Viral solutions – the promise of bacterial viruses as antibiotic alternatives
- The Fleming Initiative
- 6 days ago
- 5 min read
On 29 January, the Fleming Initiative hosted its inaugural Science Summit, in partnership with Imperial College London and the University of Cøpenhagen. The one-day event brought together leading researchers, clinicians, policymakers and innovators to explore the potential of phage therapy as part of the response to antimicrobial resistance (AMR).
The summit focused on both the scientific advances driving renewed interest in phages and the systems-level changes needed to translate phage biology from bench to bedside. Programme development was led by Dr Simon Dryden (Fleming Initiative) and Professor Ramesh Wigneshweraraj (Department of Infectious Disease, Imperial College London).
Phages are viruses that infect and replicate within bacteria. Although they have been recognised for over a century and used therapeutically in some parts of the world, phage therapy has not been broadly integrated into modern healthcare. As antibiotics resistance escalates worldwide, phages are gaining renewed attention as precise, adaptable and potentially transformative alternatives to treat bacterial infections.
From momentum to translation
The summit opened with a scene-setting address from Professor Martha Clokie (University of Leicester), who described the resurgence of global interest in phage therapy more than a century after their discovery. She highlighted growing international guidance, increasing government engagement and investment, the emergence of national phage strategies, and expanding pathways as well as rising demands for compassionate use of phage therapy as signs of rapidly accelerating global momentum behind phage-based interventions to manage difficult-to-treat bacterial infections.
Professor Clokie also emphasised the persistent gap between phage research and clinical application. She described how limited coordination, fragmented infrastructure and a lack of robust clinical trial data continue to slow progress. Bridging this gap, she argued, will require stronger clinical evidence, well-characterised and diverse phage libraries, scalable and quality-assured manufacturing, and regulatory frameworks that integrate phage therapy into the wider antimicrobial ecosystem through coordinated, cross-sector collaboration.
From innovation to scaling discovery
The summit brought together experts at the forefront of phage research to showcase how innovations in machine learning and artificial intelligence are advancing the field.
Professor Thomas Sicheritz-Ponten (University of Cøpenhagen) showed how developments in genome sequencing and machine learning are rapidly transforming the discovery and characterisation of therapeutic phages. These approaches are improving precision matching between phages and bacterial pathogens and deepening understanding of phage–bacteria infection mechanisms. Dr Tiago Dias Da Costa (Department of Life Sciences, Imperial College London) and Dr Alan Kartikesalingam (Google DeepMind) presented their groundbreaking research demonstrating how artificial intelligence can be used as a “co-scientist” for rapidly generating hypotheses, enabling revolutionary discoveries, and reshaping how phage–bacteria interactions are studied.
Prof Bent Petersen (University of Cøpenhagen) emphasised the need for open, scalable computational infrastructure to support prediction, access and training as the innovation advances. Scaling phage therapy, he noted, is simultaneously a biological, computational and human challenge, with progress in each area dependent on the others.
Presentations by Dr Jakob Rostøl (Imperial College Research Fellow at the Department of Infectious Disease, Imperial College London) and Professor Hanne Ingmer (University of Cøpenhagen) highlighted the importance of understanding the fundamental biology underpinning phage-bacteria interaction, which could illuminate the way phages are used therapeutically. Their work illustrated how interactions within microbial ecosystems, including competition between phages, and bacterial defence mechanisms that protect bacterial cells from phage attack, can influence therapeutic outcomes.
The UK Ministry of Defence was represented by Lt Col (Dr) Lucy Lamb and Major Aaron Mason who highlighted the need for phage therapy as an important arsenal in biodefense. Together, these talks underscored the complexity of phage–bacteria interactions and the need for convergent, interdisciplinary approaches supported by robust data infrastructure to accelerate translation from fundamental research to clinical application.
From science to systems
Beyond discovery, the summit examined the wider systems needed to bring phage therapy to scale. Dr Tine Rikke Jørgensen (University of Cøpenhagen) highlighted the potential of phage therapy as part of a One Health approach to antimicrobial resistance, recognising the interconnectedness of human, animal and environmental health in preventing and treating infections.
Regulatory pathways for phage therapy were also a key focus. Dr Carmen Coxon (Medicines and Healthcare products Regulatory Agency) stressed enduring challenges, including environmental impact assessment, clarity around synthetic phages, the lack of international harmonisation, access and reimbursement, cross-sector usage and reference standards.
Complementing this, Dr Mark Sutton (UK Health Security Agency) outlined ongoing efforts to strengthen the national phage therapy landscape. These include developing rapid phage susceptibility testing, supporting clinical trials, fostering cross-sector partnerships, and leveraging emerging technologies to drive both discovery and implementation.
From promise to practice
Talks by patient Peter Knox, who benefited from phage therapy, and Dr Kavita Dave (Royal Brompton and Harefield hospitals) powerfully underscored the significance of the summit and described a compelling case why phage therapy stands as a genuine and viable alternative to antibiotics. However, they also reflected on the real-world challenges of treating complex infections with phages, including limited access to licensed phage products, reliance on unlicensed use under clinician discretion, and the absence of domestic GMP manufacturing infrastructure.
The summit concluded with a panel discussion with Professor Martha Clokie (University of Leicester), Dr Clare Trippett (Principal Strategic Opportunities Manager, CPI), Dr Rita Ramalhete (Associate Editor, Nature Comms) and Charles Perrard (Chief Executive Officer, Inteliphage), chaired by Prof Ramesh Wigneshweraraj. The discussion focused on the practical steps needed to move phage therapy from promise to practice. Topics included manufacturing and purification standards, characterisation of phage products, cost-effectiveness evidence and economic incentives necessary for innovation, and the role of real-world patient data in informing clinical trials. Panellists also explored how AI and advanced diagnostics could support prediction, production and clinical decision-making.
As Professor Alison Holmes, Director of the Fleming Initiative, emphasised:
“Science and innovation is a critical pillar of the Fleming Initiative’s work. Beyond advancing research, we aim to showcase the extraordinary work being done locally, nationally and globally. This summit highlights phage therapy as an emerging priority in the fight against antimicrobial resistance, and we hope it will catalyse collaboration and action across the entire community.”
And Professor Ramesh Wigneshweraraj extended:
“The successful broad clinical implementation of phage therapy can only be built to scale on fundamental understanding of how phages interact with their bacterial prey in disease relevant contexts and how phagessynergise with other emergent antibacterial therapeutics, including conventional antibiotics.”
The Fleming Initiative will continue to drive science-led solutions to AMR, building on the momentum of this inaugural summit. We are already looking ahead to our next science summit in June 2026, which will spotlight antifungal resistance and bring together experts to advance collaboration, innovation, and action in this critical area.
We are grateful to the NIHR Imperial Biomedical Research Centre (BRC) for supporting this event.
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