The majority of GAFFI’s work has been conducted on a volunteer basis with direct support for the 4 Global Fungal Infection Forum meetings and the Guatamala demonstration project.
- Influenced the WHO to include several key diagnostic tests for fungi on the first Model List of in vitro Diagnostic Tests including microscopy, fungal culture, blood culture, cryptococcal and Histoplasma antigen testing, Aspergillus antigen testing, Aspergillus antibody testing, and Pneumocystis PCR. View Global Fungal Infection Forum 3 Report. View press release on WHO Essential Diagnostics List.
- Working with the local NGO ASI, GAFFI’s program in AIDS in Guatemala. of a national program of fungal disease diagnosis and management has shown a fall in mortality in 2 years of 7% https://gaffi.org/fungal-disease-diagnosis-is-lifesaver-for-patients-with-hiv-and-aids/
- Successfully lobbied the WHO to place amphotericin B and flucytosine on the Essential Medicines List to treat cryptococcal meningitis and other life-threatening fungal infections, in a coalition with other agencies including US Centres for Disease Control, attendees from LIFE, WHO, Medicines Sans Frontieres (MSF), Clinton Health Access and numerous universities and public health institutions.” View selection and use of Essential Medicines.
- Successfully lobbied the WHO to place itraconazole, voriconazole, and natamycin 5% ophthalmic solution onto the Essential Medicines List (EML) to treat aspergillosis, histoplasmosis, sporotrichosis, chromoblastomycosis T. marneffei infection and other skin infection, as well as fungal keratitis, in a coalition with the Instituto de Salud Carlos III, International Foundation for Dermatology, London School of Hygiene of Tropical Medicine and The University of Manchester. https://gaffi.org/ruling-by-world-health-organisation-delights-doctors/
- Encouraged and supported the WHO in developing and then broadcasting the first-ever Fungal Pathogen Priority List, issued in October 2022. This list identified 4 fungal pathogens as ‘critical’. [View GAFFI press release]
- Documented the availability and cost of generic antifungal (amphotericin B, fluconazole, itraconazole, voriconazole, flucytosine and natamycin eye drops) in almost all countries (see the maps here) and published: https://gaffi.org/limited-availability-of-generic-antifungals-across-the-world.
- Documented the availability of diagnostics for cryptococcal meningitis, the key treatments for it, and country guidelines for all African countries, in the world’s first dashboard for this disease.
- Launched the 10-year Roadmap ‘95-95 by 2025’ at the ISHAM conference in Melbourne, calling on all national governments and public health agencies to reduce the toll of death and blindness from fungal diseases. 95-95 means 95% of patients with life or sight-threatening fungal disease will be diagnosed and 95% treated by 2025. GAFFI proposed a target of reducing AIDS deaths to under 500,000 by 2020, which has been adopted by UNAIDS as a key target. 10 year ’95-95 by 2025′ GAFFI Roadmap.
- GAFFI and its partners have estimated the global burden of serious fungal infections for >6 billion people (over 80% of the world’s population) including Algeria, Argentina, Australia, Austria, Azerbaijan, Bangladesh, Belgium, Belarus, Benin, Bolivia, Brazil, Burkina Faso, Cameroon, Canada, Chile, China, Congo (Democratic Republic of (DRC)), Congo (Republic of), Costa Rica, Cote d’Ivoire, Cuba, Czech Republic, Denmark, Dominican Republic, Ecuador, Egypt, Eritrea, Ethiopia, France, Germany, Ghana, Greece, Guatemala, Honduras, Hungary, India (3 topics), Indonesia, Iran, Iraq, Ireland, Israel, Italy, Jamaica, Japan, Jordan, Kazakhstan, Kenya, Kuwait, Kyrgyzstan, Madagascar, Malawi, Mali, Malaysia, Mexico, Mongolia, Morocco, Mozambique, Namibia, Nepal, Netherlands, New Zealand, Nicaragua, Nigeria, Norway, Oman, Pakistan, Panama, Paraguay, Peru, Philippines, Portugal, Qatar, Romania, Russia, Saudi Arabia, Senegal, Serbia, Singapore, South Africa, South Korea, Spain, Sri Lanka, Sudan, Sweden, Taiwan, Tajakistan, Tanzania, Thailand, Trinidad and Tobago, Togo, Turkey, Uganda, UK, Ukraine, Uruguay, Uzbekistan, Venezuela, Vietnam, Zambia and Zimbabwe: https://gaffi.org/media/country-fungal-disease-burdens/
- Successfully applied for the WHO to recommend to the World Health Assembly for the disfiguring skin disease chromoblastomycosis and other deep mycoses (sporotrichosis and paracoccidioidomycosis) to be included as Neglected Tropical Disease (NTD), with support form the governments of Brazil and Madagascar. View press release.
- Successfully lobbied the WHO to include the echinocandins (micafungin, caspofungin, and anidulafungin) onto the Essential Medicines List (EML) to treat invasive candidiasis, Candida bloodstream infections, and aspergillosis in collaboration with Universidad Nacional del Litoral, Argentina. https://gaffi.org/antifungal-echinocandins-added-to-the-whos-essential-medicines-list/
- GAFFI has modeled how many lives could be saved from AIDS over 5 years with 60% implementation of fungal diagnostics and antifungal drug availability for cryptococcal meningitis, disseminated histoplasmosis, Pneumocystis pneumonia (PCP) and chronic pulmonary aspergillosis – over 1 million. View press release.
- GAFFI has pointed out in a perspective published in the CDC journal Emerging Infectious Diseases that the availability of rapid, non-culture-based diagnostics for fungal diseases is essential in the fight against Antimicrobial Resistance (AMR) by limiting unnecessary anti-bacterial therapy. View press release.
- Developed consensus recommendations on the diagnosis of chronic pulmonary aspergillosis after TB, so often misdiagnosed as ‘smear-negative TB. View Global Fungal Infection Forum 2 Report. View press release.
- GAFFI drafted the revisions to the International Classification of Diseases for ICD11, in collaboration with the WHO. https://icd.who.int/en This is crucial to the collection of data internationally, as data is coded using ICD codes all over the world.
- Supported the Ending Cryptococcal Meningitis Deaths by 2030 strategic framework in collaboration with the WHO (HIV Treatment and Care), CDC (Mycotic Diseases Branch), MSF (Access Campaign), Clinton Health Access Initiative (CHAI) and International treatment Preparedness Coalition (ITPC) and Drugs for Neglected Diseases initiative (DNDi).
- Supports the Histoplasmosis Action Group (HistoAG) a collaboration between numerous clinicians and researchers, the US Centers for Disease Control, the Caribbean Public Health Agency and Prevention, and the Pan-American Health Organisation which issued the Manaus Declaration in March 2019 calling for “ Every American country to have access to rapid testing for histoplasmosis (antigen or PCR/molecular) and availability of itraconazole and both standard and lipid formulations of amphotericin B.” View. This resulted in PAHO and WHO issuing the world’s first guidelines for disseminated histoplasmosis in AIDS.