Roadmap
Concerted Action Against Azole-Resistant Aspergillus fumigatus
Azole-resistant Aspergillus fumigatus (ARAf) is rapidly emerging as a major global One Health threat. Resistant fungal strains are increasingly compromising the effectiveness of essential antifungal therapies used to treat vulnerable and immunocompromised patients worldwide. At the same time, environmental selection pressure linked to agricultural azole fungicide use highlights the complex interconnection between human health, agriculture, the environment, and food security.
To address this urgent challenge, the Global Roadmap on Azole-Resistant Aspergillus fumigatus presents a coordinated international strategy built on science, multidisciplinary collaboration, and practical implementation. The roadmap defines six strategic objectives and outlines a five-year action framework focused on awareness, surveillance, innovation, sustainable agriculture, environmental mitigation, and global One Health collaboration.
The roadmap was developed through the international ABR2AFR initiative and reflects the collective expertise of leading specialists from public health, clinical mycology, environmental sciences, agriculture, policymaking, diagnostics, industry, and academia. Experts and stakeholders from Europe, North America, Africa, Asia, and international organizations contributed to shaping feasible actions, critical success factors, and implementation priorities.
The Essential Role of ZonMw
A special acknowledgment goes to ZonMw — the Netherlands Organisation for Health Research and Development — whose support made this ambitious international initiative possible. Through funding project 10680012310024, ZonMw enabled the development of this roadmap, the organization of the ABR2AFR stakeholder event, and the multidisciplinary collaboration required to translate scientific concern into a concrete global action agenda.
The project demonstrates the importance of strategic public investment in tackling emerging antimicrobial and antifungal resistance threats from a true One Health perspective. ZonMw’s contribution helped create a platform where experts from multiple sectors could jointly identify practical solutions to preserve the effectiveness of antifungal therapies for future generations.
Authors
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Dr Maarten van Dongen — AMR Insights, The Netherlands
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Prof Paul Verweij — Radboud University Medical Centre, The Netherlands
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Dr Auke de Jong — Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), The Netherlands
Important Disclaimer
This roadmap is intended strictly for informational and strategic discussion purposes. Although the authors have made every effort to ensure the scientific accuracy, completeness, and reliability of the information presented, no guarantees are provided regarding the absence of errors, omissions, or evolving scientific interpretations. Antifungal resistance is a rapidly developing field, and knowledge, policies, and regulatory frameworks may continue to change over time.
The views and recommendations expressed in this publication are those of the authors and do not necessarily represent the official positions, policies, or endorsements of affiliated institutions, participating organizations, funding bodies, governmental agencies, or stakeholders mentioned throughout the report or acknowledgements.
The roadmap should therefore not be interpreted as formal regulatory guidance, medical advice, governmental policy, or legally binding recommendations. Readers, institutions, and organizations are encouraged to independently evaluate the applicability of the information within their own scientific, regulatory, and operational contexts.
No part of this publication may be reproduced, distributed, modified, or republished in any form without prior written permission from the authors.
