It's a pleasure to be here
in Edinburgh, Scotland,
the birthplace of the needle and syringe.
Less than a mile from here in this direction
in 1853 a Scotsman
filed his very first patent on the needle and syringe.
His name was Alexander Wood
and it was at the Royal College of Physicians.
This is the patent.
What blows my mind when I look at it even today
is that it looks almost identical
to needle in use today
Yet, it's 160 years old.
So we turn to the field of vaccines
most vaccines are delivered with
the needle and syringe,
this 160 year old technology.
And credit where its due on many levels
vaccines are a successful technology.
After clean water and sanitation,
vaccines are the one technology that has increased
our life span the most.
That's a pretty hard act to beat.
But just like any other technology
vaccines have their shortcomings
and the needle, the needle and syringe
is a key part within that narrative ...
this old technology.
So let's start with the obvious:
many of us don't like the needle and syringe.
I share that view.
However, 20 percent of the population
have a thing called needle phobia.
That's more than disliking the needle
that is actively avoiding being vaccinated
because of needle phobia.
And that's problematic in terms of the rollout
of vaccines.
Now related to this is another key issue
which is needlestick injuries.
And the WHO has figures
that suggest about 1.3 million deaths per year
take place due to cross contamination
with needlestick injuries.
These are early deaths that take place.
Now these are two things that
you probably may have heard of
but there are two other shortcomings of
the needle and syringe you may not have heard about.
One is it could be holding back
the next generation of vaccines
in terms of their immune responses.
And the second is that it could be responsible
for the problem of the cold chain
that I'll tell you about as well.
I'm going to tell you about some work that
my team and I are doing in Australia
at the University of Queensland
on a technology of design
to tackle those four problems.
And that technology is called the Nanopatch.
Now, this is a specimen of the Nanopatch.
To the naked eye
it just looks like a square
smaller than a postage stamp,
but under a microscope
what you see is thousands of tiny proejctions
that are invisible to the human eye.
And there's about 4 thousand projections
on this particular square compared
to the needle.
And I've designed those projections
to serve a key roll which is to work
with the skin's immune system.
So that's a very important function
tied into the Nanopatch.
Now we make the Nanopatch
with a technique
called deep reactive ion etching ...
and this particular technique is one that's been
borrowed from the semiconductor industry
and therefore, is low costing
and can be rolled out in large numbers.
Now we dry coat vaccines to the projections
of the Nanopatch
and apply it to the skin.
Now the simplest form of application
is using our finger
But our finger has some limitations.
So we've devised an applicator
and it's a very simple device
you could call it a sophisticated finger
it's a screen operated device.
What we do is when we apply the Nanopatch to the skin
as so
immediately a few things happen
so firstly the projections on
the Nanopatch breach through the tough outer layer
and the vaccine is very quickly released
within less than a minute in fact.
Then we can take the Nanopatch off
and discard it
And indeed we can make a reuse
of the applicator itself.
So that gives you an idea of
the Nanopatch and immediately
you can see some advantages
talk about a thing needle free.
These are projections that you can't even see
and of course we get around the needle-phobia
issue as well.
Now if we take a step back and think about these other two
really important advantages
one is improved immune responses through delivery
and the second is getting rid of the cold chain.
So let's start with the first one
this immune asdjfks idea takes a little while
to get our head around
but I'll try to explain it in simple terms
So I'll take a step back and explain to you
how vaccines work in a simple way
So vaccines work by introducing to our body
a thing called an antogen
which is a safe form of a germ.
Now that safe germ, that antogen,
tricks our body into an immune repsonse
learning and remembering how to deal with intruders
When the real intruder comes along
the body quickly mounts an immune response
to deal with that vaccine
and neutralizes the infection.
So it does that well.
Now, why it's done today
with the needle and syringe
is most vaccines are delivered with this old technology
and the needle but it could be argued
that the needle is holding back
our immune responses
it's missing our immune sweet spot
So to describe this idea
we need to take a journey through the skin
starting with one of those projections
and applying the Nanopatch to the skin
and we see this kind of data
Now this is real data
that thing that we can see there is one projection
from the Nanopatch that's been applied to the skin
and those colors are different layers.
Now to give you an idea of scale
if the needle was shown here it be much bigger
it be ten times bigger than the size of that screen
going ten times deeper as well.
It's off the grid in time
You can see immediately that we have those projections in the skin
that red layer is a tough outer layer of dead skin
but the brown layer
and the magenta layer
are jammed full of immune circles.
As one example in the brown layer
theres a certain type of cell called Langue
and so every square millimeter of our body
is jammed full of those Langerhan cells
body that we have explained in this image
but you can immediately see that the Nanopatch
achieves that penetration deep
we target thousands upon thousands of these particualar cells
just residing in the hairs width
surface of the skin
now as the guy that has invented this thing
and found out to do I find that exciting
But so what?
So what if you've targeted the cells
in the world of vaccines
what does that mean?
The world of vaccines is getting better
it's getting more systematic
however, you still don't reallly know if a vaccine is going to work
until you roll your sleeves up and vaccinate and wait
it's a gambler's game even today
So, we had to do that gamble.
We obtained a new kind of vaccine, we applied it to Nanopatches
and we applied the Nanopatches to the skin
and this isn't a live animal.
And we waited a month
and this is what we found out:
This is a data slide showing the immune responses that we've generated with a Nanopatch
compared to the needle a syringe and --
So in the horizontal access we have the dose show in Nanograms
on the vertical access we have the immune response generated on that dashed line
At that dashed line indicates the protection threshold
If we're above that dashed line it's considered
If we're below that line, it's not.
So the red line is mostly that curve
and as you see theres only one point achieved with the needle thats protected
and thats with a high dose of 6 thousand nanograms
but notice immediately the distinctly different curve that we achieve
with the blue line.
That's what's achieved with the nanopatch
the delivered dose of the Nanopatch is a completely different
immune- fads curve
that's a real fresh opportunity
suddenly we have a brand new leaver
in the world of vaccines
We can push it one way where we can take a vaccine that works
but is too expensive and we can get protection
with a hundredth of the dose
Or we can take it afkdaslf
down to ten cents and that's particularly important
within the developing world
But there's another angle to this as well
you can take vaccines that currently don't work
and get them over that line
and get them protective
And certainly in the world of vaccines
that can be important
let's consider the big three
HIV, Malaria, Tuberculosis
they're responsible for about 7 thousand deaths per year
and there is no adequate vaccination method for any of those.
So potentially with this new leaver that we have with the Nanopatch
we can help make that happen, we can push that leaver
to help get those asdfkasfjla vaccines over the line.
Now of course we've worked with the lab with many other vaccines
that have attained similar responses and similar curves
achieved with influenza
I'd like to now switch to talk about
another key shortcoming of today in vaccines
and that is the need to maintain the cold chain.
As the name suggests, it's the requirement of keeping a vaccine right from production
all the through to when the vaccine is applied
to keep it refrigerated.
Now, that presents some logistical challenges
but we have ways to do it.
This is a slightly extreme case in point
but it helps illustrate the logistical challenges
in particular settings of what's required to get settings to maintain the cold chain
if the vaccine is to warm the vaccine breaks down
but interestingly the vaccine can be too cold
and it will break down as well.
The steaks are very high
the WHR estimates that in Africa up to half
the vaccines used there
are considered to not be working properly because at some point
the cold chain has fallen over
So it's a big problem
and it's tied in with the needle and syringe
because the liquid at needs of refrigeration
A key attribute of our Nanopatch is that the vaccine is dry
and when it's dry it doesn't need refrigeration.
Within my lab theres we can keep the vaccine stored
at twenty-three degree's celcius for more than a year
without any loss
That's an important improvement.
(Applause)
We're delighted about it as well.
And the thing about it is that we've well and truly proven
the Nanopatch within the laboratory setting.
And as a scientist, I love that and I love science.
However, as an engineer,
as a biomedical engineer
and also as a human being,
I'm not going to be satisfied until we've
rolled this thing out and taken it out of the lab
and got it to people in large numbers
and particularly the people who need it the most.
So we've commenced this particular journey
and we've commenced it in an unusual way
We've started with Papua New Guinea.
Now Papua New Guinea
is an example of a developing world country
and its about the same size as France
but it suffers from many of the key barriers
existing within the world of todays vaccines.
There's logistics:
Within this country there are only 800 refrigerators
to keep vaccines chilled.
Many of them are old like this one in Port Moresby.
Many of them are breaking down
and many of them are not in the Highlands
where they are required.
That's a challenge.
But also, Papua New Guinea
has the worlds highest incidence of HPV,
Human Papilloma Virus, the cervical cancer vaccine.
Yet, that vacccine is not available in large numbers
because it's too expensive.
So for those two reasons
with the attributes of the Nanopatch
we've got into field
and worked with the Nanopatch
and taken it to Papua New Guinea
and we'll be following that up shortly.
Now doing this kind of work is not easy.
It's challenging,
but there's nothing else in the world
I'd rather be doing.
And as we look ahead
I'd like to share with you a thought —
it's the thought of a future where
the 17 million deaths per year
that we currently have
due to infectious disease is a historical footnote.
And it's a historical footnote that has been achieved
by radically improved vaccines.
Now standing here today in front of you
at the birthplace of the needle and syringe
a device that's 160 years old
I'm presenting to you an alternative approach
that could really help make that happen
and it's the Nanopatch
with it's attributes of being needle-free, pain-free
the ability for removing the cold chain
and improving the immunogenicity.
Thank you.
(Applause)