0:00:00.360,0:00:01.779 It's a pleasure to be here 0:00:01.779,0:00:03.728 in Edinburgh, Scotland, 0:00:03.728,0:00:06.891 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 0:00:11.706,0:00:14.134 filed his very first patent on the needle and syringe. 0:00:14.134,0:00:16.236 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 the 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 0:00:37.390,0:00:41.534 the needle and syringe, [br]this 160-year-old technology. 0:00:41.534,0:00:43.445 And credit where it's due -- on many levels, 0:00:43.445,0:00:47.096 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 0:00:55.259,0:00:57.789 our life span the most. 0:00:57.789,0:01:00.264 That's a pretty hard act to beat. 0:01:00.264,0:01:02.057 But just like any other technology, 0:01:02.057,0:01:03.902 vaccines have their shortcomings, 0:01:03.902,0:01:06.538 and the needle and syringe 0:01:06.538,0:01:08.741 is a key part within that narrative -- 0:01:08.741,0:01:11.670 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 0:01:22.557,0:01:24.833 have a thing called needle phobia. 0:01:24.833,0:01:26.594 That's more than disliking the needle; 0:01:26.594,0:01:29.063 that is actively avoiding being vaccinated 0:01:29.063,0:01:30.927 because of needle phobia. 0:01:30.927,0:01:34.934 And that's problematic in terms [br]of the rollout of vaccines. 0:01:34.934,0:01:37.079 Now, related to this is another key issue, 0:01:37.079,0:01:39.412 which is needlestick injuries. 0:01:39.412,0:01:41.384 And the WHO has figures 0:01:41.384,0:01:45.219 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. 0:01:48.895,0:01:51.577 These are early deaths that take place. 0:01:51.577,0:01:54.558 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 0:01:56.438,0:01:58.922 of the needle and syringe you [br]may not have heard about. 0:01:58.922,0:02:00.903 One is it could be holding back 0:02:00.903,0:02:02.382 the next generation of vaccines 0:02:02.382,0:02:04.671 in terms of their immune responses. 0:02:04.671,0:02:07.598 And the second is that it could be responsible 0:02:07.598,0:02:12.210 for the problem of the cold chain[br]that I'll tell you about as well. 0:02:12.210,0:02:13.792 I'm going to tell you about some work 0:02:13.792,0:02:15.860 that my team and I are doing in Australia 0:02:15.860,0:02:17.601 at the University of Queensland 0:02:17.601,0:02:21.998 on a technology designed to [br]tackle those four problems. 0:02:21.998,0:02:26.343 And that technology is called the Nanopatch. 0:02:26.343,0:02:32.817 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 0:02:42.215,0:02:44.533 what you see are thousands of tiny projections 0:02:44.533,0:02:46.754 that are invisible to the human eye. 0:02:46.754,0:02:48.511 And there's about 4,000 projections 0:02:48.511,0:02:51.893 on this particular square compared to the needle. 0:02:51.907,0:02:54.551 And I've designed those projections 0:02:54.551,0:02:58.601 to serve a key role, which is to [br]work with the skin's immune system. 0:02:58.601,0:03:00.996 So that's a very important function 0:03:00.996,0:03:02.452 tied in with 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. 0:03:09.615,0:03:11.659 And this particular technique [br]is one that's been borrowed 0:03:11.659,0:03:13.286 from the semiconductor industry, 0:03:13.286,0:03:15.122 and therefore is low cost 0:03:15.122,0:03:17.316 and can be rolled out in large numbers. 0:03:17.316,0:03:22.382 Now we dry-coat vaccines to [br]the projections of the Nanopatch 0:03:22.382,0:03:24.201 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, 0:03:33.399,0:03:35.483 so we've devised an applicator. 0:03:35.483,0:03:36.970 And it's a very simple device -- 0:03:36.970,0:03:39.088 you could call it a sophisticated finger. 0:03:39.088,0:03:42.128 It's a spring-operated device. 0:03:42.128,0:03:45.950 What we do is when we apply [br]the Nanopatch to the skin as so -- 0:03:45.950,0:03:47.819 (Click) -- 0:03:47.819,0:03:50.736 immediately a few things happen. 0:03:50.736,0:03:54.783 So firstly, the projections on the Nanopatch 0:03:54.783,0:03:56.460 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. 0:04:05.358,0:04:11.244 And indeed we can make [br]a reuse of the applicator itself. 0:04:11.244,0:04:13.980 So that gives you an idea of the Nanopatch, 0:04:13.980,0:04:16.556 and immediately you can see some key advantages. 0:04:16.556,0:04:18.496 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 [br]responses through delivery, 0:04:34.877,0:04:38.471 and the second is getting rid of the cold chain. 0:04:38.471,0:04:40.843 So let's start with the first one, [br]this immunogenicity idea. 0:04:40.843,0:04:42.849 It takes a little while to get our heads around, 0:04:42.849,0:04:46.578 but I'll try to explain it in simple terms. 0:04:46.578,0:04:48.428 So I'll take a step back and explain to you 0:04:48.428,0:04:51.838 how vaccines work in a simple way. 0:04:51.838,0:04:54.415 So vaccines work by introducing into our body 0:04:54.415,0:04:56.518 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 [br]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, the way it's done today [br]with the needle and syringe, 0:05:20.980,0:05:23.431 most vaccines are delivered that way -- 0:05:23.431,0:05:25.115 with this old technology and the needle. 0:05:25.115,0:05:30.264 But it could be argued that the needle [br]is holding back our immune responses; 0:05:30.264,0:05:33.706 it's missing our immune sweet spot in the skin. 0:05:33.706,0:05:36.702 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 10 times bigger 0:05:59.945,0:06:02.867 than the size of that screen,[br]going 10 times deeper as well. 0:06:02.867,0:06:05.082 It's off the grid entirely. 0:06:05.082,0:06:08.275 You can see immediately that we [br]have those projections in the skin. 0:06:08.275,0:06:11.327 That red layer is a tough outer layer of dead skin, 0:06:11.327,0:06:13.834 but the brown layer and the magenta layer 0:06:13.841,0:06:17.022 are jammed full of immune cells. 0:06:17.022,0:06:18.878 As one example, in the brown layer 0:06:18.878,0:06:21.232 there's a certain type of cell [br]called a Langerhans cell -- 0:06:21.232,0:06:23.445 every square millimeter of our body 0:06:23.445,0:06:26.465 is jammed full of those Langerhans cells, 0:06:26.465,0:06:28.568 those immune cells, and [br]there's others shown as well 0:06:28.568,0:06:30.363 that we haven't stained 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 particular cells 0:06:37.709,0:06:40.047 just residing within a hair's width 0:06:40.047,0:06:43.328 of the surface of the skin. 0:06:43.328,0:06:47.090 Now, as the guy that's invented[br]this thing and designed it to do that, 0:06:47.090,0:06:50.526 I found that exciting. But so what? 0:06:50.526,0:06:52.478 So what if you've targeted cells? 0:06:52.478,0:06:55.281 In the world of vaccines, what does that mean? 0:06:55.281,0:06:57.702 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 0:07:04.731,0:07:06.946 and vaccinate and wait. 0:07:06.946,0:07:09.648 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 our Nanopatches 0:07:16.256,0:07:18.727 and we applied the Nanopatches to the skin, 0:07:18.727,0:07:20.460 and we waited -- 0:07:20.460,0:07:22.288 and this is in the live animal. 0:07:22.288,0:07:24.139 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 0:07:30.599,0:07:34.375 compared to the needle and syringe into muscle. 0:07:34.375,0:07:37.969 So on the horizontal axis we have [br]the dose shown in nanograms. 0:07:37.969,0:07:40.674 On the vertical axis we have [br]the immune response generated, 0:07:40.674,0:07:46.189 and that dashed line indicates [br]the protection threshold. 0:07:46.189,0:07:48.642 If we're above that line it's considered protective; 0:07:48.642,0:07:51.568 if we're below that line it's not. 0:07:51.568,0:07:54.136 So the red line is mostly below that curve 0:07:54.136,0:07:57.660 and indeed there's only one point that [br]is achieved with the needle that's protective, 0:07:57.660,0:08:00.869 and that's with a high dose of 6,000 nanograms. 0:08:00.869,0:08:03.402 But notice immediately the distinctly different curve 0:08:03.402,0:08:06.466 that we achieve with the blue line. 0:08:06.466,0:08:08.366 That's what's achieved with the Nanopatch; 0:08:08.366,0:08:10.103 the delivered dose of the Nanopatch is 0:08:10.103,0:08:13.464 a completely different immunogenicity curve. 0:08:13.464,0:08:15.297 That's a real fresh opportunity. 0:08:15.297,0:08:17.675 Suddenly we have a brand new lever 0:08:17.675,0:08:19.203 in the world of vaccines. 0:08:19.203,0:08:20.714 We can push it one way, 0:08:20.714,0:08:23.305 where we can take a vaccine [br]that works but is too expensive 0:08:23.305,0:08:24.964 and can get protection 0:08:24.964,0:08:27.788 with a hundredth of the dose [br]compared to the needle. 0:08:27.788,0:08:31.839 That can take a vaccine that's suddenly [br]10 dollars down to 10 cents, 0:08:31.839,0:08:35.019 and that's particularly important [br]within the developing world. 0:08:35.019,0:08:36.886 But there's another angle to this as well -- 0:08:36.886,0:08:39.938 you can take vaccines that currently don't work 0:08:39.938,0:08:41.134 and get them over that line 0:08:41.134,0:08:43.092 and get them protective. 0:08:43.092,0:08:45.320 And certainly in the world of vaccines 0:08:45.320,0:08:46.540 that can be important. 0:08:46.540,0:08:48.038 Let's consider the big three: 0:08:48.038,0:08:50.735 HIV, malaria, tuberculosis. 0:08:50.735,0:08:53.327 They're responsible for about [br]7 million deaths per year, 0:08:53.327,0:08:56.534 and there is no adequate vaccination [br]method for any of those. 0:08:56.534,0:08:59.066 So potentially, with this new lever [br]that we have with the Nanopatch, 0:08:59.066,0:09:00.901 we can help make that happen. 0:09:00.901,0:09:05.771 We can push that lever to help get those [br]candidate vaccines over the line. 0:09:05.771,0:09:07.589 Now, of course, we've worked within my lab 0:09:07.589,0:09:09.379 with many other vaccines that have attained 0:09:09.379,0:09:12.197 similar responses and similar curves to this, 0:09:12.197,0:09:15.962 what we've achieved with influenza. 0:09:15.962,0:09:18.121 I'd like to now switch to talk about 0:09:18.121,0:09:21.453 another key shortcoming of today's vaccines, 0:09:21.453,0:09:24.873 and that is the need to maintain the cold chain. 0:09:24.873,0:09:27.547 As the name suggests -- the cold chain -- 0:09:27.547,0:09:30.487 it's the requirements of keeping [br]a vaccine right from production 0:09:30.487,0:09:33.163 all the way through to when the vaccine is applied, 0:09:33.163,0:09:36.261 to keep it refrigerated. 0:09:36.261,0:09:39.507 Now, that presents some logistical challenges 0:09:39.507,0:09:42.497 but we have ways to do it. 0:09:42.497,0:09:47.033 This is a slightly extreme case in point 0:09:47.033,0:09:49.516 but it helps illustrate the logistical challenges, 0:09:49.516,0:09:51.906 in particular in resource-poor settings, 0:09:51.906,0:09:55.192 of what's required to get vaccines 0:09:55.192,0:09:56.910 refrigerated and maintain the cold chain. 0:09:56.910,0:10:00.724 If the vaccine is too warm the vaccine breaks down, 0:10:00.724,0:10:02.931 but interestingly it can be too cold 0:10:02.931,0:10:05.492 and the vaccine can break down as well. 0:10:05.492,0:10:08.874 Now, the stakes are very high. 0:10:08.874,0:10:11.409 The WHO estimates that within Africa, 0:10:11.409,0:10:14.060 up to half the vaccines used there 0:10:14.060,0:10:15.913 are considered to not be working properly 0:10:15.913,0:10:18.903 because at some point the [br]cold chain has fallen over. 0:10:18.903,0:10:21.469 So it's a big problem, and it's tied [br]in with the needle and syringe 0:10:21.469,0:10:26.702 because it's a liquid form vaccine, and [br]when it's liquid it needs the refrigeration. 0:10:26.702,0:10:29.213 A key attribute of our Nanopatch 0:10:29.213,0:10:31.186 is that the vaccine is dry, 0:10:31.186,0:10:33.975 and when it's dry it doesn't need refrigeration. 0:10:33.975,0:10:36.387 Within my lab we've shown that we can keep 0:10:36.387,0:10:39.067 the vaccine stored at 23 degrees Celsius 0:10:39.067,0:10:42.783 for more than a year without [br]any loss in activity at all. 0:10:42.783,0:10:45.170 That's an important improvement. 0:10:45.170,0:10:51.770 (Applause) 0:10:51.770,0:10:54.233 We're delighted about it as well. 0:10:54.233,0:10:58.529 And the thing about it is that[br]we have well and truly proven 0:10:58.529,0:11:01.192 the Nanopatch within the laboratory setting. 0:11:01.192,0:11:05.165 And as a scientist, I love that and I love science. 0:11:05.165,0:11:07.673 However, as an engineer, 0:11:07.673,0:11:09.386 as a biomedical engineer 0:11:09.386,0:11:11.589 and also as a human being, 0:11:11.589,0:11:12.820 I'm not going to be satisfied 0:11:12.820,0:11:15.513 until we've rolled this thing [br]out, taken it out of the lab 0:11:15.513,0:11:17.944 and got it to people in large numbers 0:11:17.944,0:11:21.480 and particularly the people that need it the most. 0:11:21.480,0:11:24.182 So we've commenced this particular journey, 0:11:24.182,0:11:26.843 and we've commenced this [br]journey in an unusual way. 0:11:26.843,0:11:29.832 We've started with Papua New Guinea. 0:11:29.832,0:11:35.637 Now, Papua New Guinea is an example [br]of a developing world country. 0:11:35.637,0:11:38.773 It's about the same size as France, 0:11:38.773,0:11:41.608 but it suffers from many of the key barriers 0:11:41.608,0:11:45.676 existing within the world of today's vaccines. 0:11:45.676,0:11:47.289 There's the logistics: 0:11:47.289,0:11:51.647 Within this country there are only 800 [br]refrigerators to keep vaccines chilled. 0:11:51.647,0:11:55.940 Many of them are old, like this one in Port Moresby,[br]many of them are breaking down 0:11:55.940,0:11:58.856 and many are not in the Highlands [br]where they are required. 0:11:58.856,0:12:00.319 That's a challenge. 0:12:00.319,0:12:05.502 But also, Papua New Guinea has the [br]world's highest incidence of HPV, 0:12:05.502,0:12:09.733 human papillomavirus, the [br]cervical cancer [risk factor]. 0:12:09.733,0:12:12.434 Yet, that vaccine is not available in large numbers 0:12:12.434,0:12:14.348 because it's too expensive. 0:12:14.348,0:12:17.094 So for those two reasons, with [br]the attributes of the Nanopatch, 0:12:17.094,0:12:19.709 we've got into the field and [br]worked with the Nanopatch, 0:12:19.709,0:12:22.160 and taken it to Papua New Guinea 0:12:22.160,0:12:26.143 and we'll be following that up shortly. 0:12:26.143,0:12:29.625 Now, doing this kind of work is not easy. 0:12:29.625,0:12:30.973 It's challenging, 0:12:30.973,0:12:34.297 but there's nothing else in [br]the world I'd rather be doing. 0:12:34.297,0:12:36.320 And as we look ahead 0:12:36.320,0:12:40.062 I'd like to share with you a thought: 0:12:40.062,0:12:44.070 It's the thought of a future where 0:12:44.070,0:12:46.003 the 17 million deaths per year 0:12:46.003,0:12:48.347 that we currently have due to infectious disease 0:12:48.347,0:12:50.981 is a historical footnote. 0:12:50.981,0:12:53.077 And it's a historical footnote that has been achieved 0:12:53.077,0:12:56.545 by improved, radically improved vaccines. 0:12:56.545,0:12:58.828 Now standing here today in front of you 0:12:58.828,0:13:00.501 at the birthplace of the needle and syringe, 0:13:00.501,0:13:03.298 a device that's 160 years old, 0:13:03.298,0:13:05.634 I'm presenting to you an alternative approach 0:13:05.634,0:13:07.883 that could really help make that happen -- 0:13:07.883,0:13:11.865 and it's the Nanopatch with its attributes [br]of being needle-free, pain-free, 0:13:11.865,0:13:16.296 the ability for removing the cold chain[br]and improving the immunogenicity. 0:13:16.296,0:13:18.249 Thank you. 0:13:18.249,0:13:21.417 (Applause)