Abstract
After years of success in reducing the global malaria burden, the World Health Organization (WHO) recently reported that progress has stalled. Over 90% of malaria deaths world-wide occurred in the WHO African Region. New tools are needed to regain momentum and further decrease the burden of malaria. Gene drive, an emerging technology that can enhance the inheritance of beneficial genes, offers potentially transformative solutions for overcoming these challenges. Gene drives may decrease disease transmission by interfering with the growth of the malaria parasite in the mosquito vector or reducing mosquito reproductive capacity. Like other emerging technologies, development of gene drive products faces technical and non-technical challenges and uncertainties. In 2018, to begin addressing such challenges, a multidisciplinary group of international experts published comprehensive recommendations for responsible testing and implementation of gene drive-modified mosquitoes to combat malaria in Sub-Saharan Africa. Considering requirements for containment, efficacy and safety testing, monitoring, stakeholder engagement and authorization, as well as policy and regulatory issues, the group concluded that gene drive products for malaria can be tested safely and ethically, but that this will require substantial coordination, planning, and capacity development. The group emphasized the importance of co-development and co-ownership of products by in-country scientists.
Highlights
Mosquitoes and several other invertebrate organisms are able to transmit infectious pathogens that are responsible for tremendous global morbidity and mortality [1]
In many high-burden African countries, there has been a decrease in malaria funding per capita population at risk in recent years [4], emphasizing the impediments these countries experience in maintaining comprehensive malaria control and elimination initiatives and the resultant threat to recent hard-earned progress
Computational modeling of a product employing this type of gene drive system predicts that release of only a few modified mosquitoes will initiate establishment and spread of the malaria transmission-reducing modification within the local population of targeted Anopheles gambiae mosquitoes and indicates great potential for reducing and preventing malaria transmission even under conditions that have proven most challenging for current mosquito control methods [12]. Such gene drive systems would in theory require only simple and infrequent delivery of low numbers of modified mosquitoes, suggesting this technology could provide cost effective and durable protection that would transform the fight against malaria in Africa [12]
Summary
Mosquitoes and several other invertebrate organisms are able to transmit (serve as vectors for) infectious pathogens that are responsible for tremendous global morbidity and mortality [1]. More than half the world’s population is at risk of contracting vector-borne diseases each year [2]. It is widely recognized that new tools are required to combat vector-borne diseases. In many high-burden African countries, there has been a decrease in malaria funding per capita population at risk in recent years [4], emphasizing the impediments these countries experience in maintaining comprehensive malaria control and elimination initiatives and the resultant threat to recent hard-earned progress. The enormous area that malaria control measures must span, given the vast size of the continent [7] and region of malaria transmission [8], makes it easy to understand why Africa presents such challenges for sustained delivery of conventional chemotherapy and vector control tools.
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