ella balasa is At 26, she realized the usual medical care that supported her was no longer working. The slender lab assistant grew up with side effects of cystic fibrosis, a genetic disorder that turns mucus in the lungs and other organs into a sticky mucus that gives pathogens a place to grow. To keep the infection under control, she followed a regimen of swallowing and inhaling antibiotics — but by early 2019, an antibiotic-resistant bacterium was colonizing her lungs, making her sicker than ever.
Balasa’s lung function dropped to 18%. She was running a fever and too weak to raise her arms above her head. Even weeks of IV colistin, a cruel last-resort antibiotic, had no effect. With nothing to lose, she asked a Yale lab if she could volunteer the organism they were studying: viruses that attack bacteria, called phages.
That January, Balasa traveled to New Haven from her home in Virginia, saddled with an oxygen concentrator and doubts about whether the treatment would work.Every day of the week, she inhales a mist of viruses isolated by biologist Benjamin Chan, scientific director of Yale University’s Center for Phage Biology and Therapeutics, because of their attacking capabilities. Pseudomonas aeruginosamultidrug-resistant bacteria clogging Balasa’s lungs.
It worked. The virus penetrates the mucus, attacks the bacteria, and kills some; the rest of the bacteria are weakened enough for antibiotics to wipe them out. Balasa’s body cleared the life-threatening infection faster than ever before.
Today, Balassa is 30; she continues to suffer from cystic fibrosis, but two more rounds of phage therapy, combined with a change in medication, have prevented her from reliving the crisis that phage therapy eliminated. Now, she advises companies developing cystic fibrosis drugs and works to raise awareness of new treatments, including bacteriophages. “I very much see them as a new way to treat infections,” she said. “If I don’t have access to phages, who knows what my life would be like at this point?”
There is an asterisk to her success: phages are unapproved drugs, not only in the US but also in the UK and Western Europe. In these countries, no company produces the drug for commercial sale, and hospitals and pharmacies do not stock it. To administer them, doctors must seek compassionate use authorization from government regulators (in Balasa’s case, the Food and Drug Administration) to show their patients have no choice.
The process is inefficient and inherently unfair, as it limits availability to those who are lucky and persistent and whose physicians have strong professional networks. Still, journal articles and researchers’ reports suggest that more than 100 patients in the United States received emergency phage therapy, most of them undisclosed. The researchers believe that if phages were legally available, many more lives could be saved.
In the end, that might be the case. In 2021, the National Institutes of Health awarded $2.5 million to 12 U.S. institutions to study phage therapy.Last year, the National Institutes of Health launched the first federally funded clinical trial of a beneficial virus, supporting 16 centers to test safety and possible dose levels Pseudomonas, the pathogen that makes Balasa sick. Other academic centers and private companies have conducted about 20 trials in the US and about 30 trials in the UK and Europe. In January, a British parliamentary committee launched an inquiry into whether phage could be marketed there.
