Indian Fungal Infection National Declaration (I-Find)

Abstract

Background: Serious fungal diseases are significant yet long neglected public health problem in India, affecting an estimated 4.1% of the population and with the mortality from invasive fungal diseases approaching 50%, surpassing several nationally prioritised conditions. The emergence and spread of drug resistant pathogens such as Candidozyma auris formerly Candida auris, azole resistant Aspergillus fumigatus, and Trichophyton indotineae together with COVID-19 associated mucormycosis epidemic, exposes critical gaps in preparedness, prevention, and care. Despite the presence of a WHO collaborating centre and an Indian Council of Medical Research (ICMR) Advanced Mycology Diagnostic and Research Centre network, major deficiencies persist in surveillance, diagnostics, antifungal access, stewardship, workforce, capacity and coordinated research. Objectives: The Indian Fungal Infection National Declaration (I- FIND) seeks to catalyse a structured, time bound national response that elevates fungal diseases to a recognised public health priority and measurably reduces morbidity, mortality, and fungal resistance. Its objectives are to identify and target key at risk populations (including those with immunosuppression, critical illnesses, chronic lung disease and poorly controlled diabetes), to acknowledge major community mycoses such as chronic dermatophytosis, vulvovaginal candidiasis, and fungal keratitis, and to define clear domains for action across governance, surveillance, diagnostics, clinical management, research, workforce development, public awareness, One Health, and accountability. Content: I- FIND identifies 9 core domains, including governance, surveillance, diagnostics, clinical management, research, workforce development, public awareness, One Health measures, and accountability. Proposals cover creating a National Task Force, issuing a five-year fungal disease control strategy, integrating mycology network, setting diagnostic standards, incorporating stewardship and prioritizing translational research funding. The declaration supported by major Indian and international professional societies, guides formal adoption and implementation across India.