Fungal diseases represent a growing yet under-recognized global health threat, with mortality comparable to major infectious diseases but a disproportionately weak therapeutic pipeline. This review examines the antifungal innovation gap as a systemic phenomenon shaped by intertwined scientific, economic, and societal constraints. While multidrug-resistant pathogens underscore the urgent need for new antifungal agents, progress is hindered by fungal–human cellular similarity, high development costs, limited commercial incentives, and toxicity concerns. Agricultural fungicide practices that drive resistance and intellectual-property regimes that restrict affordability and generic entry further complicate this landscape. These scientific and economic barriers coexist with profound inequities in global access to existing antifungals, revealing a persistent gap between therapeutic availability and public health needs. The resulting public-health consequences include delayed treatment, reliance on suboptimal therapies, and widening disparities in outcomes across low-resource settings. This review proposes that antifungal agents should be conceptualized as global public goods and that non-profit development models offer a promising pathway to overcome current bottlenecks. An integrated perspective across clinical, agricultural, regulatory, and public-health domains underscores the need for coordinated strategies to restore innovation, ensure equitable access, and strengthen global preparedness against fungal diseases.
László Galgóczy (Thu,) studied this question.