The Board of Trustees, who are also directors of the Charity for the purposes of the Companies Act 2006, present their report and financial statements of Fungal Infection Trust for the year ended 30 April 2016. The financial statements have been prepared in accordance with the accounting policies as set out on page 8 and
comply with the charity’s trust deed, the Companies Act 2006 and the Statement of Recommended Practice – Accounting and Reporting by Charities 2005.

STRUCTURE, GOVERNANCE AND MANAGEMENT

The Fungal Infection Trust (“The Charity” or “The Trust”) is a company limited by guarantee and governed by its Memorandum and Articles of Association.

DIRECTORS AND TRUSTEES

The directors of the charitable company are its Trustees for the purpose of charity law and throughout this report are collectively referred to as the Trustees

The Trustees serving during the year were as follows:

Mr J C Morgan              Secretary

Mr P J Folkman

Mr P G Oxnam               Chairman

Dr C L Pankhurst

Mr J C Wood-Collins

Professor J Cooke

New trustees are interviewed and appointed by the existing trustees. Before taking up their positions, new trustees are sent on externally run training courses where appropriate.

Risk Management

The trustees have examined the major strategic, business and operational risks which the charity faces and confirm that systems have been established to enable regular reports to be produced so that the necessary steps can be taken to lessen these risks.

The Trustees have undertaken a review of Employment issues and updated their procedures accordingly with particular attention to Health and Safety matters to comply with recent legislative changes.

Organisational Structure and Governance

The Trust is managed by the Trustees. The Trust has no paid or voluntary employees. Accounts are prepared by the Secretary on a regular basis and presented to the Trustees at their meetings. The financial status of the Trust is reviewed by a Trustee sub-committee prior to each Trustees meeting and its recommendations presented
to the meeting. A minimum of three Trustees meetings are held each year.

Responsibilities of Trustees

Law applicable to charities in England & Wales requires the trustees to prepare financial statements for each financial year which give a true and fair view of the incoming resources and application of the resources of the charity during the year and of its state of affairs at the end of the year. In preparing financial statements giving a true and fair view, the trustees should follow best practice and:

  • select suitable accounting policies and then apply them consistently;
  • make judgements and estimates that are reasonable and prudent;
  • state whether applicable accounting standards and statements of recommended practice have been followed;

prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charity will continue in operation. The trustees are responsible for keeping proper accounting records which disclose with reasonable accuracy the financial position of the charity and which enable them to ascertain its financial position and to ensure that the financial statements comply with the Companies Act 2006 and the Statement of Recommended Practice – Accounting and Reporting by Charities 2005 and the Trust Deed. They are also responsible for safeguarding the assets of the charity and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

OBJECTIVES AND ACTIVITIES

  1. To promote research in all aspects of mycology, mycotic diseases, fungal toxicology and microbial disease (of all living things) and to publish the useful results thereof.
  2. To advance education particularly among physicians and scientists about mycology, mycotic diseases, fungal toxicology and microbial diseases in general.
  3. To generally support basic research into fungi and fungal disease, train scientists into mycology and related disciplines.
  4. To provide information to patients suffering from fungal diseases, in particular aspergillosis.
  5. To raise awareness of fungal pathogens and fungal diseases amongst the general public in the UK and internationally.

Review of Activities

In 2015/16, most of the FIT’s activity was devoted to health professional education, public outreach and research. The FIT website (www.fungainfectiontrust.org) averaged 9,500 unique visitors per month in 2016 and 10,000 visits per month.

The Aspergillus Website (www.aspergillus.org.uk)
The Aspergillus Website continued its role as the world’s most comprehensive resource about the pathogenic and allergenic fungi Aspergillus and the diseases that they cause, and is completely free to all users. With support from the UK National Health Service, various corporate donors, notably Basilea, Merck, Pfizer, Astellas and Gilead, the website continues to evolve. New sections on geomicrobiology and new antifungal agents were added.

There are extensive sections for clinicians, scientists and patients, including a comprehensive collection of treatment protocols covering 43 distinct therapeutic areas and all known current antifungal drug datasheets, as registered. A new disease section on Aspergillus bronchitis was added. The Aspergillus Website also provides information on evidence supporting (or otherwise) some herbal and alternative remedies. The site provides simple, free access to 95,300 pages indexed in Google, ready to be searched, over 10,000 scientific articles and over 13,500 conference abstracts from 1974 onwards. The comprehensive list of drug interactions with antifungals is continually updated. This database is also available as an ‘App’ via iPhone and Android smartphones to allow ease of access and use, both are updated regularly. Over 2,300 potentially harmful interactions are listed. There are 9,119 active links to www.aspergillus.org.uk.

If ‘aspergillus’ is searched in Google, there are 6 million results. The Aspergillus Website is listed at number 1, 1, 1 and 2 in Google.co.uk and at number 1, 1, 1 and 2 in Google.com. Searching The Aspergillus Website on Bing and Yahoo! for ‘aspergillus’, ‘ABPA’ ‘aspergillosis’ and ‘aspergilloma’ comes up 4, 3, 4, 6 (Bing) and 3, 3, 3, 5 (Yahoo) respectively. There were 3,706,325 requests for content (images and pages) for the month prior to 7th July 2016, nearly half of which comes from the US. In the same time period there were visits from 60,612 unique computers (the measure we use to estimate individual people visiting the website) and (a low estimate) 220,000 visits.

The countries primarily using the Aspergillus Website are: 1. USA, 2. UK, 3. China, 4. Unknown, 5. France, 6. India. Over 175 countries accessed The Aspergillus Website in 2015/16. Monthly newsletters from the Aspergillus Website are sent out to over 20,000 (free) subscribers. This figure is driven by newly registered members seeking to access our secure ‘articles’. There are ~44,000 people registered on The Aspergillus Website (32% medics, 23% scientists, 6% vets and 39% laypeople).

Patients’ website (www.nacpatients.org.uk)
There were 341,698 total requests (pages & images) over the last month from 7,901 unique visitors. The top countries utilising this website by origin are: 1. USA, 2. UK, 3. Germany, 4. Unknown, 5. France, 6. Australia.
There are 21,885 active links to this website.

There are 841 patients & carers currently registered with the support discussion group on Yahoo! (now declining in favour of Facebook), 852 on Facebook and the another 716 who joined NHS choices community for aspergillosis. The Professional LinkedIn members (Aspergillus and Aspergillosis Group) has 514 members.

The provision of live and recorded online events held by the National Aspergillosis Centre, happening on a monthly basis (400 views per month) that provide several means of support including factual and social issues has provided a focus for patients and their carers. Website users now have use of Facebook pages for Aspergillus & Aspergillosis (https://www.facebook.com/Aspergillus.and.Aspergillosis), and Patients Support (https://www.facebook.com/groups/aspergillussupport/) and all updates of the website are broadcast via Twitter (@AspergillusWeb – 813 followers) and Facebook.

Leading International Fungal Education (LIFE) (www.LIFE-Worldwide.org)
The FIT continued to support the expansion of the educational brand LIFE, a summary website with key information of fungi causing disease, the most important fungal diseases, diagnostic tests, including skin allergy tests and imaging, and antifungal therapies, in English and Spanish. The quarterly LIFE newsletter on major developments in the topic, especially related to public health, is delivered to >11,500 email subscribers around the world in English and Chinese (to China). News items are focussed on issues of public health related to fungal disease, new diseases, antifungal resistance, therapy or clinical practice and are posted every 7-10 days. In a typical month in 2016, there were over 12,500 page views from multiple countries, in descending order: 1. USA, 2. UK, 3. India, 4. Mexico, 5. Colombia, 6. Spain, 7. Australia, 8. Brazil, 9. Canada, and 10. France. There are 509 active links to this website.

A component of the LIFE effort was to boost public awareness of fungal infections generally. This has involved estimating the burden of serious fungal disease in many countries, to highlight the seriousness of a range of primary and secondary fungal diseases. Last year, individual country ‘burden of fungal disease’ estimates were made in over 50 countries. Abstracts at conferences have been converted into peer-reviewed papers for Belgium, Czech Republic, Denmark, Dominican Republic, Germany, Greece, Hungary, Ireland, Israel, Jamaica, Mexico, Nepal, Qatar, Senegal, Spain, Sri Lanka, Tanzania, Trinidad and Tobago, Ukraine and Vietnam. Abstracts estimating the burden of fungal diseases by country have been presented at international meetings for Algeria, Bangladesh, Congo France, Greece, Japan, Madagascar, Malaysia, Mozambique, Pakistan, Peru, Portugal, Serbia and Venezuela.

The taught Masters in Medical Mycology course in Manchester attracted 15 international students in its three years from 5 continents. The course relies on the infrastructure provided by the FIT.

The FIT also supported a number of interesting and significant research projects. The 25 peer-reviewed publications of calendar year 2015 relate to these grants and infrastructure support in prior years are shown in Appendix 1. The notable outputs included the burden of fungal infections in multiple countries (see above), the remarkable finding of massive increase in production of a pro-inflammatory molecule (PPBP) in allergic, and especially chronic aspergillosis of the lungs, descriptions of the progression from allergic to chronic aspergillosis over time in many patients and poor responses to bacterial vaccines in those with chronic aspergillosis of the lungs.

Last year the FIT funded the development of an online Microscopy and Histology course, of which Modules 1 (safety, stains, samples and microscopic handling), Module 2 (direct microscopy) and Module 3 (histopathology of common invasive fungi) are complete. It is in pilot phase at www.microfungi.net and will be launched officially in the summer of 2016, with an accompanying video. Additional resource has been attracted from Gilead to extend the scope of the course to Module 4 (histopathology of rare fungi) and translate it into Spanish, French and Portuguese. The FIT awarded a scholarship to a senior mycologist from South Africa to develop Module 4.

In addition Travel and Living Allowance Grants for attendance and presentation at scientific conferences totalling £9,710 were made during the year as part of the Trust’s policy to support scientists in the early stages of their careers in mycology.

Who benefited from the Trust’s Activities?

Researchers all over the world.
Doctors all over the world, especially through the Drug Interactions database.
Patients and their carers.
Students of medicine, pharmacy, biology and microbiology.
The public – school children, their teachers and parents.

How do the Trust’s Activities Benefit the Public?

The Aspergillus Website has been pivotal in making the topic easier to access for all users, creating strong online communities. There is a continual need to keep pace with the revolution in social media that has strongly influenced the development of communities on the World Wide Web.

In 2015, The Aspergillus Website added provision of live and recorded online events held by the National Aspergillosis Centre in Manchester, happening on a monthly basis. These provide several means of support including factual, social and information on present and possible future means to diagnose and treat aspergillosis. Support for carers is being actively promoted via specialist speakers from the Manchester Carers Group. These meetings have spawned 6 regional meetings across the UK, lead by patients.

The Patient’s Website, affiliated to and managed by The Aspergillus Website team, has made it possible for patients to start writing (and update periodically) their own stories complete with pictures and in some cases have videoed patients telling parts of their stories. Website users now have use of Facebook pages for Aspergillus & Aspergillosis, Mycotoxin Research as well as Patients Support and all updates of the website are broadcast via Twitter (@AspergillusWeb).

Future plans

For The Aspergillus Website, the addition of Russian papers and a focus on new antifungals coming through will occupy some of the new information to be added. A much more detailed website section on dampness and mould in the home is planned, offering information and support to tenants & landlords. The antifungal drug
interaction database will continue to be updated with the help of a consultant pharmacist to ensure information quality is as high as possible. Integration of the 50,000-strong Aspergillus Website community with Facebook (local patients & carers support in UK and US), LinkedIn (professional groups), Yahoo Groups (patients & carers), HealthUnlocked (patients and clinical trials), Wikispaces (patients' own stories), Slideshare (patients support meetings, aspergillus study day for professionals, audio & slides), is ongoing.

The online Microscopy and Histology course will be launched in English, with an infographic and press release, and then translated into Spanish, French and Portuguese.

FINANCIAL REVIEW

The results for the period are set out on page 7. There was a surplus of Income over Expenditure for the year of £57,565 (2015 – £8,608).

Investment Policy

The trustees do not consider that they have sufficient free reserves to invest surplus funds for any medium to long term. Consequently, funds are maintained in a bank deposit account

Reserves Policy

The charity have established a policy to maintain unrestricted funds not committed or invested in fixed assets i.e. ‘free reserves’ at a level of between one and two years of unrestricted expenditure. This provides sufficient levels of funds to be able to continue the current activities of the charity and to provide sufficient time to consider and replace existing funding sources should there be a significant change in present funding arrangements.
The reserves policy will be reviewed annually.

Secretariat

The trustees wish to express their appreciation of the work undertaken by Mr J Morgan in running the secretariat and administrative functions of the Trust during the past year.

Independent Examiners

In accordance with the Trust Deed, a proposal to appoint Company Solutions Ltd for the forthcoming year will be put to the general meeting.

On behalf of the Trustees

Phillip Oxnam Date: 28 September 2016