Back in the 1920s and 1930s, millions of dollars were poured in to the study of bacteriophages – viruses that kill bacteria but are otherwise harmless to humans. Back then, diseases like cholera and dysentery were running rampant throughout the planet, and millions died from those two diseases alone. But then Alexander Fleming discovered the antibiotic properties of penicillin in 1928, and Western medicine dropped bacteriophage study almost en masse to move into the new and sexy world of antibiotics.
Looking back on it now, that was a pretty boneheaded move. The overuse and misapplication of antibiotics has helped to hasten the day when bacteria become resistant to many (if not most) types of antibiotics. You see, not every single bacterium is affected equally by an antibiotic. Some antibiotics merely weaken a bacterium until the antibiotic ceases to be administered. Other bacterium might be completely immune to an antibiotic. Regardless, the important thing is that those bacteria most able to survive against antibiotics are the ones that survive and multiply. And given the short life of bacteria in general, natural selection can work its magic in months or even days, instead of the centuries and millennia that humans tend to associate natural selection with. Staphylococcus aureus is not only one of the most common infections in hospitals, it’s one of the hardiest too, having developed resistance to penicillin as early as 1947. MRSA (methicillin-resistant Staphylococcus aureus) is now considered to be “quite common” in British hospitals. And to show you what a problem its become, MRSA was the cause of 37% of all fatal cases of blood poisoning in the UK in 1999; less than a decade earlier, only 4% of blood poisoning deaths in the UK were caused by MRSA.
Thankfully though, not everyone ditched the study of bacteriophages. Antibiotic research was cutting edge stuff back in the 1930s and 1940s, and most of it was well outside the medical budget of the Soviet Union. Bacteriophages were relatively simple to study in comparison, and besides – the bacteriophages themselves are everywhere – in the soil, rivers… even your own gut! Joseph Stalin himself helped set up the Eliava Phage Research Institute in Tbilisi, (Soviet) Georgia in 1923. And although the West might have conquered Soviet ideas on many fronts, Western scientists have come to Tbilisi in droves, making this former Soviet satellite the forefront of a major revolution in medicine.
You see, bacteriophages are the natural enemy of the bacterium. Unlike antibiotics – which have to be carefully created or manipulated in labs – bacteriophages naturally mutate to keep up with their targets. If, for example, a city were hit with a particular strain of e. coli for which there was no known antibiotic cure, researchers would likely find a bacteriophage ready, willing and able to combat the bacteria in the pre-treated water at the local treatment plant. Indeed, scientists in Georgia are so well-versed with bacteria-bacteriophage behavior that they can usually come up with a cure in days, not weeks or months. Another plus with most phages is that each phage (usually) only attacks certain types of bacteria, leaving other types of bacteria alone. In this they work like a narrow spectrum antibiotic and not a broad spectrum antibiotic that kills the “helpful bacteria” that your body needs (see: yeast infection). Some phage types can even be combined into a “cocktail” if a broad spectrum medication is needed. Even better: Georgian doctors have tens of thousands of bacteriophages cataloged and ready to be replicated if need be.
So what’s keeping bacteriophageamania from sweeping the West? Two nasty things, actually: the American patent system and the FDA.
Patents are the way pharmaceutical companies make money. They spend x amount of dollars developing a drug, then they patent it – which gives them the exclusive right to manufacture the drug for a specific amount of time, during which they can charge a premium for their product. If everything goes right, the company will make back what it spent in R&D… and hopefully even make a little profit too. Unfortunately, you can’t easily patent a virus, and you certainly can’t patent a naturally-occurring virus you’ve just pulled from sewer water. And unless all of the drug companies join together to jointly fund a huge study on the overall safety of bacteriophages, you’ll probably never see a single company take the risk.
And then there’s the FDA. As you might guess, bacteriophages are custom-engineered for each season (like flu shots), and they can also be engineered for specific individuals. For example, if you (and only you) come down with some rare tropical disease after touring the Amazon, Eliava can take a sample of the bacteria that’s infecting you and locate a bacteriophage just for you. Which is great, but it flies in the face of the FDA’s drug model, which insists that every drug be exactly the same and tested on a wide range of individuals for effectiveness. They also require that each drug undergo DNA sequencing and thorough clinical trials. As you might guess from my Amazon example, you’d almost certainly die before Eliava (or any other company) could a) save up the money for such testing; b) submit it for sequencing and testing; and c) round up enough people in the world that have your disease to test the phage on.
It’s depressing and it’s pointless, but that’s what happens when the government gets involved. However, there’s nothing stopping anyone from traveling to Georgia to get a phage themselves. And in the face of ever-increasing antibiotic resistance, phages might one day be our only option. And government red tape hasn’t prevented at least one company dedicated to phage research to open in the United States, and researchers at various American universities are looking at phage research using livestock instead of humans (which would come under the aegis of the USDA, not the FDA).
For more about bacteriophages, check out this Wikipedia article, this Slate article, and this transcript of a 1997 BBC Horizon program.