Approximately 80% of the world’s population is at risk of one or more vector-borne diseases (VBDs), which together are responsible for 17% of the global burden of disease. Considering the significance of these diseases, the Economic Community of West African States (ECOWAS) agreed to the establishment of a West Africa - Integrated Vector Management (WA-IVM) Programme. The purpose of this programme is to establish and operationalise a platform for the region to foster collaborations among member states on issues relevant to the effective control of vectors. Key thematic areas to be covered by this programme are biosafety, environment, ethics, regulatory oversight, health systems, among others. The WA-IVM platform also aims to equip and capacitate the region with innovative technologies and novel approaches for controlling vectors.
Malaria is the most important vector-borne disease in sub-Saharan Africa. According to the WHO 2020 report, there were 229 million cases and 409,000 deaths in 2019, 94% of which were in Africa. The significance of Malaria as the most challenging vector-borne disease and the most widespread in Africa informs its choice by the WA-IVM programme as an important pathfinder disease for developing its platform activities.
Gene drive is a phenomenon of biased inheritance in which the prevalence of a genetic element (natural or synthetic) or specific alternate form of a gene (allele) is increased, even in the presence of some fitness cost. This leads to the preferential increase of a specific genotype that may determine a specific phenotype from one generation to the next and potentially spread throughout a population. This process favours biased inheritance of certain genes from generation to generation and can alter wild populations of harmful mosquitoes, either by preventing them from transmitting pathogens or by suppressing the population towards elimination [8, 9]. Mathematical modelling suggests that successful development and deployment of this technology could, in combination with existing interventions, significantly improve and accelerate malaria control in various African settings. One model predicted that considerable suppression of vector populations could be achieved within just four years of using a female sterility gene but warned actual impact might likely vary over time and geography.
Despite the enormous potential anticipated, applying new technologies such as this will also create new ethical challenges that may need to be addressed. For example, since mosquitoes are mobile organisms, it will be difficult to conduct confined field trials in any country without raising transboundary concerns. Moreover, gene drive technologies could give rise to issues with anthropocentric or non-anthropocentric dimensions and therefore question current norms and values.
This document is part of a series of guidelines developed jointly by AUDA-NEPAD and WAHO, under the WA-IVM programme, to support regulation of both research on and the deployment of genetically modified mosquitoes in the region. The document provides a framework for addressing ethical considerations relevant to such projects.
