A review on fungal pathogens in the One Health framework: connecting plant, animal, and human health.
The growing burden of fungal diseases on human, animal, plant, and environmental health is a serious global problem that requires a "One Health" approach beyond disciplinary silos. Fungal diseases are often neglected, yet their prevalence and importance are increasing at an alarming rate. Complex interactions among different host organisms, coupled with human activities, anthropogenic environmental impacts, climate change, globalization, and antifungal drug use, particularly in agriculture, are significant contributing factors. The emergence and spread of resistance to existing antifungal agents is one of the most important consequences, leading to poor treatment outcomes in both clinical and agricultural settings. Azole fungicides used in crops have been associated with the selection of resistant strains in some fungi common in the environment and associated with human disease, such as Aspergillus flavus and Fusarium spp., which have a unique enzyme paralogue cyp51C, and efflux pumps that flush out the azoles, thereby leading directly to treatment failure. The article explains how fungal pathogens can affect each of the three pillars of One Health. In plant health, fungal infections affect food security and economic outcomes, while the use of fungicides for treatment can lead to cross-resistance with clinical medications. In animal health, fungal diseases affect livestock well-being and productivity, and animals act as reservoirs for the zoonotic transmission of resistant strains to humans. In human health, the impact on immunocompromised populations is high, as invasive fungal infections result in significant morbidity and mortality. Limited availability of antifungal drugs, diagnostic challenges, and limited surveillance. To combat these multifaceted, interconnected challenges, a collaborative, multisectoral approach is imperative. Looking ahead, future initiatives should emphasize genomic and eco-epidemiological research to elucidate the drivers of emergence, anticipate outbreaks, and identify emerging threats. In conclusion, addressing the global burden of fungal diseases necessitates a holistic One Health approach that aligns surveillance, research, policy, and public health interventions to preserve the efficacy of existing treatments and protect the health of all interconnected domains.