2022 Annual Report

Unlocking Microbiome Science for a Healthier Future

Welcome Letter

Most people think of bacteria as villains that make us sick, but we see these microbes as the next heroes of global health. They play a vital role in our immune system, metabolism, and cognitive function. Understanding and harnessing the therapeutic potential of the microbiome is key to solving global health challenges such as antimicrobial resistance, malnutrition, depression, as well as autoimmune and metabolic disorders.

In 2022, OpenBiome and microbiome biotech companies took major steps in establishing this new, promising field of medicine. This past November, the U.S. Food and Drug Administration announced the approval of the first microbiome-based therapeutic for recurrent C. difficile. This major milestone—made possible in part by our pioneering work with fecal transplants—is a win for patients who will now have access to additional treatment options. The approval also validates the efforts of the microbiome field that is developing new approaches to address unmet medical needs.

But there are reasons to worry that the benefits of microbiome science may not accrue equitably. Today, scientists’ understanding of the human microbiome is vastly incomplete, based primarily on samples collected from the U.S. and Europe – leaving 86% of the world’s population behind - again.

In 2022, OpenBiome expanded our mission globally to address systemic inequities in microbiome science and scale our impact on global health.

We partnered with the Global Microbiome Conservancy (GMbC)—an  initiative founded at the Massachusetts Institute of Technology (MIT) dedicated to conserving and promoting understanding of the global diversity of the human microbiome to advance public health. Together, we are engaging researchers from nearly 40 countries to build and share the most accessible, inclusive, and globally representative microbiome library of its kind.

OpenBiome is also building global research programs to develop new therapies for neglected communities. Our first program aims to engineer a microbiome-based therapy for severe acute malnutrition, which causes 2 million preventable child deaths every year.

I hope you will join us in recognizing science as a crucial pillar of global development and health equity. Together, we can accelerate research and drive innovation to improve health worldwide.

Headshot of Julie Barrett O'Brien

2022 Impact: By the Numbers


Patients have received urgently needed investigational FMT preparations distributed by OpenBiome.



Bacteria isolates housed in our microbiome library, the most globally representative collection of its kind.



Research collaborators from across more than three dozen countries engaged in our research consortium.


Solving Critical Gaps in Microbiome Science

OpenBiome is a pioneering nonprofit that accelerates bold discoveries to improve health for all. Read more below to explore our approach to closing the global microbiome research gap and our latest work on the frontiers of microbiome science.

11/5/15 Medford, Mass. -- Gina Mendolia, product development associate at OpenBiome pipettes a microbiota preparation for FMT Capsule G3 used as a treatment for C. difficile infection in Medford, Mass. November 5, 2015. Erik Jacobs for the New York Times

The Problem: The world urgently needs a deeper, more globally representative understanding of the human microbiome that addresses the health needs of all

Understanding the human microbiome is critical to solving global health challenges — such as antimicrobial resistance, malnutrition, depression, as well as autoimmune and metabolic disorders — that are linked to the communities of bacteria that live within us.

However, our current body of knowledge, largely based on U.S. and European populations, is biased and vastly incomplete. As industrialization disrupts human microbiome diversity on a global scale, the window of opportunity to study and apply the full potential of the human microbiome is closing.

Public human microbiome data are dominated by highly developed countries

A 2022 study analyzing the world’s three largest genomic repositories found that more than 70 percent of human microbiome data come from Northern America and Europe, which are home to just over 14 percent of the world’s population. Meanwhile other regions remain highly underrepresented. For example, only 1.8 percent of samples come from Central and Southern Asia, home to 26 percent of the world’s population.


Our Solution

OpenBiome works with frontline scientists and clinicians to drive an urgent global agenda that closes the microbiome research gap and ensures therapies benefit people worldwide.

We address system inequities in microbiome science to scale its impact by:

Building and sharing the world’s most globally representative microbiome library.

Supporting and training frontline researchers in low- and middle-income countries.

Alleviating suffering around the world starting with C. difficile and malnutrition.

Visit our website to learn more about how OpenBiome is solving critical gaps in microbiome science.

Pioneering a New Field of Medicine

OpenBiome was originally founded as a stool bank in 2013. For the past decade we have been turning healthy people’s poo, and the bacteria it contains, into investigational medical treatments known as fecal microbiota transplantation (FMT).

To date, we have provided over 68,000 FMT preparations for patients with antibiotic-resistant infections.

This work proved that microbes could treat incurable illness and laid the foundation for a new field of medicine and biotech innovation.

Watch a testimonial from a patient who received an investigational FMT from OpenBiome.


C. difficile infects about 400,000 people in the United States each year leading to approximately 20,000 deaths.


2022 Highlights


Conserving, studying, and sharing human microbiome diversity

In 2022, OpenBiome partnered with the Global Microbiome Conservancy (GMbC), a nonprofit initiative that conserves and promotes understanding of global human microbiome diversity to advance public health.

Since it's founding out of an MIT laboratory in 2016, the GMbC has established a network of 90+ researchers in over three dozen countries and built a diverse collection of samples and bacterial isolates to spark scientific discovery and enable new solutions to microbiome-associated disease.

Our Approach to Expanding Understanding of the Human Microbiome

OpenBiome and the GMbC are building a globally representative collection of underrepresented and non-industrialized human microbiome samples, bacterial isolates, and associated metadata as a resource for the research community. Collaborating with scientists around the world, we collect and conserve microbiome samples (primarily gut, but also mouth, skin and other body sites) and generate bacterial isolates for further research. This unique platform offers researchers a radically expanded view of the human microbiome by sharing access to previously unavailable diversity


Our Progress

To date, the GMbC has:

  • Sampled from over 40 communities
  • Trained over 35 researchers in microbiome collection and processing
  • Generated and sequenced almost 10,000 bacterial isolates—a key requirement for mechanistic and functional studies that drive translational breakthroughs
  • Published a paper in Cell, a high impact academic journal, with two more papers anticipated in late 2023

Next Steps: OpenBiome, in collaboration with local scientists and institutions, has organized sampling studies in Iraq and Argentina for 2023 and is planning additional research projects in Ethiopia, Borneo, Paraguay, and Bhutan in 2024.

Planned and completed GMbC sampling projects.
Planned and completed GMbC sampling projects.

About the Global Microbiome Conservancy:
The Global Microbiome Conservancy (GMbC) was founded in 2016 by scientists Mathieu Groussin, PhD and Mathilde Poyet, PhD in the laboratory of Professor Eric Alm at the Massachusetts Institute of Technology (United States), with seed funding from the Center for Microbiome Informatics and Therapeutics and key support from Dr. Ramnik Xavier of the Broad Institute and Massachusetts General Hospital.

Harnessing the Microbiome to Prevent and Treat Malnutrition

The Global Impact of Malnutrition

Severe acute malnutrition (SAM) results in nearly 2 million preventable child deaths every year. OpenBiome's program in Malnutrition is bringing together a coalition of scientists to advance new therapies for this urgent public health threat.


children under 5 years of age are affected by wasting (defined as low weight-for-height).


children under 5 years of age are affected by stunting (defined as low height-for-age).


of childhood deaths under 5 years of age are linked to undernutrition.

Going Beyond Standard Treatments

Children with SAM typically receive antibiotics and nutrient-enhanced foods, however over a third of patients don’t respond to standard treatment. These children are likely lacking gut microbes required to absorb and maximize the nutrition that is available to them.

OpenBiome and our research collaborators are working to identify the crucial microbes that children with SAM are missing and develop live biotherapeutic therapies to be administered alongside nutrient-enhanced foods.

Spotlight on THRIVE

  • In 2019, OpenBiome embarked on an inaugural global health study, THRIVE (Transfer of Healthy Gut Flora for Restoration of Intestinal Microbiota via Enema), with the University of Cape Town, South Africa.


  • THRIVE is the first clinical trial of FMT in Africa, and the first to evaluate microbiome manipulation in children with malnutrition. In our pilot study, we saw the intervention was safe and well tolerated, improved the gut microbiome diversity of children with SAM, and improved biomarkers of gut inflammation and nutritional recovery in children.


  • The study has the potential to catalyze novel therapeutic avenues to address malnutrition and improve outcomes for millions of children every year.
11/11/16 Somerville, MA -- Lab tech, Meyling Chang processes a fecal microbiota preparation at OpenBiome in Somerville, Mass. November 11, 2016.  Photo by Erik Jacobs



About Us

OpenBiome accelerates bold discoveries in microbiome science—ethically and equitably– to improve health for all. As a pioneering nonprofit, OpenBiome catalyzes cutting edge research, advances treatment, and expands scientific capacity to unlock the full potential of the human microbiome.

Since its founding at MIT in 2012, OpenBiome has provided investigational fecal microbiota transplantation (FMT) treatments to more than 68,000 patients with recurrent C. difficile infections and supported over 40 studies investigating how the microbiome affects human health. OpenBiome is now partnering with scientists around the world to build a more inclusive microbiome research ecosystem. Through international collaborations, OpenBiome bridges the gap in training and materials for frontline microbiome scientists advancing public health in their communities.

A group of scientists in lab coats and purple rubber gloves holding a box of stool samples and giving thumbs up
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