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WHO reinstates important drugs amphotericin B and flucytosine after pressure from leading expert

A doctor believes the lives of tens of thousands of people worldwide who develop a deadly type of could now be saved thanks to a U-turn by the (WHO).

, who is recognised as an international expert in infectious and fungal diseases, has campaigned with others to have two drugs reinstated on the Essential Medicines List following a definitive trial from Vietnam.

The trial, led by who trained in Manchester, shows that a combination of oral flucytosine and intravenous amphotericin B and flucytosine demonstrated a 40 per cent lower chance of death in patients with the deadly form of meningitis.

is a serious infection of the brain and spinal column that can occur in adults and children living with HIV. It claims the lives of over half a million people every year and is caused by a fungus, Cryptococcus neoformans which is very common in the environment and can be found in soil and in pigeon droppings.

Professor David Denning, who is Professor of Infectious Diseases and Global Health at UHSM (University Hospital of South Manchester) says:

“The WHO has two lists of medicines – main and complementary. Flucytosine was put on the complementary list and then was dropped many years ago because other antifungals, like fluconazole, came along and it was perceived that it was unnecessary. And indeed its sales are low at about $3M annually. The recent work by Day et al has consolidated its position, putting it back in a prime spot.

“I believe the WHO’s enlightened decision opens the door to saving many thousands of lives weekly from this devastating fungal meningitis in AIDS. The challenge now is to translate this recommendation into local availability and actual treatment on the ground in every country.”


University Hospital of South Manchester NHS Foundation Trust