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Electron micrograph of Bacteriophages
Electron micrograph of Bacteriophages
Raphaëlle Maruchitch

PARIS — After he was in a car accident, Serge Fortuna was left with an infected wound that wouldn’t heal. When his doctors started talking about amputation, he refused and decided to try something else: a trip to the Republic of Georgia for phagotherapy, a treatment that uses specific bacteria-fighting viruses to heal antibiotic-resistant infections. The treatment was a success, and Fortuna now helps others get the treatment.

Later this year, hospitals in France, Belgium and Switzerland will begin unprecedented clinical trials of bacteriophages, viruses that attack bacteria, and will base their research in France. Phagotherapy is an ancient treatment that has already proven its medical potential, and now it is inspiring hope in the fight against antibiotic-resistant bacterial infections.

But it still illegal everywhere except Russia and Georgia. Just 18 months ago, Dr. Alain Dublanchet — a microbiologist, former hospital chief and fervent supporter of phagotherapy — still faced a massive number of obstacles in his crusade to reintroduce the treatment in France legally.

At the time, the French start-up Pherecydes Pharma was starting preliminary clinical trials of phages on animals. Since then, the results have shown “very high efficacy,” says Jérôme Gabard, CEO of the company. Along with two other doctors, Gabard assembled an application for financing from the European Union. Last June the group was given a little over 3.8 million euros to investigate the use of phages against stubborn infections.

The project is called Phagoburn, and it is being rolled out in burn units in public, private and military hospitals. The trials will include about 200 burn patients. Pherecydes Pharma will finalize the virus cocktail, and a Nantes-based company called Clean Cells will produce them.

There will be two versions — against two different bacterial strains — to test on infected burns. “We hope to show that phages are just as effective as the standard treatment, but that they actually clean up infections sooner,” says Dr. François Ravat, one of the project leaders.

On the road toward legalization

The trials represent a big step toward legalizing phagotherapy in Europe, but not the only one. Politicians in France and the rest of the European Union are becoming more comfortable with the idea, and phagotherapy was even included in the European Commission’s Horizons 2020 report.

Meanwhile, Serge Fortuna created a non-profit called Phages of the Future that helps people travel to the Republic of Georgia, where phagotherapy is widely practiced. The organization accompanies patients to Georgia, handles logistics and provides translation services to patients who want to try the treatment as a last resort. They are making their third trip this month.

Why are pharmaceutical companies so interested in this kind of therapy? The phages themselves can’t be patented, because they are living creatures. But Gabard says individual phage cocktails can be patented. “As the Phagoburn project advances, the industry will see that things are changing,” says Ravat.

But Jean-Marc Chatellier is one person who has personally confronted the reality that phagotherapy is still illegal in France. When his mother contracted an antibiotic-resistant infection, phagotherapy was not an option for her in her own country, and a trip to Georgia was not feasible. She died from the infection, at age 73, about a year ago.

For his part, Dublanchet and other phagotherapy supporters accept some patients but limit their use of the illegal treatment. “Establishing protocols for the use of phagotherapy” has become his primary goal, he says. “They should not be allowed to be used completely freely, like was the case with antibiotics,” Dublanchet warns.

For the moment, the biggest problem is that it is difficult to guarantee the stability of the phage cocktails. And for the therapy to be approved, regulators will have to evaluate a stable and ready-to-use mixture.

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Society

How India’s Women Are Fighting Air Pollution — And The Patriarchy

India is one of the world's worst countries for air pollution, with women more likely to be affected by the problem than men. Now, experts and activists are fighting to reframe pollution as a gendered health crisis.

A woman walking through dense fog in New Delhi

*Saumya Kalia

MUMBAI In New Delhi, a city that has topped urban air-pollution charts in recent years, Shakuntala describes a discomfort that has become too familiar. Surrounded by bricks and austere buildings, she tells an interviewer: "The eyes burn and it becomes difficult to breathe". She is referring to the noxious fumes she routinely breathes as a construction worker.

Like Shakuntala, women’s experiences of polluted air fill every corner of their lives – inside homes, in parks and markets, on the way to work. Ambient air in most districts in India has never been worse than it is today. As many as 1.67 million people in the country die prematurely due to polluted air. It is India’s second largest health risk after malnutrition.

This risk of exposure to air pollution is compounded for women. Their experiences of toxic air are more frequent and often more hazardous. Yet “policies around air quality have not yet adequately taken into account gender or other factors that might influence people’s health,” Pallavi Pant, a senior scientist at the Health Effects Institute, a nonprofit in the U.S., told The Wire Science.

“It’s unacceptable that the biggest burden [rests on] those who can least bear it,” Sherebanu Frosh, an activist, added. People like her are building a unique resistance within India.

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