Scientists can create malaria-proof mosquitoes – but is the world ready?

Worker Solomon Conteh dissects a mosquito at Sanaria Inc. facility in Rockville, Maryland, October 26, 2007

Image:  REUTERS/Jim Young

Calestous Juma
Director, Science Technology and Globalization, Belfer Center for Science and International Affairs, Harvard Kennedy School of Government
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Future of Global Health and Healthcare

The ability to edit the genetic code of organisms is hailed as one of the most profound technological achievements of the past five years. Specific techniques known as “gene drives” can transmit inheritable traits throughout the entire population of an organism.

Image: US National Academies, Washington, DC

There are several ways by which gene drives can be used to control major diseases such as malaria, which killed nearly 395,000 people in Africa in 2015. One approach is to introduce gene drives that induce sterility in mosquitoes. Another is to release into the environment mosquitoes that do not transmit malaria.

According to a recent report from the US National Academies, gene drives “hold promise for addressing difficult-to-solve challenges, such as the eradication of insect-borne infectious diseases and the conservation of threatened and endangered species”.

The report cautions, however, that “proof-of-concept in a few laboratory studies to date is not sufficient to support a decision to release gene-drive modified organisms into the environment”. As research advances, it is important to identify ways to reduce the potential for unintended catastrophic consequences. Such impacts could result from mutations in the altered organisms, transfer of the gene drives into other related organisms, and transformation of ecosystems.

Image: US National Academies, Washington, DC

As I argue in Innovation and Its Enemies: Why People Resist New Technologies, uncertainty in the availability of scientific knowledge and regulatory capacity is a key barrier to innovation. Such uncertainties can be reduced through interactions between government, industry, academia and civil society. However, the leadership role of these actors varies across countries, levels of development, and technologies.

What mobile phones teach us about gene drives

Lessons from the divergent experiences in the introduction of mobile phones and transgenic crops provide cautionary examples on how to manage the adoption of gene drives. In both cases the public sector played a decisive role in policy formulation, capacity building, and public engagement. The differences, however, were shaped considerably by the nature of the technology and existing capabilities.

Despite popular narratives that understate the role of government, public policy played a key, positive role in paving the way for the introduction of mobile phones. Ministries of telecommunications took the lead in liberalizing the policy environment to allow for niche adoption of mobile phones.

In many cases they faced stiff opposition from the landline sector. In Kenya, for example, the incumbent industry tried to lock itself in by starting to manufacture telephone sets locally. Opponents of mobile phones used scare tactics about the risks of brain cancer from radiation to try to stall the adoption of mobile phones.

But as prices of SIM cards and handsets dropped, the market expanded from urban centres into rural areas. The success of the business models adopted by the mobile firms that included the use of advance payments was possible because of the supportive policy environment created by governments.

Furthermore, the industry relied on preexisting technologies that did not require the creation of new engineering capacity. The bulk of the work involved standard installation of mobile infrastructure and importation of handsets.

The story of transgenic crops was different. First, African countries needed to build capacity to transfer the desired traits into local varieties. Only countries with such preexisting expertise, such as South Africa, were able to enter into the field. Most of the other African countries focused on creating restrictive biosafety laws before they secured the capacity to develop the technology. A comprehensive review of the evidence by the US National Academies shows that these early concerns that resulted in the adoption of restrictive biosafety laws were overstated.

An important role for the public sector

There were significant variations in public engagement. For mobile phones, private entrepreneurs and the market became the arena for public engagement. For transgenic crops, civil society organizations and the media became the forums for public debates, which were aimed mostly at stalling the adoption of the technology.

In both cases there was limited university involvement. National research institutes carried out most of the work on transgenic crops. It is notable, however, that the mobile revolution has inspired the creation of new multimedia or telecommunications universities and academic wings in countries such as Egypt, Sudan, Kenya and Ghana. No comparable efforts have been undertaken in the field of agricultural biotechnology.

The main lesson from these examples is that the public sector will continue to play a key role in shaping the development of transformative technologies such as gene drives, where policy reform, capacity building and public engagement are essential for adoption.

The key point is that the private sector will find it easier to take root where governments play their entrepreneurial role in creating a supportive policy environment. Furthermore, African universities and research institutes – most of which are publicly funded – need to be key actors in building capacity and undertaking the needed research. When they are excluded, they become incubators of resentment.

Fostering inclusive innovation will involve at least three critical stages. The first step is a genuine assessment of existing capabilities in African universities and research institutes upon which to base new research partnerships. Such technological inclusion efforts will also create a strong stakeholder base for gene drives.

Second, government support is needed to create the appropriate regulatory environment for gene drives. Ideally, such regulations should coevolve with the technology from research to commercial release. Preemptive regulations are unlikely to work, and neither can a legislative vacuum support the interest. The process of legislative evolution needs to benefit from enlightened public engagement supported by scientific and technical assessments.

Finally, it is important to identify a wide range of technology diffusion arrangements that involve partnerships between government, industry, academia, and civil society. Failure to recognize the importance of public sector institutions in Africa in lowering the knowledge and capability uncertainties could result in popular pushback against gene drive technology.

Calestous Juma directs the Harvard Kennedy School’s Health Innovation Policy in Africa Project, which is funded by the Bill and Melinda Gates Foundation.

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