A New Tool with Potential to Eliminate Malaria

The Plasmodium parasite causes malaria by infecting red blood cells.
Fredros Okumu, Ph.D.

“When kids are affected by malaria they are absent from school, and their parents lose days of work and the daily wages the family depends on. There is also psychological distress of losing family members from a disease that is largely treatable. That impact is much bigger than what we can compute in terms of just number of cases and deaths.”

— Fredros Okumu, Ph.D., Ifakara Health Institute, Ifakara, United Republic of Tanzania

Following years of success in reducing malaria across the globe, progress has stalled. According to the World Health Organization, there were an estimated 219 million cases of malaria in 2017, an increase from 217 million in 2016. Reductions in mortality rates have similarly plateaued and scientists, countries and communities find themselves at a critical juncture.

“There has been little innovation in malaria control and so for the first time with the coming of technology like gene drive, particularly after the discovery of the gene editing technique CRISPR, many of us started to believe that we have a tool now that could potentially be revolutionary. Nonetheless, more research is needed to assess benefits and risks. And that's what we are asking our scientists to do,” explained Fredros Okumu, Ph.D.

Gene drive is a mechanism that promotes the preferential inheritance of a genetic trait to increase its prevalence in a population. Recent advances in gene editing allow this natural mechanism to be mimicked in the laboratory. Many applications of this emerging technology are being considered, including its use on mosquitoes to reduce the transmission of mosquito-borne diseases, such as malaria. As the technology is still in its early stages, it requires careful consideration and assessment before gene drive products can be field-tested and deployed.

The FNIH is working with partners like Dr. Okumu to facilitate important discussions on gene drive technology among various stakeholders to develop and share best practices, technical advice and training to advance responsible research. In 2018, Dr. Okumo was part of an FNIH-led working group that presented their paper at the American Society of Tropical Medicine and Hygiene (ASTMH) Annual Meeting, which outlines recommendations for the safe and ethical testing of gene drive technology on mosquitoes to reduce the burden of malaria transmission in Africa. Previously published in ASTMH's scientific journal, the paper proposes a pathway for the responsible development and testing of gene drive products.

“Our interest now is to encourage scientists to investigate the potential of the technology,” said Dr. Okumu. “If we don't do scientific research on this technology then we won't be able to understand it. Given the complexity associated with this tool, it is only right to bring everyone together to try to make sure people are speaking the same language. Maybe for the first time, if we do things right, we could have a tool that dramatically shifts the needle towards the dream of malaria elimination which has been elusive for a long time.”