This one isn’t by me, it’s by one of my coworkers, but I think it’s a great piece of writing on a complicated and important high-stakes topic.
Kevin Esvelt wants me to know that if I fuck up this article, 25,000 children could end up dead.
Esvelt is a biologist at MIT and the first person to formulate a technology known as a CRISPR gene drive, a gene editing application that represents humanity’s single best chance to eradicate malaria.
Somewhere between 438,000 and 720,000 people were killed by the parasite in 2015. Seventy-two percent of those were kids younger than 5, and nearly 90 percent were in sub-Saharan Africa. Many more people infected with malaria don’t die but suffer a painful and temporarily disabling infection nonetheless. In 2015, anywhere from 187 million to 222 million people were infected. That’s about 3 percent of all humans on Earth, every year.
We have eliminated malaria from the rich world; it used to be endemic to France just as it is to Mali today. And now, with CRISPR gene drives, we have the potential to wipe it out globally and save millions of lives.
CRISPR is a tool developed in the past decade that has made it dramatically easier to make precise edits to the genes of everything from viruses and bacteria to mosquitos and humans. Gene drives allow humans to change the genetic makeup of a species by changing the DNA of a few individuals that then spread the modification throughout an entire population.In the case of malaria, the idea is to change the three species of mosquito most responsible for its transmission — Anopheles gambiae, Anopheles coluzzii, and Anopheles arabiensis — so that all their offspring would be male, effectively leading to the species’ extinction. Or you could just add a gene making them resistant to the malaria parasite, preventing its transmission to humans.CRISPR gene drives combine the gene drive idea with the CRISPR gene editing technique. They were first proposed in a 2014 paper — and the world of malaria research immediately realized the opportunity the idea presented. Target Malaria, a research consortium uniting Imperial College London with partner institutions in Burkina Faso, Mali, Uganda, and Ghana, is currently working with much more limited genetic engineering techniques to fight the disease. But according to engagement manager Delphine Thizy, they are hoping to apply for approval to test gene drives in the field as soon as 2023.
The science behind the tool, while not quite ready for release, is very, very, very close. I asked Ethan Bier, a professor at UC San Diego and one of the first people to help build an actual working CRISPR gene drive, how soon a drive targeting malaria could be released, as a scientific matter.Bier hesitated, and stressed that we shouldn’t release anything without regulatory approval and much more consideration. But he concluded, “To be honest with you, if there were some kind of emergency and one absolutely needed to do it, we could pretty much do it.”
And Esvelt, whose work helped pave the way for Target Malaria’s efforts, is terrified, simply terrified, of a backlash between now and then that could derail it. This is hardly a theoretical concern. In 2002, anti-GMO hysteria led the government of Zambia to reject 35,000 tons of food aid in the middle of a famine out of fear it could be genetically modified. Esvelt knows that the CRISPR gene drive is a tool of overwhelming power. If used well, it could save millions of lives, help rescue endangered species, even make life better for farm animals.
If used poorly, gene drives could cause social harms that are difficult to reverse. What if gene drives get a bad rap? What if an irresponsible scientist moves too fast and prompts a strong political countermovement, like that which has stymied other genetically modified organisms since the 1990s? What if an irresponsible journalist — let’s call him Dylan Matthews — writes a bad article that misconstrues the issue and sends the project off the rails?
“To the extent that you or I say something or publish something that reduces the chance that African nations will choose to work with Target Malaria by 1 percent, thereby causing a 1 percent chance that project will be delayed by a decade, the expected cost of our action is 25,000 children dead of malaria,” Esvelt tells me. “That’s a lot of kids.”
A genetically modified organism could end malaria and save millions of lives — if we decide to use it
Published
A Middleground 