Reflections from the Lords Select Committee on phages; what we’ve achieved and where next for phage therapy?
Dr Jason Clark, Director and CSO, NexaBiome
On January 14, I had the privilege of giving evidence to a Lords Science and Technology Select Committee hearing on the antimicrobial potential of phages. The session aimed to explore the current state of phage therapy and its potential to combat antimicrobial resistance (AMR). The committee sought evidence from phage community experts and government representatives to reflect on the strides made in phage research, and the current roadblocks that are inhibiting the UK from fulfilling its phage potential.
The history behind phage therapy
Phages are viruses that specifically infect and kill bacteria. They occur naturally all around us in the environment and have evolved to be powerful bacterial killing machines. They can be used therapeutically, either alone or alongside antibiotics. Unlike antibiotics, phages only kill the harmful pathogens without harming other bacteria, some of which have beneficial effects. While phage therapy has historically been around for decades, particularly in Eastern Europe, the onset of the antibiotic era overshadowed their development.
Having worked in phage research for 25 years, I have witnessed its journey from being a niche interest to a practical solution to combat superbugs. One which is already helping those in desperate need. For much of their history phages have had the potential to be used as human therapies but their development was sidelined in preference of antibiotics, which have traditionally been seen as a simpler and more commercially appealing treatment. Today, however, the urgency to tackle the growing global health threat of antimicrobial resistance (AMR), where bacteria have become resistant, sometimes to all existing antibiotics, has never been more apparent. Consequently, viable alternative treatments for drug-resistant bacterial infections are being sought; with phage therapy one of the most promising.
The increasing momentum around phages is evidenced by the growing interest from the UK government and regulators. For the first time, the Medicines and Healthcare products Regulatory Agency (MHRA) is to issue specific guidance on the development of phage therapy products for both licensed and unlicensed use, paving a clearer regulatory path for the use of phage therapy in modern medicine. A new national phage service, which is the first government-hosted compassionate-use phage service, has opened its doors at the UK Health Security Agency (UKHSA). Initiatives like the Phage Innovation Network and successful cases of compassionate use phage therapy have also exemplified the potential for the therapeutic use of phages, but significant hurdles to their wide-spread deployment remain.
Challenges to modern-day adoption
Despite progress, there is consensus among experts that several challenges still need to be addressed for the UK to harness the full clinical and commercial potential of phages.
Firstly, the UK needs to invest in building phage-specific Good Manufacturing Practice (GMP – the standard required for all human medicines) infrastructure for phage production. While phages for compassionate use can currently be sourced from trusted suppliers abroad, having a UK-based manufacturing facility would enhance healthcare security, reduce logistical hurdles, and ensure better hands-on quality control. Government investment or subsidies here would help kickstart this process and represent a significant step forward in advancing manufacturing capabilities. Additionally, creating a centralised phage bank facility to store and distribute phages manufactured to GMP, would open up opportunities and significantly accelerate treatment timelines from months to days, potentially saving patients from life-altering morbidity or mortality.
Similarly, a lack of funding at specific points in the development cycle has been a bottleneck for phage adoption. Having more resource available to support companies who are bridging the translational gap that exists in the pre-clinical space for phage, both supports and accelerates the UKs path to clinical trials and ultimately widespread phage adoption.
Lastly, as a country we need to address the skills gap in phage biology; training specialised teams capable of managing phage production and application is vital for sustaining the momentum in this field. Partnering with industry researchers like NexaBiome, who have a highly trained, specialist team with years of expertise in phage development, can bridge this gap and allow transfer of knowledge to pharmaceutical teams. To ensure its long-term success, broader sector-wide initiatives to encourage more young professionals to enter the field are also necessary to meet growing demand and secure the future of phage.
Transforming the UK into a phage powerhouse
To position the UK as a leader in phage therapy, we must act decisively. The Lords Committee hearing and the House of Commons Science Innovation and Technology Committee report on the antimicrobial potential of bacteriophages are steps in the right direction, increasing the conversation around phage therapy.
In tandem, we would like to see government investment in a GMP manufacturing facility, and a phage bank to facilitate clinical trials and treatment provision. These investments would attract further private sector interest and bolster the UK’s standing in phage development.
Additionally, increased funding for translational research will be important to bridge the gap between academic discoveries and real-world applications and ensure sustained progress.
Finally, fostering collaboration within the phage community, industry, and regulators is key. Initiatives like the Phage Innovation Network and the supportive stance of MHRA must be sustained and scaled to provide a unified approach to overcoming regulatory and logistical challenges.
Final thoughts
The Lords Select Committee underscored both the promise and the hurdles of phage therapy. With strategic investment, further collaboration from the phage community, and a clear vision, the UK has the potential to become a global leader in this field. It now seems inevitable that phages will play a key role in our response to antimicrobial resistant infections and the only question remaining is whether the UK will position itself as a global leader, and exploit the commercial opportunities available, or simply follows in the wake of the successes in other countries.
