There have been confirmed cases of infection from the US, and is believed to be present in India, Pakistan and other South Asian countries. It is dangerously persevering, given it is resistant to almost all major anti-fungal medication.
The New York Times (NYT) warns of imminent catastrophe, precipitated by the spread of a drug-resistant fungi, Candida auris (C. auris), that can kill immuno-compromised patients and those with undeveloped immune systems like babies. It threatens to be a pandemic like none seen so far, having already hit a neonatal unit in Venezuela, a hospital in Spain, an ICU (that was shut down because of this) in a well-known British medical centre. There have been confirmed cases of infection from the US, and is believed to be present in India, Pakistan and other South Asian countries. It is dangerously persevering, given it is resistant to almost all major anti-fungal medication. And yet, surprisingly little seems to be shared with the public by the administration of the nations that face any quantum of risk. In countries where a large section of the population depends on overextended public healthcare, drug resistance is a ticking time bomb, because hospitals are the commonest reservoirs of resistant microbes like C. auris (over 90% of strains are resistant to at least one major drug while 30% are resistant to two or more drugs).
With bacteria, protozoic pathogens like Plasmodium and now fungi developing resistance, the world needs to take urgent action.
The WHO has flagged antimicrobial resistance as a global health emergency. Despite this, precious little seems to be happening in countries on drug overuse and abuse. From aggressive prescription by doctors to ending up on the dinner table via antibiotic use in farm animals and pesticide use in plants, the unbalanced consumption of antimicrobials continues unchecked despite well-meaning initiatives of various governments, including India’s.
The problem is compounded by the fact that the antimicrobial R&D pipeline ran dry a few decades ago, and interest from drug companies, though rekindled over the past few years, still seems feeble. Part of the silence on drug resistance is systemic; the NYT reports that hospitals and local governments are reluctant to disclose cases for the fear of being singled-out as reservoirs. In fact, the American federal disease-research and action body, the Center For Disease Control, under its contract with the states, is not allowed to name the location or the hospital involved in an outbreak.
Such silence is also the reason the urgency of the problem doesn’t percolate down to the public and help generate awareness on drug resistance and action to control it. That leads to ease of contamination—after all, a person unaware that he could be carrying a resistant microbe is less likely to act to check its spread—and behaviour such as unchecked use of fungicides (this is being thought of as having resulted in the drug resistant strains of C. auris developing). Unless there is more concerted action on spreading awareness—and this would mean information sharing will have to trump upholding reputation—and correcting risky behaviour that fosters resistance, a human-facilitated pandemic is upon the world.