Rising threat of antifungal resistance

World Antimicrobial Resistance (AMR) Awareness Week, focusing on “Educate. Advocate. Act Now,” has had limited impact on community awareness and behavioral change towards rational antimicrobial use. AMR, a’silent pandemic’, has claimed three lives per minute since 1990 and is projected to increase to 1.9 million deaths annually by 2050. The economic impact is significant, with the World Bank estimating AMR could cost up to $1trn globally by mid-century and force 28 million into extreme poverty by 2050. AMR affects both humans and animals, with escalating antifungal use in veterinary and agriculture contributing to resistant strains. Aflatoxin contamination is a significant concern in Nepal, particularly in maize, rice, and animal feed. Climate change exacerbates the fungal threat by promoting fungal growth and aflatoxin production through erratic rainfall, seasonal variation, poor air quality, and shifting monsoon patterns. Droughts and flooding spread spores, while climate change allows fungi to spread into new areas and adapt to higher temperatures, increasing the prevalence of pathogens like Candida auris.