0:00:00.453,0:00:01.549
It's a pleasure to be here

0:00:01.549,0:00:03.606
in Edinburgh, Scotland,

0:00:03.606,0:00:06.891
the birthplace of the needle and syringe.

0:00:06.891,0:00:09.732
Less than a mile from here in this direction

0:00:09.732,0:00:11.706
in 1853 a Scotsman

0:00:11.706,0:00:13.996
filed his very first patent on the needle and syringe.

0:00:13.996,0:00:16.236
His name was Alexander Wood

0:00:16.236,0:00:19.987
and it was at the Royal College of Physicians.

0:00:19.987,0:00:22.465
This is the patent.

0:00:22.465,0:00:25.176
What blows my mind when I look at it even today

0:00:25.176,0:00:27.349
is that it looks almost identical

0:00:27.349,0:00:29.106
to needle in use today

0:00:29.106,0:00:32.666
Yet, it's 160 years old.

0:00:32.666,0:00:35.161
So we turn to the field of vaccines

0:00:35.161,0:00:37.390
most vaccines are delivered with

0:00:37.390,0:00:38.242
the needle and syringe,

0:00:38.242,0:00:41.529
this 160 year old technology.

0:00:41.529,0:00:43.492
And credit where its due on many levels

0:00:43.492,0:00:47.096
vaccines are a successful technology.

0:00:47.096,0:00:50.985
After clean water and sanitation,

0:00:50.985,0:00:55.259
vaccines are the one technology that has increased

0:00:55.259,0:00:57.743
our life span the most.

0:00:57.743,0:01:00.618
That's a pretty hard act to beat.

0:01:00.618,0:01:02.057
But just like any other technology

0:01:02.057,0:01:03.902
vaccines have their shortcomings

0:01:03.902,0:01:06.585
and the needle, the needle and syringe

0:01:06.585,0:01:08.696
is a key part within that narrative ...

0:01:08.696,0:01:11.670
this old technology.

0:01:11.670,0:01:13.969
So let's start with the obvious:

0:01:13.969,0:01:17.451
many of us don't like the needle and syringe.

0:01:17.451,0:01:19.365
I share that view.

0:01:19.365,0:01:22.557
However, 20 percent of the population

0:01:22.557,0:01:25.003
have a thing called needle phobia.

0:01:25.003,0:01:26.364
That's more than disliking the needle

0:01:26.364,0:01:29.063
that is actively avoiding being vaccinated

0:01:29.063,0:01:30.927
because of needle phobia.

0:01:30.927,0:01:33.304
And that's problematic in terms of the rollout

0:01:33.304,0:01:35.253
of vaccines.

0:01:35.253,0:01:37.079
Now related to this is another key issue

0:01:37.079,0:01:39.412
which is needlestick injuries.

0:01:39.412,0:01:41.219
And the WHO has figures

0:01:41.219,0:01:45.219
that suggest about 1.3 million deaths per year

0:01:45.219,0:01:47.611
take place due to cross contamination

0:01:47.611,0:01:48.895
with needlestick injuries.

0:01:48.895,0:01:51.547
These are early deaths that take place.

0:01:51.547,0:01:54.558
Now these are two things that [br]you probably may have heard of

0:01:54.558,0:01:56.438
but there are two other shortcomings of

0:01:56.438,0:01:58.922
the needle and syringe you may not have heard about.

0:01:58.922,0:02:00.903
One is it could be holding back

0:02:00.903,0:02:02.490
the next generation of vaccines

0:02:02.490,0:02:04.671
in terms of their immune responses.

0:02:04.671,0:02:07.568
And the second is that it could be responsible

0:02:07.568,0:02:08.893
for the problem of the cold chain

0:02:08.893,0:02:12.273
that I'll tell you about as well.

0:02:12.273,0:02:14.008
I'm going to tell you about some work that

0:02:14.008,0:02:15.707
my team and I are doing in Australia

0:02:15.707,0:02:17.601
at the University of Queensland

0:02:17.601,0:02:18.956
on a technology of design

0:02:18.956,0:02:22.229
to tackle those four problems.

0:02:22.229,0:02:26.252
And that technology is called the Nanopatch.

0:02:26.252,0:02:32.817
Now, this is a specimen of the Nanopatch.

0:02:32.817,0:02:34.466
To the naked eye

0:02:34.466,0:02:36.650
it just looks like a square

0:02:36.650,0:02:39.549
smaller than a postage stamp,

0:02:39.549,0:02:42.215
but under a microscope

0:02:42.215,0:02:44.426
what you see is thousands of tiny proejctions

0:02:44.426,0:02:46.678
that are invisible to the human eye.

0:02:46.678,0:02:48.404
And there's about 4 thousand projections

0:02:48.404,0:02:50.265
on this particular square compared

0:02:50.265,0:02:51.861
to the needle.

0:02:51.861,0:02:54.598
And I've designed those projections

0:02:54.598,0:02:56.119
to serve a key roll which is to work

0:02:56.119,0:02:59.033
with the skin's immune system.

0:02:59.033,0:03:00.996
So that's a very important function

0:03:00.996,0:03:02.452
tied into the Nanopatch.

0:03:02.452,0:03:04.699
Now we make the Nanopatch

0:03:04.699,0:03:07.236
with a technique

0:03:07.236,0:03:09.615
called deep reactive ion etching ...

0:03:09.615,0:03:11.306
and this particular technique is one that's been

0:03:11.306,0:03:13.286
borrowed from the semiconductor industry

0:03:13.286,0:03:15.122
and therefore, is low costing

0:03:15.122,0:03:17.316
and can be rolled out in large numbers.

0:03:17.316,0:03:20.722
Now we dry coat vaccines to the projections

0:03:20.722,0:03:22.336
of the Nanopatch

0:03:22.336,0:03:24.201
and apply it to the skin.

0:03:24.201,0:03:28.757
Now the simplest form of application

0:03:28.757,0:03:30.779
is using our finger,

0:03:30.779,0:03:33.399
but our finger has some limitations.

0:03:33.399,0:03:35.653
So, we've devised an applicator

0:03:35.653,0:03:36.786
and it's a very simple device --

0:03:36.786,0:03:39.088
you could call it a sophisticated finger.

0:03:39.088,0:03:42.128
It's a screen operated device.

0:03:42.128,0:03:44.169
What we do is when we apply the Nanopatch

0:03:44.169,0:03:48.460
to the skin, as so ...

0:03:48.460,0:03:50.736
immediately a few things happen.

0:03:50.736,0:03:53.046
So firstly, the projections

0:03:53.046,0:03:54.830
on the Nanopatch

0:03:54.830,0:03:56.460
breach through the tough outer layer

0:03:56.460,0:03:58.506
and the vaccine is very quickly released,

0:03:58.506,0:04:00.854
within less than a minute in fact.

0:04:00.854,0:04:03.420
Then we can take the Nanopatch off

0:04:03.420,0:04:05.358
and discard it.

0:04:05.358,0:04:07.385
And indeed we can make a reuse

0:04:07.385,0:04:11.876
of the applicator itself.

0:04:11.876,0:04:13.811
So that gives you an idea of the Nanopatch

0:04:13.811,0:04:16.280
and immediately you can see some key advantages.

0:04:16.280,0:04:18.496
We've talked about it being needle-free,

0:04:18.496,0:04:20.730
These are projections that you can't even see

0:04:20.730,0:04:22.441
and of course we get around

0:04:22.441,0:04:25.514
the needle phobia issue as well.

0:04:25.514,0:04:27.445
Now, if we take a step back and think about

0:04:27.445,0:04:30.841
these other two really important advantages:

0:04:30.841,0:04:34.877
one is improved immune responses through delivery

0:04:34.877,0:04:38.610
and the second is getting rid of the cold chain.

0:04:38.610,0:04:39.599
So let's start with the first one,

0:04:39.599,0:04:41.501
this immunogenicity idea, it takes a little while

0:04:41.501,0:04:43.126
to get our head around but

0:04:43.126,0:04:46.578
I'll try to explain it in simple terms.

0:04:46.578,0:04:48.290
So I'll take a step back and explain to you

0:04:48.290,0:04:51.838
how vaccines work in a simple way

0:04:51.838,0:04:54.600
So vaccines work by introducing to our body

0:04:54.600,0:04:56.518
a thing called an antigen

0:04:56.518,0:04:59.695
which is a safe form of a germ.

0:04:59.695,0:05:01.715
Now that safe germ, that antigen,

0:05:01.715,0:05:05.220
tricks our body into mounting an immune response,

0:05:05.220,0:05:09.288
learning and remembering how to deal with intruders.

0:05:09.288,0:05:11.656
When the real intruder comes along

0:05:11.656,0:05:13.417
the body quickly mounts an immune response

0:05:13.417,0:05:15.053
to deal with that vaccine

0:05:15.053,0:05:16.953
and neutralizes the infection.

0:05:16.953,0:05:18.643
So it does that well.

0:05:18.643,0:05:20.980
Now, why it's done today with the needle and syringe

0:05:20.980,0:05:23.431
is most vaccines are delivered that way --

0:05:23.431,0:05:24.885
with this old technology and the needle.

0:05:24.885,0:05:26.677
But it could be argued

0:05:26.677,0:05:29.191
that the needle is holding back

0:05:29.191,0:05:30.358
our immune responses;

0:05:30.358,0:05:32.237
it's missing our immune sweet spot

0:05:32.237,0:05:34.106
in the skin.

0:05:34.106,0:05:36.702
To describe this idea

0:05:36.702,0:05:39.191
we need to take a journey through the skin

0:05:39.191,0:05:41.815
starting with one of those projections

0:05:41.815,0:05:44.260
and applying the Nanopatch to the skin.

0:05:44.260,0:05:46.660
And we see this kind of data ...

0:05:46.660,0:05:48.469
now this is real data ...

0:05:48.469,0:05:50.815
that thing that we can see there is one projection

0:05:50.815,0:05:53.271
from the Nanopatch that's been applied to the skin

0:05:53.271,0:05:55.196
and those colors are different layers.

0:05:55.196,0:05:56.480
Now to give you an idea of scale,

0:05:56.480,0:05:58.420
if the needle was shown here it would be too big.

0:05:58.420,0:05:59.945
It would be ten times bigger

0:05:59.945,0:06:02.637
than the size of that screen[br]going ten times deeper as well.

0:06:02.637,0:06:05.482
It's off the grid entirely.

0:06:05.482,0:06:06.952
You can see immediately that we have those

0:06:06.952,0:06:08.252
projections in the skin.

0:06:08.252,0:06:11.327
That red layer is a tough outer layer of dead skin

0:06:11.327,0:06:12.773
but the brown layer

0:06:12.773,0:06:13.841
and the magenta layer

0:06:13.841,0:06:17.530
are jammed full of immune cells.

0:06:17.530,0:06:18.878
As one example, in the brown layer

0:06:18.878,0:06:20.956
theres a certain type of cell called Langerhan cell --

0:06:20.956,0:06:23.445
every square millimeter of our body

0:06:23.445,0:06:26.465
is jammed full of those Langerhan cells,

0:06:26.465,0:06:28.368
those immune cells, and [br]there's others shown as well

0:06:28.368,0:06:30.363
that we haven't [unclear] in this image

0:06:30.363,0:06:32.543
but you can immediately see that the Nanopatch

0:06:32.543,0:06:34.280
achieves that penetration indeed.

0:06:34.280,0:06:37.709
We target thousands upon thousands [br]of these particualar cells

0:06:37.709,0:06:40.124
just residing within a hair's width

0:06:40.124,0:06:43.328
of the surface of the skin.

0:06:43.328,0:06:45.444
Now, as the guy that has invented

0:06:45.444,0:06:47.074
this thing and designed it to do that

0:06:47.074,0:06:51.080
I found that exciting. But so what?

0:06:51.080,0:06:52.310
So what if you've targeted cells,

0:06:52.310,0:06:55.558
in the world of vaccines what does that mean?

0:06:55.558,0:06:57.702
The world of vaccines is getting better.

0:06:57.702,0:06:59.426
It's getting more systematic.

0:06:59.426,0:07:01.648
However, you still don't really know

0:07:01.648,0:07:03.392
if a vaccine is going to work

0:07:03.392,0:07:04.731
until you roll your sleeves up

0:07:04.731,0:07:06.812
and vaccinate and wait.

0:07:06.812,0:07:09.648
It's a gambler's game even today.

0:07:09.648,0:07:12.160
So, we had to do that gamble.

0:07:12.160,0:07:14.640
We obtained an influenza vaccine,

0:07:14.640,0:07:16.256
we applied it to Nanopatches

0:07:16.256,0:07:19.235
and we applied the Nanopatches to the skin

0:07:19.235,0:07:20.460
and we waited.

0:07:20.460,0:07:22.335
And this is in the live animal.

0:07:22.335,0:07:24.139
And we waited a month

0:07:24.139,0:07:25.951
and this is what we found out:

0:07:25.951,0:07:28.276
This is a data slide showing the immune responses

0:07:28.276,0:07:30.599
that we've generated with a Nanopatch

0:07:30.599,0:07:34.406
compared to the needle and syringe into muscle.

0:07:34.406,0:07:37.972
So in the horizontal access we have [br]the dose show in Nanograms

0:07:37.972,0:07:39.351
on the vertical access we have

0:07:39.351,0:07:42.701
the immune response generated on that dashed line.

0:07:42.701,0:07:46.282
At that dashed line indicates the protection threshold

0:07:46.282,0:07:48.796
If we're above that line it's considered protective;

0:07:48.796,0:07:51.568
If we're below that line, it's not.

0:07:51.568,0:07:54.136
So the red line is mostly that curve

0:07:54.136,0:07:55.969
and indeed there's only one point achieved

0:07:55.969,0:07:57.731
with the needle that's protective

0:07:57.731,0:07:59.169


0:07:59.169,0:08:00.608
and thats with a high dose of 6 thousand nanograms

0:08:00.608,0:08:04.187
but notice immediately the distinctly different curve that we achieve

0:08:04.187,0:08:06.392
with the blue line.

0:08:06.392,0:08:08.520
That's what's achieved with the nanopatch

0:08:08.520,0:08:11.152
the delivered dose of the Nanopatch is a completely different

0:08:11.152,0:08:12.912
immune- fads curve

0:08:12.912,0:08:15.392
that's a real fresh opportunity

0:08:15.392,0:08:17.784
suddenly we have a brand new leaver

0:08:17.784,0:08:19.280
in the world of vaccines

0:08:19.280,0:08:22.312
We can push it one way where we can take a vaccine that works

0:08:22.312,0:08:25.800
but is too expensive and we can get protection

0:08:25.800,0:08:27.912
with a hundredth of the dose

0:08:27.912,0:08:30.705
Or we can take it afkdaslf

0:08:30.705,0:08:33.520
down to ten cents and that's particularly important

0:08:33.520,0:08:35.544
within the developing world

0:08:35.544,0:08:37.240
But there's another angle to this as well

0:08:37.240,0:08:40.400
you can take vaccines that currently don't work

0:08:40.400,0:08:41.490
and get them over that line

0:08:41.490,0:08:43.232
and get them protective

0:08:43.232,0:08:45.352
And certainly in the world of vaccines

0:08:45.352,0:08:46.664
that can be important

0:08:46.664,0:08:48.224
let's consider the big three

0:08:48.224,0:08:51.800
HIV, Malaria, Tuberculosis

0:08:51.800,0:08:53.776
they're responsible for about 7 thousand deaths per year

0:08:53.776,0:08:56.512
and there is no adequate vaccination method for any of those.

0:08:56.512,0:08:58.992
So potentially with this new leaver that we have with the Nanopatch

0:08:58.992,0:09:02.472
we can help make that happen, we can push that leaver

0:09:02.472,0:09:06.330
to help get those asdfkasfjla vaccines over the line.

0:09:06.330,0:09:07.996
Now of course we've worked with the lab with many other vaccines

0:09:07.996,0:09:11.645
that have attained similar responses and similar curves

0:09:11.645,0:09:15.793
achieved with influenza

0:09:15.793,0:09:18.291
I'd like to now switch to talk about

0:09:18.291,0:09:20.209
another key shortcoming of today in vaccines

0:09:20.209,0:09:25.136
and that is the need to maintain the cold chain.

0:09:25.136,0:09:31.117
As the name suggests, it's the requirement of keeping a vaccine right from production

0:09:31.117,0:09:33.225
all the through to when the vaccine is applied

0:09:33.225,0:09:36.369
to keep it refrigerated.

0:09:36.369,0:09:39.569
Now, that presents some logistical challenges

0:09:39.569,0:09:42.329
but we have ways to do it.

0:09:42.329,0:09:46.172
This is a slightly extreme case in point

0:09:46.172,0:09:49.781
but it helps illustrate the logistical challenges

0:09:49.781,0:09:57.347
in particular settings of what's required to get settings to maintain the cold chain

0:09:57.347,0:10:00.987
if the vaccine is to warm the vaccine breaks down

0:10:00.987,0:10:02.931
but interestingly the vaccine can be too cold

0:10:02.931,0:10:05.680
and it will break down as well.

0:10:05.680,0:10:09.106
The steaks are very high

0:10:09.106,0:10:15.488
the WHR estimates that in Africa up to half

0:10:15.488,0:10:16.553
the vaccines used there

0:10:16.553,0:10:17.577
are considered to not be working properly because at some point

0:10:17.577,0:10:19.105
the cold chain has fallen over

0:10:19.105,0:10:20.810
So it's a big problem

0:10:20.810,0:10:21.705
and it's tied in with the needle and syringe

0:10:21.705,0:10:23.321
because the liquid at needs of refrigeration

0:10:23.321,0:10:25.819
A key attribute of our Nanopatch is that the vaccine is dry

0:10:25.819,0:10:34.377
and when it's dry it doesn't need refrigeration.

0:10:34.377,0:10:37.890
Within my lab theres we can keep the vaccine stored

0:10:37.890,0:10:40.210
at twenty-three degree's celcius for more than a year

0:10:40.210,0:10:42.970
without any loss

0:10:42.970,0:10:45.170
That's an important improvement.

0:10:45.170,0:10:51.970
(Applause)

0:10:51.970,0:10:54.359
We're delighted about it as well.

0:10:54.359,0:10:58.714
And the thing about it is that we've well and truly proven

0:10:58.714,0:11:01.346
the Nanopatch within the laboratory setting.

0:11:01.346,0:11:05.382
And as a scientist, I love that and I love science.

0:11:05.382,0:11:07.827
However, as an engineer,

0:11:07.827,0:11:09.340
as a biomedical engineer

0:11:09.355,0:11:11.482
and also as a human being,

0:11:11.482,0:11:13.145
I'm not going to be satisfied until we've

0:11:13.145,0:11:15.468
rolled this thing out and taken it out of the lab

0:11:15.468,0:11:17.930
and got it to people in large numbers

0:11:17.930,0:11:20.452
and particularly the people who need it the most.

0:11:21.511,0:11:24.244
So we've commenced this particular journey

0:11:24.244,0:11:26.982
and we've commenced it in an unusual way

0:11:26.982,0:11:29.973
We've started with Papua New Guinea.

0:11:29.973,0:11:32.125
Now Papua New Guinea

0:11:32.125,0:11:35.502
is an example of a developing world country

0:11:35.502,0:11:38.959
and its about the same size as France

0:11:38.959,0:11:41.749
but it suffers from many of the key barriers

0:11:41.749,0:11:45.862
existing within the world of todays vaccines.

0:11:45.862,0:11:47.445
There's logistics:

0:11:47.445,0:11:50.669
Within this country there are only 800 refrigerators

0:11:50.669,0:11:51.885
to keep vaccines chilled.

0:11:51.885,0:11:54.365
Many of them are old like this one in Port Moresby.

0:11:54.365,0:11:55.741
Many of them are breaking down

0:11:55.741,0:11:57.453
and many of them are not in the Highlands

0:11:57.453,0:11:59.166
where they are required.

0:11:59.166,0:12:00.413
That's a challenge.

0:12:00.413,0:12:01.879
But also, Papua New Guinea

0:12:01.879,0:12:05.475
has the worlds highest incidence of HPV,

0:12:05.475,0:12:10.690
Human Papilloma Virus, the cervical cancer vaccine.

0:12:10.690,0:12:12.589
Yet, that vacccine is not available in large numbers

0:12:12.589,0:12:14.182
because it's too expensive.

0:12:14.182,0:12:15.619
So for those two reasons

0:12:15.619,0:12:17.206
with the attributes of the Nanopatch

0:12:17.206,0:12:18.681
we've got into field

0:12:18.681,0:12:19.704
and worked with the Nanopatch

0:12:19.704,0:12:21.608
and taken it to Papua New Guinea

0:12:21.608,0:12:26.143
and we'll be following that up shortly.

0:12:26.143,0:12:29.550
Now doing this kind of work is not easy.

0:12:29.550,0:12:30.918
It's challenging,

0:12:30.918,0:12:32.567
but there's nothing else in the world

0:12:32.567,0:12:34.359
I'd rather be doing.

0:12:34.359,0:12:36.320
And as we look ahead

0:12:36.320,0:12:39.832
I'd like to share with you a thought —

0:12:39.832,0:12:44.070
it's the thought of a future where

0:12:44.070,0:12:46.342
the 17 million deaths per year

0:12:46.342,0:12:48.714
that we currently have

0:12:48.714,0:12:51.380
due to infectious disease is a historical footnote.

0:12:51.380,0:12:53.366
And it's a historical footnote that has been achieved

0:12:53.366,0:12:56.716
by radically improved vaccines.

0:12:56.716,0:12:58.905
Now standing here today in front of you

0:12:58.905,0:13:00.703
at the birthplace of the needle and syringe

0:13:00.703,0:13:03.191
a device that's 160 years old

0:13:03.191,0:13:05.820
I'm presenting to you an alternative approach

0:13:05.820,0:13:08.730
that could really help make that happen

0:13:08.730,0:13:09.870
and it's the Nanopatch

0:13:09.870,0:13:11.863
with it's attributes of being needle-free, pain-free

0:13:11.863,0:13:14.271
the ability for removing the cold chain

0:13:14.271,0:13:16.135
and improving the immunogenicity.

0:13:16.135,0:13:17.711
Thank you.

0:13:17.711,9:59:59.000
(Applause)