Australian director and producer Emma Watts first encountered a fascinating treatment called ‘phage therapy’ while working in the United States in 2017.
Discovered in Paris in 1917 by French-Canadian microbiologist Félix d’Hérelle, bacteriophages (or phages for short) are viruses that can be used to attack harmful bacteria. While d’Herelle’s finding sparked interest globally, it was in the former Soviet Union, particularly Georgia, where phage therapy flourished. However, in the West, the advent of highly effective antibiotics by the 1940s soon overshadowed phage therapy.
Antibiotics were so successful and their use so widespread, bacteria and other harmful microbes have evolved mechanisms to protect them from their effects. With antibiotic resistance now looming as a major global-health crisis, phage therapy could offer new hope.
“The problem with antibiotic resistance is that not many people know or care about it,” says Watts. “I find that so deeply puzzling. There’s this huge crisis – this tidal wave that’s coming – and no one seems to engage with it. Why is that?”
When Watts told her husband, an infectious disease doctor, that she’d been reading about phage therapy, he was incredulous. “He asked which medical journals I’d been reading,” she laughs. “He put a critical doctor’s eye on it.”
Undeterred, she kept investigating the long-forgotten therapy.
Watts soon came across the story of an American health sciences researcher, Dr Steffanie Strathdee, whose husband had acquired a ‘superbug’ – identified as Acinetobacter baumannii – while on holiday in Egypt. Topping the list of the World Health Organisation’s most critical antibiotic-resistant infections, the deadly bug (often hospital-acquired) landed her husband in intensive care back home in the United States, with dwindling options.
Desperate to save his life, Strathdee looked into unconventional therapies and started cold-calling phage-therapy researchers. At the 11th hour, they were able to find a phage to ‘match’ her husband’s infection, and the treatment saved his life.
Pandemic pivot
Watts knew that she had found the perfect story to create a documentary about phage therapy and started filming with Strathdee in 2019. But the project was soon railroaded by a bigger story that was unfolding across the globe: COVID-19.
At the onset of the pandemic, Watts returned to her home in Melbourne, where she worked on several films and TV series about COVID-19 – but, while her first documentary attempt had fallen through, phages were never far from her mind.
One day, Watts learned about a new ‘compassionate-use’ trial of phage therapy that was about to get underway at the Alfred Hospital in Melbourne, where her husband worked. She connected with local phage researchers at Monash University – Dr Jeremy Barr and Professors John Iredell and Anton Peleg – and the seeds for a new phage therapy documentary had been sown.
Watts would follow, in real-time, the stories of three candidates for the phage trial, all suffering life- or limb-threatening infections. It took three years to produce the documentary, which included raising funds and securing permission from the hospital to film, but finally Last Chance To Save A Life was aired on SBS, on 15 February 2024. The outcomes they face at the conclusion of the film are as diverse as their health challenges – and reflect both the challenges and potential of phage therapy at its current stage of development.
Mentorship and collaboration
Watts teamed up with veteran Australian documentary maker, Sonya Pemberton, for the project. Pemberton’s team at Genepool Productions, a Melbourne-based production company that specialises in science documentaries, had itself been researching a proposal for a film about phages for more than five years. But until Watts came along, they lacked a key ingredient, says Pemberton.
“The thing with film-making is that it’s not just about summarising the science. You have to find a story, and we hadn’t yet found the story,” says Pemberton. “Yes, [phage therapy] is important science. Yes, it’s got an amazing history. But until we find the actual angle – the story to tell – there’s no film.”
Existing phage-related films had focussed on retrospective success stories, Pemberton says. What caught her interest about Watts’ project was that it had the compelling angle where no-one – not the patients, nor the scientists or the film-makers – would know the outcome.
Filming took 18 months, and required careful protocols around sensitively working with and presenting the stories of extremely vulnerable people – and presenting a final product that is both compelling and accessible, without sensationalising the science.
Heart project
Watts has directed several documentary-style TV series and films, but Pemberton recognised this as her first experience with a “heart project”, as she calls it – a passion project that she felt personally connected to. Pemberton mentored her through the process.
“It was very important to me that she got to tell the story the way she wanted to tell it,” Pemberton says.
Part of this mentorship included supporting Watts through the emotional experience of working closely with people in such dire health situations. On this, Pemberton recalls having supportive phone calls with Watts in her car before Watts would go into people’s homes to film.
“Personally, it was a very difficult process to follow these people and these stories,” says Watts. “I definitely became more personally and more emotionally involved than I thought I would at the beginning. There were a lot of things in making this documentary that were very shocking as they happened. But I think that’s also what makes it such a compelling film – we were there, in real time.”
Key to the power of Last Chance – and of documentaries more broadly – is its ability to share, visually and viscerally, the human side of the story. “Antibiotic resistance is a very difficult topic to get people interested in, but that changes immediately when you show the human side of the story,” Watts says. In her film, this includes not just the stories of the patients, but the scientists involved as well – their passion, their fears and their emotions are all laid bare.
“What science communication through film has to offer is an emotional wallop, because you can see something happening – you can go on the journey,” says Pemberton.
In an uncanny case of life imitating art, Watts herself contracted an antibiotic-resistant infection in the final stages of editing the film – most likely picked up from the gym or childcare, the doctors told her. While she has fully recovered, she calls the experience “terrifying” and says treatment included surgery under general anaesthesia.
“It really brought home for me how this can affect us all,” she says. “That’s a message I’d love the film to get across – that this problem is something that’s going to affect us all in the future. We should all be paying attention.”
Last Chance To Save A Life is an SBS Australia Uncovered documentary written and directed by Emma Watts, produced by Genepool Productions with Screen Australia in association with VicScreen. It is available to watch on SBS On Demand.
Story by Gemma Chilton
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