Phages for Global Health

Solution Name:

Phages for Global Health

One-line solution summary:

Helping scientists in Africa and Asia develop inexpensive antibacterial phage products that can kill antibiotic-resistant bacteria locally

Pitch your solution.

A 2014 report predicted that by 2050 approximately 10 million people will die each year from antibiotic-resistant infections -- equivalent to >10 times the annualized death rate for coronavirus. Inappropriate use of antibiotics in COVID-19 patients is expected to accelerate antibiotic resistance rates further. Thus, we urgently need antibiotic alternatives, particularly in Africa and Asia, where 90% of the antibiotic-resistant deaths will occur.

Before antibiotics were discovered, bacteriophages (AKA phages) were utilized as antibacterial agents. Phages are viruses that exist in the environment and our bodies, and they can kill antibiotic-resistant bacteria. Phage-based drugs are now regaining popularity in the US and Europe, but few researchers in developing countries know anything about them. We are filling that gap by teaching developing world scientists how to isolate phages, then partnering with them to develop phage products locally. By empowering these scientists, our work could save thousands of lives, if not millions.

Film your elevator pitch.

What specific problem are you solving?

We are addressing the antibiotic resistance problem, which has been likened to climate change in terms of the potential global impacts. Misuse of antibiotics in livestock, food crops and people has accelerated development of resistance worldwide. To compound the problem, no new antibiotics have been introduced in over 30 years; all recent antibiotics are simply variations in existing drug classes. In addition, the vast scale of the growing crisis -- at least 10 million deaths expected each year from antibiotic-resistant infections -- is predicted to increase due to the coronavirus pandemic. Reports indicate that up to 50% of patients who have died from COVID-19 had secondary bacterial infections, significantly increasing the use of antibiotics globally. 

Almost 90% of the deaths from antibiotic resistance will occur in developing countries in Africa and Asia and, regrettably, drug companies consider antibiotics too costly to develop for developing world populations. Without new types of drugs to combat infections, the World Health Organization warned in 2014 that a post-antibiotic era -- in which routine infections can once again become life threatening -- is “far from being an apocalyptic fantasy, [but] is instead a very real possibility for the 21st century”.

What is your solution?

We work in developing countries to facilitate the application of phages as inexpensive, naturally-occurring antimicrobial agents that can kill antibiotic-resistant bacteria. Phages can be selected to target only specific bacteria while leaving other helpful bacteria and human cells unharmed. Also, phages are well-suited for use in the developing world, since they can be easily isolated from contaminated environments, are inherently quick and inexpensive to manufacture and are safe, having been utilized for the past century in the former Soviet Union. The FDA and USDA have approved a number of phage products in the US, but no phage products are yet available in developing countries, and few scientists there have any knowledge about the potential benefits of phages.

We are bridging this gap through two broad approaches: 

1. Teaching scientists how to develop phage products (through a series of hands-on laboratory workshops in Africa and Asia)

2. Creating international teams of global phage experts and developing world scientists to co-develop phage products (e.g., for poultry meat decontamination, cholera prevention, tuberculosis treatment, etc)

Locally developed phages could be used to manage problem bacteria in agriculture, food and water, and for direct treatment of people, significantly impacting health and economic development in Africa and Asia.

Who does your solution serve, and in what ways will the solution impact their lives?

We are reaching two different levels of target populations: first, public health scientists in developing countries and, second, the communities they serve. Our primary goal is to provide scientists with expertise in phage technology to help combat the antibiotic resistance crises in their countries. By partnering with them through trainings and collaborations, we aim to empower these regional experts to develop products that are not only technically effective, but also socially accepted within their local cultural contexts. 

While traditional drug development is a long-term process -- a conventional drug typically costs $1 billion and takes 10 years to develop -- phage product development could potentially happen faster and cost less. For example, we delivered our first two laboratory training workshops in 2017 and 2018 in Uganda and Kenya, respectively, and the 50 scientists who participated in those workshops have already:

- Taught phage biology to more than 700 others through their home institutions

- Initiated 34 phage product development projects

- Won 6 grants totaling to over $818,000

These early impact data indicate that practical aspects of phage biology can be quickly learned, applied, and shared with other scientists, even in resource-limited countries.

Explain how the problem, your solution, and your solution’s target population relate to the Challenge.

For decades in the Soviet Union, governmental institutions stored large collections of phages that could be used to kill many different types of bacteria. When a new bacteria emerged, the phage collection was rapidly screened and effective phages were quickly deployed (often for infected military personnel fighting in new territories). The US-based company Adaptive Phage Therapeutics has recently received FDA approval to test a similar approach, utilizing a pre-characterized phage collection for rapid treatment of antibiotic-resistant infections. Since phages can be isolated using basic laboratory equipment, developing countries could employ phage collections to target new bacterial strains that emerge locally.

What is your solution’s stage of development?

Who is the primary delegate for your solution?

Tobi Elaine Nagel, PhD

In what city, town, or region is your solution team headquartered?