Documentary

In order to better understand the status quo of (antimicrobial resistance and) phage therapy we made a documentary built around interviews with top experts within the field, treated patients and other persons of interest.

The documentary addressed the reason why antimicrobial resistance remains as a global health issue decades after its first discovery and what the potential options to solve it are. Amongst those, we chose phage therapy as our project. We interviewed experts in phages and phage therapy, to give us more insight about this novel technique. They addressed the challenges from the perspective of research focus, pharmaceutical incentive, delivery and applications.

To view the full video, click here, otherwise continue reading to get insights to some of the bits that we found most surprising and interesting.

Learning by interviewing

In 2017 Pranav and his wife Apurva founded their own company to help improve access to phage therapy for those suffering from antibiotic resistant infections.

Pranav himself suffered from an infection and got treatment at the Eliava Phage center.

I could start living life again the way I used to — Pranav

In some regions of the world, phage therapy has emerged as a viable alternative in the face of rising antimicrobial resistance (AMR). However, there remains much to be learned. To get further information about AMR we met Bengt Mattson, manager of policy at the Swedish association of the pharmaceutical industry.

The challenges remain for antimicrobial resistance and viable options to solve this problem. He speaks of the challenge of finding new antibiotics, the struggles of creating protocols for clinical trials and the general misuse of antibiotics.

A lot of the antibiotics that come out are really the last resort, last step type of antibiotics, for people that are really really sick — Bengt Mattson

He speaks of methods for combating AMR by restricting antibiotics and using them responsibly, lowering the risk of infection by hygiene, sanitation and vaccines and improving diagnostics. However, there is always a need for new antibiotics.

A big challenge here is that antibiotics are expensive to produce for pharmaceutical industries, and since we want to restrict the use of them, there is not a big market for them.

Therefore there is an interest in novel techniques, such as phage thereapy. To know more about phage therapy we met with Christian Giske, professor and Senior physician Karolinska Institutet.

Giske adresses new mechanism for approval of therapeutics for Phage Therapy and the challenging perspectives with Phage Therapy as "novel".

He argues that it still requires more research to be fully and systematically understood. New approaches of dosing phage therapy correctly are novel. Giske states that phage therapy is a customized therapy, but that it renders it costly. He also argues that current legislation is not well suited for Phage Therapy. He is also asking how money can be made from Phage Therapy as it is personalized medicine and the companies would need to have many lines of phages to be able to treat multiple infections.

We should not underestimate the challenges but also not give up easily. You can understand from our interviews how powerful phage therapy can be, and how low collateral damage they have on the microbiome. When you see this you can not stop being excited about their potential!

Anni-Maria Örmälä-Odegrip, postdoctoral researcher Karolinska Institutet states that there is a consensus that Phage Therapy does work and that now we need it more than ever.

Rapid and extensive increase in the multi drug resistant bacteria has made people more open minded. There was a period of 10 years when there was a lot of talk of phage therapy, but it takes more than the willpower of researchers. Investors and legislating authority needs to allow new ways of doing things. Örmälä-Odegrip says regarding phages potential that using modified Phages enables more sophisticated Phage Therapy.

Conclusions

Through interviews and discussions we have been able to see our project through the eyes of others. The making of this documentary made us realise that collaborations between researchers like us and clinical institutions need to happen on a bigger scale to improve the clinical efficacy of phage therapy. Big pharmaceuticals need to invest in the development of the therapy. With these interviews we realised that the pace of phage therapy research is increasing and limitations are only time bound.

While the future of phage therapy awaits on the horizon, we hope that through our work we have brought the future a little bit closer.