Addressing the dual-use of antifungals and fungal antimicrobial resistance (fAMR) through a One Health approach
Fungal antimicrobial resistance (fAMR) is accelerating, driven in part by the dual-use of antifungal modes of action in agriculture and medicine, threatening therapy. Addressing this challenge requires a unified One Health response that balances agricultural productivity, economic stability, and human and animal health. By focusing on the United Kingdom's policy approach, we argue that current efforts are constrained by fragmented governance, surveillance and regulation. To resolve this, we propose three policy recommendations: 1. a cross-government fAMR body, 2. mandatory environmental and clinical surveillance, and 3. for fungicide approvals to look beyond crop pathogens and integrate risk assessments for potential hotspots of resistance selection in human fungal pathogens. These measures will safeguard current and future antifungals while providing much-needed regulatory clarity and will be translatable to other national and regional contexts.
Authors
- J. H. Rex
- A. Brown
- D Kang James
- P. L. White
- K. Doughty
- A. M. Borman
- H. West
- M. C. Fisher
- M. J. Bottery
- M. Grimmer
- S. Weeks
- M. Birch
- D. Freeman
- R. Bryson
- M. Bromley
- N. Bennett
Institutions
- University of Nottingham (GB)
- Agricultural Development Advisory Service (United Kingdom) (GB)
- University of Exeter (GB)
- British Society for Antimicrobial Chemotherapy (GB)
- Harefield Hospital (GB)
- University of Manchester (GB)
- Public Health England (GB)
- University of Oxford (GB)
- Thames Water (United Kingdom) (GB)
- Public Health Wales (GB)
- Crop Protection Association (GB)
- Cheshire West and Chester (GB)
- Laboratoire National de Référence (MA)
- Parliament of United Kingdom (GB)
- Institute of Infection and Immunity (CA)
- Imperial College London (GB)
- Cardiff University (GB)
- Medical Research Council (GB)
Publication Details
- Journal
- npj Antimicrobials and Resistance
- Published
- 2026-05-29
- DOI
- https://doi.org/10.1038/s44259-026-00220-9
- Primary Topic
- Antifungal resistance and susceptibility
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Canadian Institute for Advanced Research
- Wellcome Trust
- Department of Health and Social Care
- Directorate for Biological Sciences
- Medical Research Council
- Biotechnology and Biological Sciences Research Council
- Natural Environment Research Council