Uncovering the Hidden Threat: WHO Fungal Priority Pathogens in Indonesia - A Systematic Review

The WHO fungal priority pathogen list (FPPL), introduced in 2022, highlights 19 fungal species posing major public health risks. This systematic review evaluates the diversity and distribution of FPPL species in Indonesia, a tropical country favorable to fungal growth. Following PRISMA guidelines, we searched PubMed, Scopus, Google Scholar, and Indonesian databases (2000-2025), identifying 79 eligible studies from 825 records. These covered clinical and environmental samples across 18 of 34 provinces. Medium-priority species were most frequent (n = 70), followed by critical (n = 32) and high-priority (n = 6). Fusarium spp. dominated plant-related samples, while Candida spp. were prevalent in clinical settings. Critical-priority pathogens such as Aspergillus fumigatus, Candida tropicalis, and Cryptococcus neoformans were reported in multiple contexts. West and East Java showed the highest species diversity (17 each), likely reflecting better surveillance. Gaps remain for Candidozyma auris, Candida parapsilosis, Cryptococcus gattii, some Mucorales, and eumycetoma agents. Frequent detection of pathogenic fungi in both environmental and clinical underscores substantial health threats. Strengthened surveillance, diagnostics, and a One Health approach are essential. Limitations include uneven geographic coverage and methodological variation, which may underestimate the true burden in Indonesia.