Treating Third World Water with Bacteriophages

Currently on the nightstand, with a common thread:

Life at the Speed of Light by J. Craig Venter

Rewire: Digital Cosmopolitans in the Age of Connection by Ethan Zuckerman

Triumph of the City : How our Greatest Invention makes us Richer, Smarter, Greener, Healthier, and Happier by Edward L. Glaeser

Venter writes about curing bacterial diseases with bacteriophages. Zuckerman writes about Makoko, a Venice-like suburb of Lagos, Nigeria. And Glaeser talks about water treatment enabling cities, and inadequate sanitation in ... Lagos, Nigeria.

Hmmm. Connect the dots.

Treating bacterial diseases in humans is fraught with difficulties. Killing bacteria in water is probably simpler, and the risks are lower. So, Dr. Venter, how about developing bacteriophages for cholera, dysentery and typhus, designed to be released in drinking water storage reservoirs in Nigeria? A relatively easy first step before developing phages for treatment of these diseases in vivo.

Bacteriophages can also be used in microscopic wells on bacteria-screening chips - the rupture of a bacterial cell wall creates a detectable electrochemical event. Screening chips could be plugged into to cell phones, which could summon an airplane to "bomb" a specific reservoir with a specific concentrated phage.

Maintaining one internationally inspected "treatment airbase" for most of a continent would be far cheaper than continuous broad spectrum treatment for all waterborne bacterial illnesses, requiring a professional staff and treatment machinery for each reservoir.

reference: A 0.18μm CMOS Integrated Sensor for the Rapid Identification of Bacteria

Q & A

> Interesting idea, but isn't chlorination simpler and known to be both effective and reasonably cheap?

About 30% of the world (90% of Nigeria?) does not get water though pipes, necessary to keep the chlorine in the water. The water must be filtered before treatment, or you get halocarbon carcinogens and other poisons. Modern water treatment is a 20th century first world technology, and requires fairly sophisticated monitoring and a dependable supply chain. London did not have sand filters until 1860, or chlorination until 1911.

Most adults worldwide have cell phones. We should design around the tools we have. If the priorities of the ultrapoor seem wonky, think again about London before 1800, when life expectancies were half of what they were in the countryside, yet people kept moving there. People will die for connectivity.

The advantage of bacteriophages is that they can be artificially evolved to keep up with their evolving bacterial targets, and are ultraspecific to those targets, harmless to people or useful gut bacteria. The phages replicate exponentially while destroying those targets, so very little material is needed per reservoir. Bacteria can evolve resistance to any water treatment, another reason the first world filters the water first. If the phages and sensors are made in first-world high tech biofabs, and distributed by air drop, the "last mile" complexity is close to nil.

Starvation and disease kills 30% of the children in Nigeria. Sadly, we cannot even save lives with 25 cents worth of electrolyte salts for diarrhea in these places.

Nigeria reminds me of fellow graduate student Jean Masango. His first "schooldesk" was an outdoor stump facing a chalkboard, no paper or books until his brilliance got him into high school and college, then a scholarship to UC Berkeley where I met him. Many more like him died before they had the chance to do the same.