In this article we explain how current events in the field of phage therapy may positively influence its future development. We discuss the shift in position of the authorities, academia, media, non-governmental organizations, regulatory agencies, patients, and doctors which could enable further advances in the research and application of the therapy. In addition, we discuss methods to obtain optimal phage preparations and suggest the potential of novel applications of phage therapy extending beyond its anti-bacterial action.
The excessive and improper use of antibiotics has led to an increasing incidence of bacterial resistance. In Europe the yearly number of infections caused by multidrug resistant bacteria is more than 400.000, each year resulting in 25.000 attributable deaths. Few new antibiotics are in the pipeline of the pharmaceutical industry. Early in the 20th century, bacteriophages were described as entities that can control bacterial populations. Although bacteriophage therapy was developed and practiced in Europe and the former Soviet republics, the use of bacteriophages in clinical setting was neglected in Western Europe since the introduction of traditional antibiotics. Given the worldwide antibiotic crisis there is now a growing interest in making bacteriophage therapy available for use in modern western medicine. Despite the growing interest, access to bacteriophage therapy remains highly problematic. In this paper, we argue that the current state of affairs is morally unacceptable and that all stakeholders (pharmaceutical industry, competent authorities, lawmakers, regulators, and politicians) have the moral duty and the shared responsibility towards making bacteriophage therapy urgently available for all patients in need.
The authorities’ first responses were the classification of COVID-19 as Group A-disease in the sense of the Law on Public Health, scaling up of regular crisis control structures, installation of an Outbreak Management Team OMT and a “National Operational Team-Corona”. COVID-surveillance is done by the RIVM (National Public Health Institute), and is based on data from Municipal Public Health Services (GGDs) supplemented with additional (inter)national sources. The OMT is the main advisory body regarding preventive measures and includes experts from relevant medical specialisms. Organisations of medical professionals gave separate advices. Sanctions to preventive measures can be fines and closure of accommodations. Initially, 80% of the population trusted the government’s messages and “intelligent lockdown” strategy. The Prime Minister’s addresses to the people were highly appreciated. However, at slow-down of the outbreak (May-June) society’s trust crumbled (“quarantine-fatigue”). The initial testing policy was very restricted and contrary to WHO’s adagium “Test, test, test!”. In June the Minister of Health announced that a capacity of 30.000 tests per day was achieved, to be scaled up to 70.000. The crises management’s primary concern was to increase the (ICU-)bed capacity and was achieved by transforming regular wards into COVID-care, setting-up external “Corona-wards” in hotels, and regional, interregional and crossborder spreading of COVID-patients. This focus on ICU-bed capacity was criticized, as half of the death cases and extreme equipment shortages occurred in other sectors (nursing homes, homecare, homes for the elderly, psychiatry, mental handicaps). Transformation of hospital wards also led to waiting lists for non-COVID care. End of June the government presented a step-by-step easing of the lockdown in which a fine-tuned epidemiological surveillance dashboard and the continuation of economical support for the economic sector are the backbones.