The most lethal creature on this earth is, surprisingly, the tiny mosquito — more specifically, the malarial plasmodium parasites that mosquitoes can transmit. Malaria, a terrible disease that affects hundreds of millions of people (particularly children under the age of five), is responsible for hundreds of thousands of deaths each year as roughly one child succumbs to it every 30 seconds. Some scientists speculate that malaria is responsible for up to half of all premature deaths in history. And yet, as a result of breakthrough technologies in genetic engineering, malaria could become a thing of the past within the next decade.
CRISPR interference, a breakthrough technology that allows scientists to edit the genome of a certain organism, could actually eradicate the disease. Scientists have already used CRISPR interference to incorporate an antibody into mosquito DNA that makes the mosquito immune to the plasmodium that causes malaria. When combined with a revolutionary new process called “gene drive” – which biases the genetic heritability of certain alleles – scientists are able to manipulate the genome of an entire species after a few reproduction cycles. This process can be done on a tremendous scale and at little cost, and it can enable scientists to make sweeping genetic changes to entire swaths of a population. If we released enough engineered mosquitoes into the wild, they could eradicate malaria in a matter of months by merely reproducing.
However, the global health community has yet to utilize this new technique. CRISPR interference was only developed in 2013, and as awe-inspiring as the technology is, its nascence begets natural skepticism. Just as Alexander Fleming’s discovery of penicillin in 1928 wasn’t utilized until 1942 in the name of further research, so too might scientists and public health officials insist on more extensive study before CRISPR interference is used. In addition, the actual delivery method in Sub-Saharan Africa, where 90 percent of malarial deaths occur each year, can be difficult to map and monitor and would require the collaboration between dozens of countries, aid organizations, and health officials.
But in the case of malaria, time is too precious to be wasted. Given the astonishing rate of malarial fatalities around the world and its disproportionately high impact on children, exhaustive study is a luxury that victims simply cannot afford. The time required to decrease uncertainty may be far too high to warrant waiting any further; governments, medical institutions, and the larger global health community can act now or act later, but for every year they spend deliberating, millions will suffer the consequences of their indecision.
The scope of the project may sound unrealistic, but humans have accomplished feats of this magnitude before. In the 1950s and ’60s, impressive multinational campaigns combatted a different deadly disease that plagued millions of people per year: smallpox. Thanks to concerted effort between the US, USSR, and World Health Organization, along with an international web of institutions that helped distribute the vaccine, smallpox was completely eradicated. The same could be done for malaria, and if the US and USSR were collaborating to end smallpox during a timespan that included the Cuban Missile Crisis, then surely the few political obstacles of today can be overcome. The chief obstacle today is actually a lack of public discussion. Peter Singer, as well as several other prominent contemporary philosophers, believe that there is a moral imperative to do whatever can be done to eradicate diseases like malaria. Given the relatively small cost of the operation, they may be correct.
The only legitimate cause for hesitation is exploring other potential solutions. For example, using a similar combination of CRISPR and gene drive to render mosquitoes infertile would eradicate mosquitoes and eliminate the primary vectors of malaria, Zika virus, dengue fever, and other plaguing illnesses. This process raises a new crop of ethical dilemmas; after all, humans would be taking it upon themselves to single-handedly wipe out an entire species from the face of the planet. While engineering mosquitoes to be resistant to the parasites that cause malaria wouldn’t affect the lives of the mosquitoes themselves, utter “speciecide” may be too far of an ethical boundary to cross. Then again, given the damage that mosquitoes inflict on humans, perhaps the benefits warrant their extinction.
To make matters more complicated, technology is advancing at a much faster rate than public discourse. In the meantime, much can be done to help those who are still suffering from malaria. Prevention is the best cure, and some organizations (such as the Against Malaria Foundation) provide people in high-risk areas with bed nets that are coated with insecticide, thus greatly reducing the risk of contracting the disease. Such groups are on the front lines of combatting malaria, but a vast gulf still exists between current relief efforts and what remains to be done before malaria is eradicated. Though it will be a difficult task, it is a necessary one. Given the sheer volume of fatalities, it is imperative that the disease not go ignored.
Thank you for bringing such an important but often ignored issue to a wider, Western, audience. It is my hope that your article will push our public health officials to truly consider the day-to-day consequences of delaying action. While I usually advocate for prudence, there have to be exceptions and you have made a powerful case that the price of prudence with respect to eradicating malaria is simply to high. Kudos!