GAFFI’s application to the WHO, was in collaboration with the International Foundation for Dermatology and pinpointed key fungal diseases with AIDS, for which itraconazole is crucial.
Itraconazole is used for the treatment of many fungal infections and is ~70% effective for fluconazole - resistant oral thrush, and is the treatment of choice for eosinophilic folliculitis, a debilitating, itchy rash associated with HIV infection.
Also Patients with Talaromyces marneffei infection (previously called penicilliosis) and which is common in SE Asia, also respond really well to itraconazole, as do those with coccidioidomycosis and paracoccidioidomycosis in the Americas.
Numerous skin fungal infections in adults and children with HIV infection are treated with the drug, griseofulvin, which remains on the EML- but is often ineffective compared to itraconazole.
Dr David Denning, President of GAFFI and Professor of Infectious Disease in Global Health at The University of Manchester explained: “Every two years WHO calls for revision to the EML, and the deadline is today - World AIDS Day (December 1st). It is remarkable that such a workhorse antifungal such as itraconazole, which has been available since 1991, has not been included on the EML previously. Registered in most countries, itraconazole will provide the first effective oral antifungal for mould infections and endemic mycoses such as histoplasmosis.”
Professor Rod Hay of the International Foundation for Dermatology stated: “Itraconazole is a highly effective oral antifungal for many skin, hair and nail fungal infections. These are more problematic in HIV infected people, and so the inclusion of itraconazole on the EML will benefit huge numbers of adults and children with these infections."
The availability and cost of itraconazole in most countries is shown here and demonstrates the gaps in access to antifungal treatments. Itraconazole is available and approved in most countries, but not all, notably Senegal, Algeria, Afghanistan, Barbados, and Eritrea. It is registered in Dominican Republic, Iraq, Nepal and Ukraine, but not available.