The Botucatu Document: One health antifungal resistance policies - A call for action

Antifungal resistance in Aspergillus fumigatus and other environmental fungi represents a growing global threat to human health, driven in part by agricultural fungicide use. The scale of the threat is masked by inadequate multisector surveillance. In December 2025, the Brazilian Network Meeting on Aspergillus fumigatus Antimicrobial Resistance convened clinical, agricultural, environmental, and public-health experts to address these challenges using a One Health framework. Through a structured plenary deliberation, participants approved "The Botucatu Document: One Health Antifungal Resistance Policies - A Call for Action," a unified Public Statement of Concern outlining governance principles and coordinated national actions for Brazil. The Statement reflects consensus across four Working Groups on clinical surveillance, environmental monitoring, fungicide regulation, and public health communication. Together, these directives call for independent AMR data collection, FAIR transparency, cross-sector governance, strengthened laboratory capacity, environmental aerobiome surveillance, new fungicide risk-assessment criteria, and comprehensive One Health communication strategies. This manuscript presents the full Public Statement as approved verbatim, situates it within global AMR policy frameworks, and highlights implications for Brazil's forthcoming National AMR Action Plan (2026-2031). The Botucatu Document represents a milestone in aligning agricultural and clinical sectors around a shared One Health AMR agenda.