Introduction
In chapters five through eight of The Forgotten Cure, we see a continuation in the rough history of phages after the war and Stalin’s regime. The book focuses on how medicine evolved in the very different places: the USSR and the Western world. While phage therapy seemed to have some effect but with no solid evidence to back it up, data and evidence existed that are still not recognized much to this day.
How Politics Affect Medicine and the Health of A Country
While young, bright-eyed scientists may dive into research thinking that they can study anything and solve any problem, the reality is that research and medicine are heavily influenced by politics and world events. This can be seen when outbreaks happen in the US – suddenly “scientists are working hard to find a cure” despite relative ignorance previously towards the illness while it existed in some third world country. Similarly, the creation of antibiotics was such a phenomenon that overshadowed alternative remedies like phage therapy and herbal medicine. But this was not the case for the USSR. The Soviet government attacked foreign pharmaceuticals with propaganda because it wasn’t “nashi“, which means “ours”. Herbs and natural remedies were promoted. For economic reasons, such as the suspension of Western funding after World War II, phage therapy was the cheaper and more natural alternative to the uprising antibiotics of the Western world.
The Soviet government was in a pretty logical mindset with having the state healthcare system, but this lacked heavily in funds for more global medicines. Also, healthcare in general was second to the production of weapons and the funding for defense. Russia could have spent more into having more antibiotics on their shelves since the doctors were relying mostly on phage therapy (which at the time still did not have much solid evidence, as uncontrolled experiments and controversial results put the effectiveness of phages into question).
Hirszfeld and His Institute for Phage Therapy
To some it is a shocking revelation that doctors and scientists can have struggles in life similar to that of an average citizen. Take for example Ludwik Hirszfeld who had to change his name, his religion, and the location of where he lived several times in order to escape the antisemitism in Poland. He lost his daughter due to illness that had developed while the family had been forced into the Warsaw Ghetto. While these tragedies affected Hirszfeld, he was able to escape the Ghetto. He recognized in further research that miscarriages were due to conflicting blood types between mother and child, however this idea directly argued against the Stalin-promoted philosophy of Trofim Lysenko. Having ideas that conflicted with Soviet science, or simply being a Jewish doctor or scientist, was like playing with fire. The Soviet government had the power to influence its empire and manipulate scientific data.
Later he founded the L.Hirszfeld Institute of Immunology and Experimental Therapy, but died before he could direct the institute. Nowadays the institute is called the Phage Therapy Center. In comparison to the Eliava Institute, the Phage Therapy Center seems a bit more Western and continues to produce research. On the Eliava Institute’s website homepage, there is a eulogy for Dr. Adamia. He was the husband of Nino and in The Forgotten Cure Nino was described as being somewhat greedy as she did not agree on a contract for $75,000 per year for two years, because the Tbilisians led by Nino wanted $1 million to be invested. Perhaps such business methods translate to medical practices.
Hesitation to Adopt Phage Therapy
Even now, phage therapy is a young area of research in the Western world due to much misunderstanding and general lack of knowledge. As mentioned in The Forgotten Cure, medical schools often do not teach phage therapy because it is an alternative method. There is this unconscious boasting of Western medicine and technology – this idea that it is without flaws. Only as antibiotic-resistant bacteria rear their ugly heads does the public see that even Western scientists may need to turn to alternative methods. Even those who have been taught about phage therapy can misuse the phages. They cannot be poured onto a wound like some easy boo-boo sprays we have today. As Magdalina Pokrovskaya mentioned about the earlier unclear results of phage therapy, most scientists did not know the complexity of using them or the storage needed for them.
Merril’s Idea of Highly Specialized Phages
Research in the USA must not only pass the strict regulations of the FDA, but also must seem profitable for private investors. Carl Merril’s story starts out humbly with showers as he pondered under the steamy waters of antibiotic resistance and phage therapy. He thought to breed viruses that outwit the liver and spleen and luckily around the same time Richard Carlton came around and decided to invest in this endeavor. Merril, Carlton, and Sankar Adhya designed the experiment then put together a proposal for a “CRADA – a cooperative research and development agreement that allows scientists in the public and private sectors to work together” (TheForgottenCure 73). The proposal was accepted and they began their work!
First the team bred phages that could evade the liver and spleen, then managed to isolate the phages that could survive in the bloodstream for 18 hours, then they tested the selected strains on mice (with control groups). It worked! The published paper contained several charts that showed strong evidence for the phage effectiveness.
So… Phage Therapy or Antibiotics? Or Other?
Carlton said at the end of chapter seven in The Forgotten Cure that he sees a future where doctors use both phage therapy and antibiotics because there is little chance that bacterium can survive both. I’m in agreement that yes, antibiotics alone are failing Western medicine due to the uprising of antibiotic-resistant bacteria. Could phage therapy alone be the solution? While phages do mutate and fears of phages turning on our bodies are present, there are many start-up companies that are dedicated entirely to furthering our understanding of bacteriophages. Perhaps as Carlton said, both could work together. It doesn’t make sense to abandon antibiotics completely, since there are still effective ones out there (we just need to pull back on our usage of them). Some longitudinal studies should be done or studies that can replicate the effects of foreign bacteriophages in the human body over a lifespan.