By Fabian Rueda
The figure that should be running on tickers, but isn’t, comes from a paper published in The Lancet in September 2024: roughly 40 million people are projected to die from antimicrobial-resistant infections worldwide between now and 2050. Today, the count is around 1.3 million a year. Most of those deaths are not exotic. They are urinary tract infections, lung infections, post-surgical infections, the everyday bacterial workload that antibiotics used to handle without much drama.
Chris Shaffer was almost one of them. By April 2021, he had an antimicrobial-resistant E. coli ESBL infection sitting in his prostate, the result of complications that started with an emergency colon surgery on Christmas Eve 2018 in Palm Springs. For more than two years, the antibiotics failed. He flew to Tbilisi, Georgia, and underwent a four-month course of phage therapy at the Eliava Institute. He has remained infection-free since.
Shaffer documented the experience in Finding Phage, his account of the search for treatment. He is now the president of Phage One Voice, a nonprofit working to bring phage therapy into the mainstream of American medicine.
Phages are viruses that infect bacteria and only bacteria. They cannot hijack human cells. The Eliava Institute, where Shaffer was treated, was founded in 1923 in Tbilisi by Georgian bacteriologist George Eliava and Félix d’Herelle, the French-Canadian scientist credited with the discovery of bacteriophages. The institute’s clinical arm now serves patients from more than 85 countries.
In the United States, phage therapy was largely abandoned after the rise of penicillin. It survives in pockets, clinical trials, compassionate-use cases, and a handful of research programs Shaffer names in his book: Texas A&M’s Center for Phage Technology, the IPATH center at UC San Diego, the phage program at Yale School of Medicine, the Naval Medical Research Center’s phage work, and Dr. Betty Kutter’s decades-long phage research program at Evergreen State College in Olympia, Washington. The FDA has not approved phage therapy for general use, so American access requires either an Investigational New Drug application, which can take more than a year, or a compassionate-use waiver, usually granted only when a patient is close to death.
Shaffer holds a Ph.D. in policy and political science and spent 45 years in education, ending his career as a district administrator after years as a high school principal. He is explicit, in his book and in his advocacy, that he is not a clinician. The research training, he writes, is what allowed him to read his own case studies and find his way to Tbilisi when his physicians did not know where to send him.
Phage One Voice is an early-stage nonprofit, not a treatment center. Its work is awareness, education, and access, building up a teaching and therapeutic phage library, developing application protocols, and pushing for phage therapy to be taught in American medical schools, where it currently is not. The longer ambition, as Shaffer describes it, is for phage use to “become commonplace in human and animal medicine, crop production, aquaculture, and cosmetics.“
The economics of new antibiotics are not coming to the rescue. A new antibiotic takes roughly a decade and around a billion dollars to bring to market, and most are taken once and then no longer needed, a poor return for a pharmaceutical company. Those who have been warning since 2022 that the pipeline is thin.
Shaffer is the first to say his story is a single data point. But it sits inside a larger one. In 2019, according to the Lancet figures cited in his book, 33 bacterial pathogens were linked to nearly 8 million deaths globally, with five, including E. coli, S. aureus, Klebsiella pneumoniae, and Pseudomonas aeruginosa, accounting for more than half. Those are the bacteria phage therapy has the longest track record against.
He is now asking American funders, philanthropists, and clinicians to take a hundred-year-old therapy seriously, while it is still early enough to matter.
Disclaimer: This article is for informational and educational purposes only and does not constitute medical advice. Phage therapy is not approved by the U.S. Food and Drug Administration for general use. Any decisions regarding treatment for bacterial infections should be made in consultation with a licensed medical professional. The personal experience described in this article is one individual’s account and is not representative of typical outcomes.
