseases complicating HIV infection will drive down AIDS deaths in the short term.  Action could and should be taken by donors, national and international public health agencies, non-governmental organisations and governments toward achieving the UNAIDS mortality reduction target and the recently announced 2030 Millennium Development Goals.”

    Denning continues, “Our projections reveal that by improving access to just 60% of those who need it, over 300,000 lives could be saved per year.  By 2020, a total of over a million lives could have been saved, helping to meet the UNAIDS mortality reduction target reducing AIDS deaths to 500,000 per year.”

    Dr Meg Doherty, Department of HIV and Global Hepatitis Programme, World Health Organisation,says: “The HIV/AIDS epidemic is one of the greatest global health challenges. We commend GAFFI on drawing attention to undiagnosed and untreated fungal infections among people living with HIV.  We need to do more work to better understand the contribution of fungal infections to HIV morbidity and mortality and assuring that our current recommendations on screening and treating fungal infections are implemented at country level.  The identification and early treatment of HIV should be a priority to save lives.”  

    En espanol

    References: Note to editors

    11.1 million [940 000 – 1.3 million] people died from AIDS-related illnesses in 2015 (Fact sheet 2016 | UNAIDS http://www.unaids.org/en/resources/fact-sheet) and 1,340,000 is the figure used in the GAFFI analysis.   The absence of accurate death registration in many countries precludes highly accurate mortality statistics.

    2 David W. Denning FRCP FRCPath FMedSci is the current President of GAFFI.  He is also Professor of Medicine and Medical Mycology, University of Manchester and the Director of the National Aspergillosis Centre (NAC), University Hospital of South Manchester, UK.

    The NAC has been commissioned by the Department of Health to provide long term care for patients with chronic pulmonary aspergillosis.

    3 Publication: Denning DW. How the UNAIDS target of reducing annual AIDS deaths below 500,000 by 2020 can be achieved. Phil Trans Roy Soc B, In press.  The analysis used a linear prediction scenario exercise, and compared the current slow downward trajectory of AIDS deaths with gradually increasing efforts to diagnose and treat fungal disease, as well as the benefits of increased ARVs. The HIV statistics used by GAFFI were based on 2013 deaths of 1.5 million, which were readjusted downwards in 2014 to 1.2 million, by UNAIDS, after the analysis was done. The absence of accurate death registration in many countries precludes highly accurate mortality statistics.

    4 The major fungal causes of death in AIDS patients are: cryptococcal meningitis, Pneumocystispneumonia (PCP), disseminated histoplasmosis and aspergillosis. Rapid diagnostic tools and antifungal agents are available for these diseases, and the study found that with 60% coverage, annual deaths for cryptococcal disease could fall by 70,000, PCP by 162,500, disseminated histoplasmosis by 48,000 and chronic pulmonary aspergillosis by 33,500.

    5 UNAIDS 2011 – 2015 Strategy ‘Getting to Zero’

    http://www.unaids.org/sites/default/files/sub_landing/files/JC2034_UNAID...

    UNAIDS 2016 United Nations political declaration 2016:http://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2016/june/20160608_PS_HLM_PoliticalDeclaration

    The Global Action Fund for Fungal Infections (GAFFI): GAFFI’S vision is to reduce illness and death associated with fungal diseases worldwide. GAFFI works to improve the health of patients suffering from serious fungal infections through better patient care, improved access to diagnostics and treatment, and by provision of educational resources to health professionals. As a Geneva-based Foundation, GAFFI is the major advocacy and fund raising body for a number of implementing partners, including governments and both national and international global health agencies. GAFFI issued a 10 year Roadmap in 2015 entitled ’95-95 by 2025’ calling for 95% of the world’s population to have access to fungal diagnostics and antifungal therapy by 2025.

    For further information and interviews contact: Kat McCamley at Munro & Forster Communications on 020 7089 6100 or [email protected]

  • How fungi kill millions globally

    What do you think of when you hear the word fungi? Mushrooms? Athlete's foot? General mold?

    Whatever comes to mind, the fact is that when most of us think of fungal infections, we think of something mild and unpleasant at best.

    But these tiny organisms can be fatal and kill an estimated 1.5 million people globally each year. It's a shockingly high figure and is greater than the number of people who die from malaria, more than twice the number of women who die from breast cancer, and an equivalent number to those who die from tuberculosis, or HIV, each year, according to professor Neil Gow, President of the Microbiology Society.

     

    Antimicrobial-resistant microbes (on the right)

    Superbugs: 5 things to know about antimicrobial resistance

    Of course, it's not the superficial infections like athlete's foot that are killing millions. There are certain kinds of fungal infections that can invade our blood, lungs and other organs within the body -- and there are a lot of them out there.

    Matching the number of deaths each year, there are around 1.5 million species of fungi -- tiny microbes found in soil, air and water -- and we interact with them every day. Three hundred of these are known to make people sick, with some proving to be fatal.

    Fatal fungi

    "Almost nobody has heard of Cryptococcus, Candida, or Aspergillus, but the three of those probably account for more than a million deaths every year," says Gow.

    He estimates that the fungus Cryptococcus, which mainly affects people with HIV in sub Saharan Africa, is killing between 200-600,000 people every year.

    When Pneumocystis is added to the mix, these four fungi account for more than 90% of fatal fungal infections worldwide, says Gow.

    And importantly, they aren't rare. In fact, most of us are in contact with them regularly.

    "Somewhere between 100 to 300 spores of a fungus called Aspergillus get in our lungs every day," says Gow, "We deal with it perfectly well because our lungs are full of immune cells, which patrol around looking for these spores, and they swallow them up and kill them."

    But for people with weakened immune systems, Aspergillus can cause lung disease and can kill after as little as 10-14 days, according to David Denning, professor of Infectious Diseases in Global Health from the University of Manchester. "It's fairly uncommon, but still life-threatening," he says.

    People with asthma and cystic fibrosis -- a genetic condition that can lead to excess mucous in the lungs -- are also more susceptible to lung disease from Aspergillus, which can cause pneumonia-like symptoms for them, such as coughing up mucus and wheezing.

    These fungi are also some of the most misdiagnosed infections in intensive care units in the UK according to Denning, which, when coupled with late diagnosis and the presence of severe underlying diseases, is what makes them deadly.

    From mild to deadly

    Not all infections are fatal. Treatable skin infections, or dermaticites, could be considered the most common fungal infection of all, affecting as many as 1-2 billion people, and resulting in ringworm, athlete's foot and even dandruff, says Gow.

    Many healthy people also naturally carry the species of yeast-like Candida fungi in, and on, their bodies, without it being harmful. Candida can also cause superficial infections like vaginal thrush and while this is treatable, it remains a burden for many, with 100 million women suffering four or more episodes annually.

    But even seemingly mild fungi like candida can prove deadly when immune systems are weakened. People living with HIV/AIDS, organ transfer patients, or cancer patients undergoing chemotherapy are vulnerable to this range of fungal infections that would normally be harmless or treatable.

    The burden on healthcare systems is equally huge, with hospitalization costs estimated to range from $11,000 to $57,000 for a patient with an invasive fungal infection -- and experts are warning that the issue needs more attention.

    Preventing infection

    "Prevention is better than a cure," says Gow. "One of the things about fungi is that they're quite difficult to dislodge once they start to grow.

    "There's not a single vaccine against any fungus at the moment."

    Without the option of a vaccine, hospitals have to work hard to avoid exposure: patients can be given drugs to help prevent infection, some hospital wards may not allow flowers because of the risk of fungal spores spreading, and they can also use air filtration barriers to protect patients. But the public also need to be informed to avoid exposure.

    "It's still the case that this information is not really even understood, and not fully appreciated by all members of even the professional community of microbiologists, and certainly not by the general public," says Gow.

    The hope is that these little known infections will gain more recognition for what they really are -- global killers.

     

    Story written by Susie East for CNN news

    Microbes on the right are all resistant to antimicrobial

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