The event: who, what, when and where?

Last month, the International Bacteriophage Research Consortium (IBRC) held its first public phage therapy lecture to raise awareness of phage therapy and antibiotic resistance in India. The event, which was entitled the Open Health Systems Colloquium, brought together scientists, clinicians, regulatory authorities and more to discuss phage therapy and to hear perspectives from patients, their family members, researchers, regulators, funders and more.

The subject of the lecture was “The Perfect Predator: A Scientist’s Race to Save Her Husband From a Deadly Superbug” by Prof. Steffanie Strathdee, and the event also included a phage therapy panel discussion and Q&A. The event was held at the India International Centre, located in the heart of New Delhi, on November 19, 2019.

In support of WHO’s World Antibiotic Awareness Week

This programme coincided with World Antibiotic Awareness Week, which was November 18 - 24 of this year, a campaign by the World Health Organization (WHO) to increase awareness of global antibiotic resistance and to encourage best practices among the general public, health workers and policymakers to avoid the further emergence and spread of antimicrobial resistance (AMR). One of the key objectives of the WHO’s Global Action Plan is to improve awareness and understanding of antimicrobial resistance.

Attendees

There were about 90-100 attendees from several parts of India, who were scientists, doctors, professors, research scholars, medical students, journalists, science communicators, venture capitalists, representatives of the WHO and funding agencies such as the NIH and the Government of India’s Department of Biotechnology, and the general public.

The goal: improving awareness of phage therapy in India

The event began with a welcome note and introduction to the Open Health Systems Colloquium (OHSC) by Dr. Koninika Ray, Director, Biomedical Research, Open Health Systems Laboratory USA (OHSL). The OHSC is a collaboration between the OHSL and the India International Centre. The aim of OHSC is to open discussions into the public domain, such that the latest developments in biomedical sciences are accessible to those interested and to spark debate and deliberation across disciplines.

We were excited since this was the first public lecture organized by IBRC to create awareness on the potential of phage therapy in the country. In India, while research on various aspects of phages is going on, phage therapy is not practiced here. In the past few years, however, there is a growing curiosity about it. Hence, we were happy to hold this session and have the presence of those who have done substantial research on phage therapy and those who had first-hand experience of receiving phage therapy.

The power of a global village: Steffanie Strathdee and Tom Patterson share their phage therapy experience

The invited speaker, Prof. Steffanie Strathdee, narrated the story of her husband, Prof. Tom Patterson, Professor of Psychiatry at University of California, San Diego, who survived a pan resistant A. baumannii infection due to intervention with phage therapy. Tom’s phage therapy was made possible by a global village of researchers and healthcare workers. She mentioned how this led to IPATH, the first phage therapy centre in North America. Prof. Patterson also briefly shared his experience as a patient in coma, and told us how thankful he is to all those who came together to his rescue.

The WHO weighs in on phage therapy, AMR, and India’s progress to date

Dr. Tjandra Yoga Aditama, Director, Communicable Diseases, WHO South-East Asia Region, addressed the audience and explained the initiatives and points of action by WHO SEARO (South-East Asia Regional Office) to manage the AMR crisis. He delivered the message of the regional director, WHO Dr. Poonam Khetrapal Singh, who could attend the event due to unforeseen circumstances. Dr. Singh’s message was that the prospect of phage therapy would be of value once necessary clinical trials take place and regulatory frameworks are established. She complimented India for joining the global AMR R&D hub and said India has a lot to offer to the cause.

The International Bacteriophage Research Consortium: building multidisciplinary teams to make phage therapy possible

I gave an introduction to the IBRC and the consortium members, and presented our envisioned road map.

The IBRC was created by OHSL and Acharya Narendra Dev College, to bring together scientists, academia, clinicians, researchers and regulatory authorities to interact, share and collaborate with an aim to contribute towards phage therapy and research.

I invited the audience to join the consortium, and highlighted the need for building teams with diverse expertise to make phage therapy possible in India.

First Indian to receive phage therapy: Pranav Johri tells his story

Mr. Pranav Johri, who was the first Indian to have undertaken phage therapy (at the Eliava Institute in Tbilisi, Georgia), was invited to present his experience. He and his wife, Mrs. Apurva Johri, also shared their initiatives to facilitate Indian patient access to phage therapy in Tbilisi.

Panel discussion: Charting a path toward phage therapy

Participants

• Prof. Steffanie Strathdee
• Prof. Thomas Patterson
• Dr. Biswajit Biswas, Chief of the Division of Bacteriophage Science, Biological Defense Research Directorate, Naval Medical Research Center, Fort Detrick, Maryland (joined through video conference)
• Prof. Sanjay Chhibber, Department of Microbiology, Panjab University, President of the Society for Bacteriophage Research and Therapy (SBRT)
• Dr. Urmi Bajpai (moderated the session)

Diverse applications for phages: vaccines, diagnostics, lysins

Dr. Biswas described his work on developing a phage bank, and mentioned phages’ application as vaccines and diagnostic agents, besides their therapeutic role, where there is a great opportunity for precision-based therapy. He said India should harvest natural phages, given their abundant presence in the natural environment. Prof. Chhibber briefly mentioned the research work being done by phage researchers in India, and shared work from his lab on nanoparticle-based delivery of endolysins and hydrogel-based phage delivery in a burn wound model.

Questions from the audience: safety, legality and ethics

A wide spectrum of queries from the audience were asked, which included legal and ethical aspects of enabling distance phage therapy, the immune system’s response to phages (how do administered phages remain in circulation without being cleared by the immune system?), criteria for their safe preparation and administration, whether phages have receptors on human cells, whether they can cross the blood brain barrier, whether resistance is developed by phages, the cost of phage therapy, and the major hurdles to get the therapy started in India. The queries were answered by Dr. Biswas and Prof. Chhibber.

Going forward: what is needed for phage therapy to become a reality in India?

• Translational studies, clinical-grade phages, phage cocktails and clinical trials
• Training programs to facilitate capacity building
• Discussions on the regulatory and safety aspects of phage therapy

More resources

Check out the IBRC’s website, and if you’re a scientist working on phages, please join the consortium!

Check out the upcoming ICBRAMR conference, hosted Dec. 12-13 in Vellore, India by the Society for Bacteriophage Research and Therapy.