Abstract
Histoplasmosis remains a neglected yet deadly fungal infection, disproportionately affecting persons living with HIV/AIDS and other immunocompromised populations in endemic regions. Despite the World Health Organization's designation of Histoplasma as a high-priority pathogen, the disease remains underdiagnosed and excluded from national surveillance systems, resulting in delayed treatment and high death rates. To coordinate a global response, the International Society for Human and Animal Mycology convened a Histoplasmosis Working Group during its 2025 congress in Brazil. Experts engaged in structured discussions across 5 domains: awareness, research, diagnostics and treatment, capacity building, and fungal biology. The group highlighted persistent diagnostic delays, underuse of antigen testing, and poor access to liposomal amphotericin B and itraconazole. Innovations such as lateral flow assays and molecular tools were discussed, alongside the need for biobanks and validated diagnostic algorithms. A global 90-90-90 target for histoplasmosis by 2030 was proposed to improve diagnosis, treatment, and survival.