In 2003, five northern Nigerian states boycotted the Oral Polio Vaccine (OPV) due to fears that it was unsafe. Almost two decades later, a technology, gene drive, is being developed to help curb the spread of another life-threatening disease, malaria, in humans. But safety has been a major talking point.
Newsbreak.ng reports that the gene drive is one of the most anticipated yet controversial tools being developed in this era.
Why Gene Drive?
In 2020, there were 228 million cases of malaria, resulting in 602,000 deaths, reported in the World Health Organization (WHO) African region, underscoring the need for the development of novel interventions that can complement existing malaria control strategies.
The use of engineered gene drives is one of such innovative approaches to control malaria vectors.
Synopsis: How Gene Drive Works
The gene drive for resisting malaria has been in the works since at least 2015.
Mosquitoes are supplied with genes that make them immune to the malaria parasite – and unable to spread it.
Researchers introduce genes that produce enzymes (called nucleases) into Anopheles gambiae. These enzymes recognise and cut very specific sequences of Deoxyribonucleic Acid (DNA).
Two of the main focus areas are biasing the sex ratio of mosquito populations and reducing female fertility.
Scientists are able to modify the Anopheles mosquito genome and push modifications through natural vector populations via the combination of gene drive and precise gene editing.
Population-suppression drives restrict the population of Anopheles mosquitoes through the spread of recessive lethal and sterility genes or by biasing the sex ratio. Population-replacement drives interfere with the ability of the Anopheles mosquito to transmit the Plasmodium parasite.
“It stagnates and alters anopheles mosquito populations carrying the malaria parasite. Also, gene drive could obliterate wild mosquito populations carrying the malaria parasite or make them resistant to its strain,” Mrs. J. Aliyu, a Nigerian-based Medical Laboratory Scientist (MLS), explains to this reporter.
Africa As A Testing Ground
The first experimental release of the gene drive for malaria control could be rolled out in Mali, Burkina Faso, Uganda, or Ghana. Apparently, Nigeria won’t be far as the next destination. The choice of these African countries by researchers is not a surprise, considering the continent is most affected by malaria — with the greatest burden in sub-Saharan Africa.
As of July 2022, four African countries accounted for just over half of all malaria deaths globally: Nigeria (31.9%), the Democratic Republic of Congo (13.2%), Tanzania (4.1%), and Mozambique (3.8%). As seen in the data, malaria is endemic in Nigeria.
Public Consensus Key To Gene Drive Acceptability
In a recent report of the high-level African Union Panel on Emerging Technologies (APET) on gene drives for malaria control and elimination in Africa, one of the suggestions of the advisory group is that early engagement with stakeholders is critical in order to ensure that emerging technologies meet their expectations, and therefore, have a great chance to be accepted and supported.
Researchers are hoping to eventually release gene drives on the African continent, but must first receive public consensus. Given the mistrust between the Global South and the Global North, coupled with the religious inclination of the colossal Northern zone in Nigeria, is there a bright chance the idea will be roundly supported in West Africa’s powerhouse?
Dr. Odulate Ibrahim, the Senior Resident Doctor at the Department of Medical Microbiology and Parasitology of the Lagos State University Teaching Hospital (LASUTH), points out that gene drive is expected to face social, political, and ecological challenges if the stakeholders (the researchers, the politicians, and the public) are not well-educated about the process and the potentially epidemiological benefit(s) of the concept. But he suggests “knowledge engagement” as a fix to the hindrance.
“Knowledge engagement is the preferred innovative dimension of public engagement that will help actors resist the traditional approaches that mimic outreach and education rather than listening and sharing with the public,” Dr. Ibrahim says.
A not-for-profit research consortium that is leading the effort to develop gene drives for malaria control, is Africa-focused and Bill & Melinda Gates Foundation-backed Target Malaria. Its Senior Regulatory Science Officer, John Connolly, makes clear that the evaluation of bionomic risks, geographical and secular considerations for gene drive applications are “particularly important”.
“Gene drive applications, both as envisaged or in development, are considered to share many of the same biosafety considerations as other genetically modified organisms (GMOs) via the characteristics of transgenesis and are thus subject to regulatory oversight and environmental risk assessment (ERA) under biosafety legal frameworks globally.
“However, unlike the case in other GMOs, gene drive transgenes for vector control are more likely to be designed to disperse beyond immediate release locations and persist for many years in target populations; this makes assessment of ecological risks with a broader scope of spatial and temporal considerations for gene drive applications particularly important,” he says.