Is Europe Building Phage Therapy or Funding Everyone Else? A Closer Look at Horizon Europe's €45.7 Million Investment
Horizon Europe has just funded three major clinical projects dedicated to phage therapy for antibiotic-resistant bacterial infections. Scientifically, this is excellent news. For years, bacteriophage therapy has suffered from a lack of large, randomized, multicenter clinical trials capable of convincing regulators, clinicians, hospitals and payers. The decision to support REPhRAME, P-PEAKS UTI and PHAGE4DAIR therefore marks a turning point. It signals that phage therapy is no longer being treated only as an emergency option, an academic curiosity or a compassionate-use intervention, but as a serious therapeutic field requiring robust clinical evidence.
This article does not question the scientific quality of the selected projects. It does not question the competence of the institutions involved, nor the legitimacy of Canada, the United Kingdom, Switzerland, Israel or the United States as world-class contributors to biomedical research. Many of the laboratories, hospitals and companies involved in these projects have made important contributions to phage therapy, antimicrobial resistance research, clinical trial design, phage manufacturing and patient care. International cooperation is essential in infectious diseases, and antibiotic-resistant bacteria do not stop at borders.
But precisely because the science is important, the funding strategy deserves scrutiny.
The three projects were selected under the Horizon Europe topic “Testing safety and efficacy of phage therapy for the treatment of antibiotic-resistant bacterial infections.” Together, they represent €45,666,509.45 in European funding. The question is not whether phage therapy deserves this money. It clearly does. The question is whether the geographical distribution of this money reflects a coherent European strategy for building European capacity in one of the most promising fields against antimicrobial resistance.
The numbers are striking. Across the three projects, only €16,317,889.16 goes to institutions located inside the European Union. That represents 35.7 percent of the total. By contrast, €29,348,620.29 goes to institutions located outside the Union, representing 64.3 percent of all funding allocated across these three projects.
This is not a small statistical imbalance. It is the central fact of the call.
The United Kingdom receives €10,865,017.77, or 23.8 percent of the total. Canada receives €10,071,446.24, or 22.1 percent. Germany receives €7,084,319.14, or 15.5 percent. Switzerland receives €4,438,125.13, or 9.7 percent. The United States receives €2,618,299.13, or 5.7 percent. France receives €1,753,166.64, or only 3.8 percent.
This means that, in this European phage therapy call, Canada receives almost six times more funding than France. The United States receives more than France, Spain, Italy, Belgium, Denmark, Sweden, Austria, Hungary, Latvia or Greece individually. The United Kingdom alone receives more than all EU countries except Germany combined in several parts of the distribution. These figures do not prove wrongdoing. But they do raise a serious policy question: what exactly is Europe trying to build?
The imbalance becomes even clearer when the three projects are examined separately.
PHAGE4DAIR, focused on Staphylococcus aureus prosthetic joint infections treated with DAIR surgery, receives €14,869,038.73. Of that amount, only €2,379,546.01 goes to EU-based participants, while €12,489,492.72 goes outside the European Union. In other words, 84 percent of the funding in this project goes to non-EU participants. The coordinator is Qeen Biotechnologies in Canada, which alone receives €4,374,508.37. United Kingdom-based partners receive substantial amounts, including University College London with €1,979,119.00 and Micron Research Limited with €1,779,376.25. France participates through Hospices Civils de Lyon, Centre Hospitalier Universitaire de Nice and Université Claude Bernard Lyon 1, but the combined French amount remains far below the Canadian and British totals.
P-PEAKS UTI, dedicated to personalized phage therapy against recurrent Escherichia coli urinary tract infections, receives €15,597,531.54. Here again, the project is coordinated outside the European Union, by Unity Health Toronto in Canada, which receives €2,378,462.33. The project includes major non-EU beneficiaries, including Qeen Biotechnologies in Canada, Mayo Clinic, Baylor College of Medicine and the Regents of the University of California in the United States, as well as Hadassah Medical Organization and the Hebrew University of Jerusalem in Israel. In total, €11,566,272.44 goes outside the European Union, representing 74.2 percent of the project’s funding. EU-based participants receive €4,031,259.10, or 25.8 percent.
REPhRAME is the only one of the three projects where the balance is clearly more European. Coordinated by Johann Wolfgang Goethe University Frankfurt, it receives €15,199,939.18. Around €9,907,084.05 goes to EU-based participants, while €5,292,855.13 goes outside the EU. The project involves strong German participation, including Goethe University Frankfurt, University Hospital Cologne, Hannover Medical School, Fraunhofer-Gesellschaft, LINQ Management and the German Center for Infection Research. It also includes SNIPR Biome in Denmark, JAFRAL in Slovenia, Riga Stradiņš University in Latvia, HUN-REN Biological Research Centre in Hungary, Leiden University Medical Center in the Netherlands, and partners from Switzerland and the United Kingdom. This project appears more consistent with the idea of building European clinical and translational capacity, although significant funding still goes to non-EU countries.
Taken together, these three projects reveal a paradox. Horizon Europe is Europe’s flagship research and innovation programme. Its stated purpose is not only to fund excellent science, but also to strengthen European research, innovation, competitiveness, technological leadership and resilience. Yet in this phage therapy call, nearly two thirds of the money flows outside the European Union.
Again, this is not an argument against international science. It is not a criticism of Canadian phage centres, British clinical trial units, Swiss bioinformatics teams, Israeli hospitals or American academic institutions. Many of them are outstanding. Some possess expertise that Europe may genuinely need. The criticism is directed primarily at the European system itself. If Europe needs to outsource such a large fraction of one of its most strategic antimicrobial resistance calls, then this reveals either a weakness in European capacity, a failure to support existing European expertise, or a lack of political will to build durable industrial and clinical infrastructure within the Union.
The issue is even more sensitive because phage therapy is not a field where Europe starts from nothing. Europe has a long and complex history with bacteriophages. France, Belgium, Poland, Georgia, Germany, the Netherlands and several Central and Eastern European countries have contributed to phage science for decades. European hospitals have treated patients under compassionate-use frameworks. European companies are developing phage products. European laboratories work on phage biology, manufacturing, biofilms, pharmacology, microbiome interactions, resistance mechanisms and regulatory science.
If a major European clinical funding call still ends up sending most of its resources outside the Union, the explanation cannot simply be that Europe lacks expertise. The question is more uncomfortable: why has European expertise not been organized, financed and politically supported strongly enough to lead more of these projects?
The geographical distribution inside Europe also deserves attention. Germany emerges as the main EU beneficiary, receiving more than €7 million across the three projects. France receives around €1.75 million. Slovenia receives €1.65 million, largely through JAFRAL in REPhRAME. Estonia receives €1.42 million, mostly through P-PEAKS UTI. Italy receives €615,756.16. Belgium receives €602,628.29. Spain receives €406,948.60. Hungary receives €377,000. Latvia receives €350,000. Denmark receives €297,769.50. Sweden receives €145,375.
This distribution is not random. It reflects the unequal capacity of European institutions to build successful consortia, attract leadership roles and capture high-value tasks such as coordination, manufacturing, trial management, data analysis and regulatory strategy. But it also illustrates a broader structural problem in European research funding: excellence-based competition often reinforces existing power centres. Countries and institutions already well connected to major networks tend to obtain more funding, while less connected regions struggle to become central players, even when they possess relevant expertise.
This matters particularly for phage therapy. Some of the most historically important phage traditions in Europe come from regions that do not necessarily dominate Horizon Europe funding. If Europe wants to build a serious phage therapy ecosystem, it cannot rely only on the same narrow circle of countries and institutions. It must also integrate clinical, microbiological and manufacturing capacities across Eastern, Central and Southern Europe, where phage therapy has often been more culturally and scientifically familiar than in Western regulatory systems.
The role of associated and third countries complicates the picture. The United Kingdom, Switzerland, Israel and Canada have specific relationships with Horizon Europe. Associated countries contribute financially to the programme and can participate under conditions that are often close to those of EU Member States. Their participation is therefore not simply “free access” to European funds. In principle, there are financial contributions, correction mechanisms and negotiated agreements.
However, this does not fully resolve the transparency problem. While the European Commission publishes detailed data on who receives Horizon Europe grants, it is much harder for ordinary citizens to find a simple, official and regularly updated table showing how much each associated country contributes annually and how much it receives back. The absence of an easily accessible “paid versus received” dashboard weakens public accountability. If the system is fair, balanced and mutually beneficial, then the numbers should be easy to publish and easy to compare.
The United States is a different case. It is not an associated country to Horizon Europe. Yet American institutions receive more than €2.6 million across these three phage therapy projects. Their involvement may be scientifically justified, particularly when they bring unique clinical expertise, patient cohorts, regulatory experience or phage therapy infrastructure. But from a European sovereignty perspective, the question remains legitimate. If American institutions can receive millions from a European programme in a strategic biomedical field, what exactly is the threshold for deciding that non-European participation is essential? Who evaluates that necessity? And how is the long-term return for Europe measured?
This is where the debate becomes political rather than technical.
Europe has repeatedly declared its ambition to strengthen its strategic autonomy in health, biotechnology, pharmaceutical production and antimicrobial resistance preparedness. The COVID-19 pandemic exposed the fragility of supply chains. Antibiotic resistance is widely recognized as a major public health threat. Phage therapy sits at the intersection of several strategic priorities: infectious disease control, biological manufacturing, personalized medicine, microbiome science, synthetic biology and regulatory innovation.
If Europe wants to become a leader in these areas, funding excellent international projects is not enough. It must ensure that public money builds lasting capacity inside Europe: GMP phage manufacturing, hospital-based phage therapy units, standardized susceptibility testing platforms, clinical trial networks, biobanks, regulatory expertise, data infrastructure, and companies capable of bringing products to market.
Otherwise, Europe risks paying for science without building sovereignty.
This does not mean closing the door to international partners. That would be scientifically foolish. Phage therapy needs global collaboration. Resistant infections are global. Clinical trials require patients, diversity of strains, standardized methods and international regulatory dialogue. Canada, the United Kingdom, Switzerland, Israel and the United States all have valuable contributions to make.
But collaboration should not become dependency. International excellence should strengthen European capacity, not replace it. If European funding systematically relies on non-EU coordinators, non-EU production centres, non-EU trial infrastructure and non-EU commercial actors, then Europe may end up financing the future market without controlling enough of the future value chain.
This is especially important because clinical trials are not neutral scientific objects. They shape standards. They define endpoints. They validate products. They create regulatory precedents. They build industrial credibility. The institutions that coordinate them gain visibility, authority and strategic advantage. In emerging fields, early leadership matters. The actors who run the first major randomized trials often shape the field for years.
That is why the allocation of these funds matters beyond the immediate amounts. The issue is not simply that Canada receives €10 million, or that the United States receives €2.6 million, or that the United Kingdom receives €10.8 million. The issue is what these numbers reveal about the balance of power in the emerging phage therapy ecosystem.
A fair defense of Horizon Europe would argue that these consortia were selected because they were scientifically excellent, clinically credible and capable of delivering results. That may be true. But if the best proposals in a European phage therapy call are so heavily dependent on non-EU partners, then Europe should ask itself why. Did European institutions lack comparable infrastructure? Were European companies insufficiently supported before the call? Were hospital networks fragmented? Were regulatory pathways too unclear? Did European phage actors fail to coordinate? Or did the call design itself favor large international consortia with established Anglo-American clinical research infrastructure?
These questions are not anti-science. They are pro-strategy.
The goal should not be to exclude non-European partners. The goal should be to ensure that European public funding produces a European return: scientific, clinical, industrial and societal. Patients in Europe should benefit from faster access to phage therapy. European hospitals should gain expertise. European regulators should receive better data. European companies should be able to grow. European manufacturing capacity should expand. European citizens should be able to see where their money goes and what it builds.
At present, the available figures suggest a mixed picture. The call is scientifically ambitious and potentially transformative. It may generate crucial evidence for phage therapy. It may help patients with recurrent urinary tract infections and prosthetic joint infections. It may accelerate the regulatory normalization of bacteriophage-based treatments.
But it also reveals a troubling imbalance. In a €45.7 million European funding effort for phage therapy, less than 36 percent of the money goes to EU-based institutions. Two of the three projects are coordinated from Canada. The United States, although not associated with Horizon Europe, receives more funding than most EU Member States in this call. France, despite its active phage therapy landscape and recent institutional progress, receives less than 4 percent of the total. Several European countries with historical or emerging phage expertise remain marginal.
That should not be dismissed as a technical detail. It is a political signal.
Europe can and should cooperate with the world. But cooperation must not become a substitute for ambition. If the European Union wants to lead in phage therapy, antimicrobial resistance and next-generation biological medicines, it must not only fund trials. It must build an ecosystem. It must support its own hospitals, companies, manufacturing platforms, regulatory science and clinical networks with the same intensity that it supports international excellence.
The real question raised by these grants is therefore not whether Canada, the United Kingdom, Switzerland, Israel or the United States deserve to participate. Many of their teams clearly do. The real question is why Europe, with its scientific history, clinical needs, public money and stated ambitions, still appears unable to keep the majority of a strategic phage therapy call within its own borders.
That is not an accusation. It is a warning.
Sources :
1) CORDIS, PHAGE4DAIR, Grant agreement ID 101287116, European Union contribution: €14,869,038.73. https://cordis.europa.eu/project/id/101287116
2) CORDIS, REPhRAME, Grant agreement ID 101287159, European Union contribution: €15,199,939.18. https://cordis.europa.eu/project/id/101287159
3) CORDIS, P-PEAKS UTI, Grant agreement ID 101289070, European Union contribution: €15,597,531.54. https://cordis.europa.eu/project/id/101289070
4) European Commission, Horizon Europe association policy and rules for associated countries. https://ec.europa.eu/info/funding-tenders/opportunities/docs/2021-2027/common/guidance/list-3rd-country-participation_horizon-euratom_en.pdf
5) European Commission, Horizon Europe country profiles and public funding data. https://research-and-innovation.ec.europa.eu/statistics/framework-programme-facts-and-figures/horizon-europe-country-profiles_en
6) Unity Health Toronto, “Unity Health to lead $25M international trial using viruses to treat drug-resistant infections,” 26 June 2026.https://unityhealth.to/2026/06/international-trial-using-viruses-to-treat-drug-resistant-infections/
7) Universitätsmedizin Frankfurt / REPhRAME public project communication, “Using Viruses Against Bacteria: €15 Million for Phage Therapy.”https://www.uni-frankfurt.de/en/newsroom/meldungen/pressemitteilungen/2026/mit-viren-gegen-bakterien-15-millionen-fuer-phagentherapie
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Full support of your criticism. I‘d like to add another aspect:
ReplyDeleteAt least 2 of the projects (PHAGE4DAIR and P-PEAKS UTI) are clearly designed to achieve a marketing license for a fixed phage medicinal product at the end of the fully subsidised studies. On behalf of these 2, not only the funding goes overseas, but the patent and the exploiting rights, too.
We will thus be paying double, because the future returns of the sales will be treasured also outside the EU - for good.
If only the'd sell at € 3,-/mL, like ELIAVA does, then people would have a real chance.
In the meantime, let's continue to cure people with precise magistral preps.
I can help with the case-management in order to direct patients, coordinate phage hunting and bringing labs, clinicians and patients together. Your PHAGEATLAS is most helpful indeed. Thx for that one.
Call me if you could do with a little help. Cheerio!
Thanks for, your comment. Indeed, this article raises some concerns. We are planning on recruiting people to increase the visiblity of The Phage Therapy and will keep you in touch !
DeleteThe announcement that Horizon Europe has funded three major clinical projects dedicated to phage therapy for antibiotic-resistant bacterial infections is, from a scientific perspective, an important milestone.
DeleteHowever, while we welcome the decision to invest in phage therapy, we are deeply concerned by the choices that were made regarding the allocation of these funds.
The selected projects overwhelmingly reflect an academic vision of phage therapy, with only limited involvement of industrial developers. This raises a fundamental question: who will ultimately translate these research programs into approved medicinal products available to patients? Academic excellence is indispensable for advancing scientific knowledge, but bringing biological therapies to market requires industrial expertise, regulatory experience, manufacturing capabilities, quality systems, and long-term commercial commitment. Without strong industrial leadership, there is a significant risk that these publicly funded projects will generate valuable scientific data without delivering licensed products that can benefit patients.
Even more concerning is the apparent allocation of approximately 64% of the awarded funding to non-European participants. At a time when the European Union repeatedly emphasizes the importance of strategic autonomy, technological sovereignty, and strengthening its biotechnology sector, such a distribution is difficult to understand and raises legitimate concerns. European taxpayers are financing a substantial proportion of research capacity outside Europe while European industrial capabilities remain underutilized.
This decision is particularly surprising because Europe already has companies that have invested for years in the clinical development and industrialization of phage therapy. Companies such as Technophage and Phaxiam / Phagenix have developed manufacturing expertise, regulatory know-how, and clinical programs that place Europe among the world's leaders in this field. These companies applied for Horizon Europe funding but were not selected.
The case of Phagenix is especially difficult to understand. The company has already obtained regulatory alignment from the FDA, the EMA, and the MHRA for a Phase II clinical trial in prosthetic joint infections, with a study ready to start. Such regulatory maturity is exceptional in the phage therapy field and represents precisely the type of industrial asset that Europe should be supporting if it genuinely wishes to accelerate patient access to innovative therapies while strengthening European competitiveness.
The choices made under this Horizon Europe call therefore appear inconsistent with the European Union's stated ambitions. Europe cannot simultaneously claim to pursue biotechnology sovereignty while directing a majority of funding outside the Union and overlooking industrial actors that have already demonstrated their ability to transform research into clinical development and, ultimately, marketable medicines.
We therefore express our profound disappointment and our incomprehension regarding these funding decisions. Supporting excellent academic science is essential, but it cannot come at the expense of Europe's industrial ecosystem. If Europe wants to lead the future of phage therapy, it must support not only scientific discovery but also the companies capable of manufacturing, registering, and delivering these innovative medicines to patients.
We hope that future European funding initiatives will adopt a more balanced approach, one that better integrates academic excellence with industrial capability and more faithfully reflects the European Union's commitments to innovation, competitiveness, and strategic sovereignty. Thibaut du Fayet - PHAGENIX CEO
Thank you, Thibaut du Fayet, for sharing this thoughtful perspective.
DeleteAt The Phage Therapy, our independent investigation of the Horizon Europe phage therapy programme also highlighted several of the issues you mention. While the €45.7 million investment represents a landmark commitment to phage therapy and deserves to be welcomed, the balance between academic excellence and industrial participation is a legitimate subject for discussion.
Translating phage therapy into licensed medicines requires much more than excellent science. It also depends on GMP manufacturing, regulatory expertise, scalable production, quality systems, clinical development and long-term industrial commitment. These capabilities are essential if publicly funded research is ultimately to benefit patients.
We also believe it is reasonable to ask whether future European funding programmes could better leverage the expertise of established European phage biotechnology companies that have already invested for years in clinical development, manufacturing infrastructure and regulatory pathways.
Scientific research and industrial development should not be viewed as competing priorities. On the contrary, they are complementary pillars of a successful innovation ecosystem. Europe's leadership in phage therapy will ultimately depend on its ability to combine world-class academic research with a strong and competitive industrial base capable of bringing these therapies to patients.
This is an important discussion for the future of phage therapy, and one that deserves to be based on evidence, transparency and open scientific debate.