The concerns raised by scientists from Cologne regarding the severely limited availability of flucytosine are not only valid but also demand immediate attention from both authorities and the pharmaceutical industry. Professor Dr. Oliver A. Cornely, who leads the efforts at the CECAD Cluster of Excellence for Ageing Research, has taken a significant step towards addressing this issue by publishing a commentary in The Lancet Regional Health – Europe in collaboration with the hospital pharmacy and the microbiology department of the University Hospital of Cologne (UHC) [https://www.sciencedirect.com/science/article/pii/S2666776223000777].
Global Action for Fungal Infections (GAFFI) has been actively advising international health organisations since 2013, stressing the critical need for global availability of flucytosine. The drug, originally developed in the 1950s as a cancer treatment, plays a pivotal role in combating various invasive fungal infections and has been classified as an essential medication by the World Health Organization (WHO). Consequently, it is imperative to ensure its availability worldwide, as it has proven to be a life-saving treatment for those facing life-threatening fungal infections.
The lack of access to flucytosine has been an ongoing challenge in numerous countries across Africa, South America, and Asia, where cryptococcal infections pose a significant threat. However, the recent shortage of flucytosine in Europe suggests that the problem has expanded beyond these regions, raising concerns about its global availability. Dr. Sprute strongly criticises the reliance of European pharmacies on remaining stocks for the past two years, emphasising that such a situation is no longer acceptable for patients in need. Professor Cornely shares this sentiment and emphasises the urgent need for action, urging both authorities and the pharmaceutical industry to take responsibility in ensuring the production and distribution of this vital drug.
GAFFI underscores the critical importance of addressing the limited availability of flucytosine on a global scale. They advocate for a clear path to getting antifungal drugs listed in the Essential Medicines List of the WHO, ensuring their availability worldwide. Flucytosine serves as a clear example, but it represents just the tip of the iceberg regarding this chronic problem. Without access to diagnosis and treatment of fungal disease, we cannot effectively combat life-threatening fungal infections, save lives, and protect vulnerable patients worldwide.