Select Committee · Science, Innovation and Technology Committee

The antimicrobial potential of bacteriophages

Status: Closed Opened: 9 Nov 2022 Closed: 28 May 2024 23 recommendations 10 conclusions 1 report

This inquiry is informed by the successful pitch to the Committee’s My Science inquiry. The World Health Organisation has warned that antibiotic resistance (AMR) is one of the biggest threats to global health, food security, and development today, while the Government’s Special Envoy on Antimicrobial Resistance, Dame Sally Davies, has called AMR the ‘silent pandemic’. …

Clear

Reports

1 report
Title HC No. Published Items Response
First Report - The antimicrobial potential of bacteriophages HC 328 3 Jan 2024 33 Responded

Recommendations & Conclusions

9 items
6 Recommendation First Report - The antimicrobial potent… Deferred

Review status of phages in AMR plans and improve research funding prospects

Because phages have had relatively limited recent research funding from public sources, we recommend that the Government reviews the status of phages within its plans to tackle AMR. We also recommend more specifically that the National Institute for Health and Care Research and the UK Health Security Agency engage with …

Government response. The government supports the principle of phage education but states that medical and veterinary training standards and curricula are the responsibility of independent statutory bodies (GMC, RCVS, and schools), thereby deflecting responsibility. It does not address the recommendation to review …
Department for Science, Innovation and Technology
11 Recommendation First Report - The antimicrobial potent… Deferred

Require DHSC to respond to phage network proposals and outline plans for knowledge sharing

We recommend that the Department for Health and Social Care responds to the UK’s Phage Knowledge Transfer Network’s proposals within six months of their publication. The Department should set out how it will help develop a network for phage-related knowledge sharing and assets such as biobanks. The Department should also …

Government response. The government states it has committed to establishing general clinical trial acceleration networks with funding, but does not specifically address responding to the Phage Knowledge Transfer Network's proposals or developing a phage-specific knowledge sharing network or biobanks.
Department for Science, Innovation and Technology
12 Recommendation First Report - The antimicrobial potent… Deferred

Integrate phage clinical use into medical training and ensure access information for healthcare staff

If phages are to be used more widely within the UK’s healthcare system it is important that healthcare professionals are aware that they are an antimicrobial alternative, especially when antibiotics have failed or are failing. We recommend that information about the clinical use of phages is included within medical training …

Government response. The government supports the principle of education and training on phages but redirects responsibility for medical and veterinary training standards and curricula to the independent General Medical Council, Royal College of Veterinary Surgeons, and medical schools.
Department for Science, Innovation and Technology
13 Recommendation First Report - The antimicrobial potent… Deferred

Public acceptance of phages is crucial for their effective role in tackling AMR

The public will need to be convinced that phages are safe and effective. This will be key if phages are to play a role in addressing AMR in healthcare and as part of a One Health approach to addressing AMR across various sectors, such as the food industry and the …

Government response. The government supports training on phage therapy but redirects responsibility for medical and veterinary training standards to the General Medical Council (GMC) and the Royal College of Veterinary Surgeons (RCVS), stating they determine curriculum content.
Department for Science, Innovation and Technology
16 Recommendation First Report - The antimicrobial potent… Deferred

Establish a publicly-funded GMP facility for phage production and address industry investment barriers

We recommend that the Department for Health and Social Care considers bringing together funders with relevant catapults and innovation centres, such as the Centre The antimicrobial potential of bacteriophages 59 for Process Innovation, to build a GMP facility that can be accessed and used by phage innovators, the NHS and …

Government response. The government indicates DHSC should review current guidance for non-GMP phages, and MHRA is developing new non-binding advisory guidance for them. However, it does not address the recommendation to build a GMP facility or invest in existing spaces for phage …
Department for Science, Innovation and Technology
18 Recommendation First Report - The antimicrobial potent… Deferred

Require MHRA to produce guidance on regulating GE phages and enzymes for GMP compliance

For phages to be effective they will need to keep pace with bacterial resistance and be amenable to adaptation for individual patients. Genetically engineered (GE) phages may be one way of ensuring this. GE phages have already been used in the UK and elsewhere. However, if they are to be …

Government response. The government's response consists solely of a list of references and links, providing no specific textual reply or commitment regarding guidance for GE phages or extracted phage enzymes.
Department for Science, Innovation and Technology
28 Recommendation First Report - The antimicrobial potent… Deferred

Mandate DHSC and MHRA to review phage clinical use rules for domestic and imported alignment

The current situation whereby in the absence of UK GMP facilities only phages imported from abroad can be used, which may themselves be non-GMP, is irrational and discriminatory. This is a costly approach based on a fragile supply chain, which is denying very ill patients rapid access to a therapy …

Government response. The government states new non-binding advisory guidance on phage regulation is under development by MHRA, but the production of a monograph will be deferred until MHRA gains experience from this guidance.
Department for Science, Innovation and Technology
30 Recommendation First Report - The antimicrobial potent… Deferred

Require MHRA to review and regulate UK non-GMP phages for compassionate use, producing monograph

We recommend that the Medicines and Healthcare products Regulatory Agency (MHRA) revisits the regulation of the clinical use of non-GMP phages produced in the UK for last resort compassionate cases where antibiotics or other antibacterial interventions have failed. The MHRA should review the use of non-GMP phages in such cases …

Government response. The government reiterates that all medicines must be manufactured to GMP and states that new non-binding advisory guidance is under development by MHRA. However, the production of a monograph specifically for non-GMP phages, as recommended, will be deferred.
Department for Science, Innovation and Technology
31 Recommendation First Report - The antimicrobial potent… Deferred

Review current regulations governing liability for clinicians and hospitals using UK non-GMP phages.

We recommend that the MHRA reviews how current regulations would govern liability for clinicians and hospitals who used UK non-GMP phages, produced to a magistral monograph. It should consider what changes, if any, could be made to provide greater reassurance regarding liability, where appropriate safety and purity standards were met.

Government response. The government rejects the recommendation, stating that regulation for pharmacy practice is beyond the remit of the MHRA and that liability for unlicensed medicines currently rests with the prescriber.
Department for Science, Innovation and Technology

Oral evidence sessions

3 sessions
Date Witnesses
26 Apr 2023 Dr Jonathan Pearce · Medical Research Council, Dr Marc Bailey · Medicines and Healthcare products Regulatory Agency, Dr Morwenna Carrington · Department for Health and Social Care, Dr Tim Jinks · Wellcome Trust, Professor Isabel Oliver · UK Health Security Agency, Professor Mark Sutton · UK Centre for Ecology and Hydrology, Richard Hebdon · Innovate UK View ↗
15 Mar 2023 Dr Hans Petter Kleppen · ACD Pharma, Dr Jean-Paul Pirnay · Queen Astrid Military Hospital, Brussels, Dr Mzia Kutateladze · George Eliava Institute of Bacteriophage, Microbiology and Virology, Greg Merril · Adaptive Phage Therapeutics, Naomi Zak · BiomX, Professor Jon Iredell · The Westmead Institute for Medical Research, Professor Robert Schooley · UC San Diego School of Medicine View ↗
8 Feb 2023 Dr James Soothill · Great Ormond Street Hospital Laboratory Medicine, Dr Josh Jones · NHS Tayside, Mr David Browning · Fixed Phage LTD, Ms Stephanie Lesage · Oxford Silk Phage Technologies Ltd, Professor Cath Rees · University of Nottingham, Professor Joanne M. Santini · University College London, Professor Martha Clokie · University of Leicester View ↗