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Azoles are frontline antifungal drugs for treating aspergillosis. The recent global emergence of azole resistance in <jats:italic>A. fumigatus<\/jats:italic> has become a serious problem worldwide. It has arisen through two routes: long\u2010term azole medical therapy, called the patient route, and the use of azole fungicides in its habitats especially for agricultural activities, called the environmental route. Resistant strains developed through the latter route show cross\u2010resistance to medical azoles because of the identical molecular target Cyp51A between azole compounds used for medical treatment and agricultural disease control. In azole\u2010resistant strains arising through the environmental route, <jats:italic>A. fumigatus<\/jats:italic> is observed frequently to possess mutations in the <jats:italic>cyp51A<\/jats:italic> gene linked to tandem repeats in the promoter region such as TR<jats:sub>34<\/jats:sub>\/L98H and TR<jats:sub>46<\/jats:sub>\/Y121F\/T289A. The results of microsatellite genotyping analyses of resistant <jats:italic>A. fumigatus<\/jats:italic> strains have suggested a transboundary spread of this microorganism in many countries. Diverse actors are involved in the global highway of transmission. Therefore, the matter must be addressed as a \u201cOne Health\u201d issue. 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