1. How did having a state health system influence the treatment of infectious disease in 1940s-50s Russia?

• After World War II, the funding which the West provided to the East for the increase in the use of antibiotics was stopped which forced the Soviet Union to rely on their own minimal resources. Because of the withdrawal of funding, the Soviet Union government urged the citizens to use homemade remedies rather than the ones created in the West as it made a connection of herbal medicines to loyalty to the country. Also, the drug supply problem came about from the lack of funding by the state. Although it was universal health care, the state did not provide an adequate amount of resources to fulfill the demands of providing a universal health care system. As there has a been an integration of homemade remedies in the culture, it has become an important part of treatment as it serves as a backup for when standard medicine fails to work.

2. The Hirszfeld Institute is also intertwined with Russian history. A tragic quote is given on page 66 by Hirszfeld about the death of his daughter.  Even so, the outcome of these 2 centers has been very different.  Discuss why you think this is so.

• The Hirszfeld Institute, despite the sad history behind the formation of the institute, became known in western Europe for a wide range of research conducted. The history began with L. Hirszfeld, a man born in Warsaw which was then Russian occupied territory. He suffered through the Holocaust and the loss of his daughter in that process. After surviving through the war, Hirszfeld and his wife settled in Wroclaw where he accepted to be the dean of the medical school. During this time, he rebegan his research on blood groups and began mass research and treatment of syphilis. In 1952, he petitioned to open an institute dedicated to immunology within the medical school. The acceptance of the request was slowed by the popularity of the idea of Lysenkoism, a belief that acquired characteristics were inherited. Then, there was a large-scale accusation that Jewish doctors were poisoning Soviet Union officials. This all ended with the death of Stalin, then Hirszfeld’s wish was granted. The institute is now modern and well-staffed, with over 300 employees. The Phage Therapy Center in Wroclaw views phages to be promising in situations where the use of antibiotics has not worked as the treatment. The Eliava Institute in Tbilisi was founded in 1923 by Prof. George Eliava along with the assistance of Felix D’Herelle who first discovered the presence of phages. However, due to Stalin Terror, Eliava was executed in 1937 and D’Herelle never returned. During the reign of the Soviet Union, the Institute prepared and manufactured products that treated almost all major bacterial and viral diseases. The outcomes of both institutes differed due to the possibility that the circumstances both institutes faced regarding the history of the time.

3. Research in the USA often differs from other countries because of regulations by the FDA and private investments. Describe the experimental design that Merril used to determine how to select for phages that were not removed by the liver and spleen.

• To select phages which are not immediately removed by the liver and spleen, Merril and his team injected phage that was active against a strand of E. coli into the stomach of mice. After several hours, Merril and his team took samples of blood and isolated the phage that were still present them reinjected them into the mice. After repeating this task 8 times, Merril and his team managed to isolate several phages which had the ability to survive in the liver and spleen for more than 18 hours. The paper published discussed the overall methods used to test their hypothesis and their results. The figures illustrate the actions of Argo1 and Argo2 with different sets of conditions to determine which experimental set provided the best option.

4. The most convincing argument for using phage is tied to the increasing problem of antibiotic resistance. Even so, many still consider phage therapy an alternative therapy.  Chapter 8 describes several start-up companies:

Phage Therapy, Phage Biotics, GangaGen, Exponential Biotherapies.  Research these companies and discuss the potential for phage therapy in modern Western medicine. What experiments need to be done?

All the companies mentioned are focused on developing therapeutic treatments using phages that are found within the environment. These companies may be working on developing a treatment which addresses the widespread of multiple strains of bacteria being resistant to antibiotics. There is potential for phage therapy in that because there is an increasing problem of resistance to antibiotics, phage therapy can prove to be an option of treatment. Some experiments which need to be done are ones that allow scientists to understand which family of phages work as treatment against a specific strain of bacteria.