Companies do not prioritise antifungals in environmental risk management

The threat of antimicrobial resistance from the manufacture of antifungals is often overlooked by companies, even in comparison to the manufacture of antibacterials.

Only 11 percent of antifungal products in scope have a defined PNEC value for safe concentration levels.
Little progress made in companies' development of antifungal waste strategies since 2020

As in 2018 and 2020, this Research Area focuses on antibacterials. However, antifungals are an area of emerging concern due to the high rate of cross-resistance between compounds employed as both broad-spectrum human antifungals and fungicides in agriculture.

The WHO is concerned about the public health threat of fungal infections, together with the rise in antifungal resistance, and is therefore developing a global fungal priority pathogens list to make sure R&D efforts are effectively prioritised.

The list published by the AMR Industry Alliance includes targets for discharge
limits for antifungals. However, in recent years, targets for 21 antifungal products in scope, marketed by 11 companies, have been removed from their list.As a result, only 13 out of all 120 (11%) antifungal products in scope have a defined PNEC value which sets out what concentration would be considered safe.

While the Alliance is steering away from antifungals, it is important that companies ensure limits apply to all antifungal products they manufacture and bring to market. The scientific field also has a role to play in defining science-based targets for more antifungals.

How do the companies’ approaches to environmental risk management differ between antibacterial and antifungal products?

All 17 companies in scope are marketing antibacterial products. The majority of companies report that they set limits, and that they quantify levels to check whether limits have been met.

Fifteen of the 17 companies in scope are marketing antifungal medicines. Just over half report that they set limits, and only a third report that they quantify discharge levels to assess whether limits are met. Eight companies report an environmental strategy that covers antifungal manufacturing compared to seven in 2020, showing little progress.

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2. WHO Report. First meeting of the WHO antifungal expert group on identifying priority fungal pathogens. World Health Organization (WHO). Published 2020. Accessed September 5, 2021. https://www.who.int/publications/i/item/9789240006355

3. AMR Industry Alliance. AMR Alliance Science-Based PNEC Targets for Risk Assessments. 2021;February:5.