One health and resistant fungi: a challenging balancing act between food security and patient survival

The article highlights that azole-resistant Aspergillus fumigatus is an escalating global health threat driven by both medical and agricultural azole use, leading to the emergence and environmental spread of resistant strains that undermine first-line antifungal therapies. It emphasizes that resistance arises through genetic mutations (notably in cyp51A) via two main routes—patient treatment and environmental exposure—resulting in reduced treatment efficacy and increased mortality. The paper further stresses major gaps in rapid diagnostics, surveillance, and awareness, arguing for improved detection methods, stewardship across clinical and agricultural sectors, and coordinated One Health strategies to contain the spread and safeguard future antifungal effectiveness.