The African malaria mosquito is the most dangerous animal on earth, claiming roughly half a million lives each year. In 2016, there were 216 million cases of malaria, 90% of which were found in sub-Saharan Africa. Each year, the deadly disease costs billions of dollars to the world economy, tears apart communities, and devastates families. Nearly half of the world is at risk, and drug resistance, poor infrastructures, and weak healthcare systems have made the mission of eradication a failure. However, a new solution to the malaria crisis has recently appeared on the horizon. The solution uses synthetic biology, a branch of biology which involves the engineering of life. Scientists plan to utilize a CRISPR gene drive, a form of genetic technology which would allow for the sterilization of an entire population of female mosquitoes, in order to drive certain species of mosquitoes responsible for spreading malaria to extinction. The solution, if implemented, would not only alter a single organism, but an entire species and ecosystem. The possibility of this technology being at our disposal brings about many complex ethical issues and questions. What responsibility to humans have to preserve the environment, and what responsibility do humans have to each other? Do we have the right to drive another species to extinction for our own benefit? Where do we draw the line on genetic engineering, and when does it go from doing more good to doing more harm? The exploration of these questions provide us with insights on whether it would be ethically permissible for our society to move forward with this major development in the field of public health.
“The African malaria mosquito is the most dangerous animal on earth,” says Conor McMeniman, assistant professor at the Johns Hopkins Malaria Research Institute (CNN). While it may be difficult to imagine an organism just shy of 5 millimeters long to outdo the lethality of the Bengal tiger or the great white shark, these words hold truth. Nearly half of the world is at risk for malaria, a disease caused by a parasite carried to humans by mosquitoes. In 2016, there were 216 million cases of the disease worldwide, resulting in an estimated 445,000 deaths overall, and making malaria one of the deadliest infectious diseases in the world. While the disease was largely eradicated in the United States, Europe, and parts of Latin America and Asia in the 1960s due to federal programs, poor infrastructures and weak health systems, as well as drug and insecticide resistance, have hobbled efforts to control the disease in sub-Saharan Africa and South and South-East Asia. Recently, a new solution to the malaria crisis has appeared on the horizon. This paper will focus on the use of CRISPR gene drives to genetically modify mosquitoes in order to stop the spread of malaria in underdeveloped countries. The solution involves synthetic biology, a branch of biology which involves the engineering of life. A CRISPR gene drive is a tool developed in the last decade which allows humans to change the genetic makeup of an entire species by changing the DNA of a few individuals. This technology can then spread the modification throughout an entire population. To stop the spread of malaria, the technique would be used to sterilize the female mosquitoes responsible for spreading malaria.
The main ethical issue I will be discussing in this paper will involve the value of responsibility, specifically, the tension between the responsibilities humans have to preserve the earth and its ecosystems in their natural states, and the responsibility humans have towards each other when considering the use of this technology. The main question I will be exploring is: Is it ethically permissible to genetically modify, and possibly drive to extinction, species of mosquitoes which carry the malaria parasite in order to end the malaria crisis? However, a broader, overarching question that I would like to consider is: when is it ethically permissible to genetically modify nature, and how can this be decided without leading to a slippery slope in which organisms and the environment are genetically modified unnecessarily for human benefit?
Mechanics of the Parasite
The natural history of malaria involves cyclical infection of humans and female Anopheles mosquitoes. Malaria can be caused by several species of single-celled Plasmodium parasites, each of which has a complex life cycle. There are four main plasmodium variants which cause malaria in humans, the two most common being P. Falciparum and P. Vivax. P. Vivax is most commonly found outside of sub-Saharan Africa, especially in Asia and Latin America. This species can lie dormant for months or even years before rising up to infect the blood of the carrier. P. Falciparum is most common in sub-Saharan Africa, and is perhaps the most deadly variant. It is characterized by its rapid multiplication inside the human body.
Malaria parasites are transmitted to human hosts by female mosquitoes of the genus Anopheles. When certain forms of blood stage parasites are ingested during blood feeding by a female Anopheles mosquito, they mate in the gut of the mosquito and begin a cycle of growth and multiplication. After 10-18 days, a form of the parasite called a sporozoite migrates to the mosquito’s salivary glands. When the Anopheles mosquito bites a human, anticoagulant saliva is injected together with the sporozoites, which migrate to the liver. The parasites grow and multiply in the liver cells and then in the red blood cells. In the blood, successive broods of parasites grow inside the red cells and destroy them, releasing daughter parasites that continue the cycle by invading other red cells. When the mosquitoes bite a human with malaria, they ingest the blood-stage parasite, thus repeating the cycle. The infected mosquito acts as a vector, carrying the disease from one human to another while infected humans transmit the parasite to the mosquito. In contrast to the human host, the mosquito vector does not suffer from the presence of the parasites. The parasite cannot make its way into the bloodstream of a human without a mosquito vector, therefore, the removal of plasmodium parasite carrying mosquitos would solve the malaria crisis (Center for Communicable Diseases (CDC))
As mentioned earlier, the plasmodium parasite enters and destroys the red blood cells of its human host. This presents itself in various ways. “Uncomplicated” malaria entails a series of recurring episodes of chills, intense fever, and sweating, sometimes including other symptoms such as headache, malaise, fatigue, body aches, nausea, and vomiting. In some cases, and especially in groups such as children and pregnant women, the disease can progress to “severe malaria,” including complications such as cerebral malaria/coma, seizures, severe anemia, respiratory distress, kidney and liver failure, cardiovascular collapse, and shock (National Institutes of Health). These symptoms demonstrate the severe nature of malaria and its devastating effects on the human body.
A Brief History
As we move towards the future of malaria, it is important to look back and see what has been done to control this disease in the past. Malaria was once prevalent around the world, including in the US and throughout Europe. Malaria has been devastating humankind for over 500,000 years, however, the specific parasite that caused this previously mysterious disease was not discovered until 1880. The first steps towards eradication were taken in 1914, when Henry Rose Carter and Rudolph H. von Ezdorf of the U.S. Public Health Service requested and received funds from the U.S. Congress to control malaria in the United States. In 1933, President Franklin Roosevelt signed a bill that created the Tennessee Valley Authority, which federally funded the improvement of land and waterways for the region. Before the implementation of this bill, 30% of the population was affected by malaria. This number was dramatically reduced by improving the infrastructure of the area as to reduce mosquito breeding grounds. During World War II, German chemists developed a drug named Resochin that would later be known as the popular pharmacologic agent chloroquine. This center, which would eventually become the modern CDC, dedicated itself to the eradication of malaria in the US, a goal that was accomplished by 1951. Among the strategies used in this campaign were improved drainage to remove mosquito breeding sites and large-scale insecticide spraying over affected areas. These strategies were effective in the United States but financially, are simply not a realistic option for developing countries today. Improving drainage sites requires a complete redesign of infrastructure. (CDC) Large-scale insecticide spraying is also expensive and not always effective due to the recent rise of insecticide-resistant mosquitoes. In 1955, the World Health Organization (WHO) began a program to eliminate malaria globally, utilizing the advent of new antimalarial compounds and DDT in its mission. Some countries, such as India, benefited remarkably from the WHO’s efforts; others, such as sub-Saharan Africa, remained largely unaffected. Today, difficulties such as drug-resistant strains of malarial parasites have ultimately made the WHO’s original mission unfeasible, necessitating its transition to a mission of control rather than eradication (World Health Organization). Malaria was once a problem everywhere, but was essentially eliminated from the “rich, western world” due to greater financial resources. This leaves us with a global socioeconomic unbalance, in which those living in developing countries are left to suffer from this disease while others living in wealthier countries are not.
Use of DDT to control malaria
One of the most prominent combatants of malaria was the chemical insecticide DDT, or Dichlorodiphenyltrichloroethane. However, its use was controversial. DDT was used to aid in the eradication of malaria in the US in the 1960s, but eventually was banned due to its severely adverse effects on wildlife and human health (CDC). Some countries still use the chemical, however. Today, scientists believe that DDT should only be used as a last resort in combating malaria. Fifteen environmental health experts, who reviewed almost 500 health studies, concluded that DDT “should be used with caution, only when needed, and when no other effective, safe and affordable alternatives are locally available” (Cone). Tiaan de Jager, a member of the panel stated that “we cannot allow people to die from malaria, but we also cannot continue using DDT if we know about the health risks.” The scientists reported that DDT may have a variety of human health effects, including reduced fertility, genital birth defects, breast cancer, diabetes and damage to developing brains. Its metabolite, DDE, can block male hormones. Therefore, the use of DDT may do more harm than good, as it would not necessarily be beneficial to either the environment or human health (Cone).
The Impact of Malaria in Today’s World
The disease of malaria was eradicated in developed countries many years ago. However, it continues to pose one of the biggest greatest to human health in the developing world, threatening some 40 percent of the global population who are living in the world’s poorest countries. In these areas with high transmission, the most vulnerable groups are young children, who have not developed immunity to malaria, and pregnant women, whose immunity has been decreased by pregnancy. It is estimated that around 70% of malaria cases affect children under age 5. Aside from its cost to human health, the social and economic tolls – on individuals, families, communities, nations – are enormous. Nicknamed ‘the disease that keeps poor people poor’, malaria has also been identified as one of the top four causes of poverty (Innovative Vector Control Consortium). In areas where malaria is a constant threat, mosquito nets and medical interventions take money away from reinvestment in agriculture, absences from work as a direct or indirect result of malaria further reduce income and children miss out on opportunities to learn. It is estimated that some sub Saharan African countries spend nearly half their health budgets on malaria treatment and prevention, leading to a total economic burden of malaria in Africa alone which is estimated at some US $12 billion per year (CDC). In 2016, an estimated 445,000 people died of malaria—most were young children in sub-Saharan Africa; in 2015, this region carried 90% of malaria cases and 92% of malaria deaths. In addition, children in Africa miss up to 50% of the school year due to malaria (National Institutes of Health). It is clear that this is an issue that has a devastating impact on those in affected parts of the world. Considering these devastating statistics, and the socioeconomic inequality outlined, it can be argued that we as humans have a primary responsibility to help those in less fortunate situations using any means available to us.
CRISPR and Gene Drives Background
CRISPR stands for Clustered Regularly Interspaced Short Palindromic Repeats, which are the hallmark of a bacterial defense system that forms the basis for CRISPR-Cas9 genome editing technology. It is the most prominent genome editing tool in its field. In the field of genetic engineering, the term “CRISPR” or “CRISPR-Cas9” is often used loosely to refer to the various CRISPR-Cas9 and -CPF1 (and other) systems that can be programmed to target specific stretches of genetic code and to edit DNA at precise locations, as well as for other purposes, such as for new diagnostic tools. With these systems, researchers can permanently modify genes in living cells and organisms. CRISPR “spacer” sequences are transcribed into short RNA sequences capable of guiding the system to matching sequences of DNA. When the target DNA is found, Cas9 – one of the enzymes produced by the CRISPR system – binds to the DNA and cuts it, shutting the targeted gene off. Using modified versions of Cas9, researchers can activate gene expression instead of cutting the DNA. These techniques allow researchers to study the gene’s function. CRISPR is often referred to as “genetic scissors” and has many potential uses, such as fixing genetic diseases in animals, sterilizing animals, enhancing traits, and modifying crop strains. CRISPR would be used in the solution to stop malaria (Broad Institute).
The second technology that would be used is gene drives. Gene drives occur naturally. During normal sexual reproduction, each of the two versions of a given gene has a 50 percent chance of being inherited by a particular offspring. Gene drives are genetic systems that circumvent these traditional rules: they greatly increase the odds that the drive will be passed onto offspring (Scientific American). This can allow them to spread to all members of a population even if they reduce the chance that each individual organism will reproduce. Engineered gene drives can be used to spread particular genetic alterations through targeted wild populations (Syntego). Because they can alter the traits of entire populations, they represent a potentially powerful tool for the sustainable management of ecosystems. There are many potential uses for engineered gene drives. In addition to eliminating diseases such as malaria, dengue, yellow fever, West Nile, and sleeping sickness, they can also be used to eradicate invasive species and pave the way towards sustainable agriculture by reversing pesticide and herbicide resistance, so weed-killers can once again be effectively used (Montenegro). Gene drives would be built using CRISPR technology. They would only work in animals that reproduce sexually, such as insects, animals, and most plants. In this case, they would be implemented in a species of mosquitoes (see fig 1).
The image above shows the difference in gene spread between normal inheritance and gene drive inheritance, showing how a gene drive allows a gene to spread throughout nearly an entire population.
CRISPR gene drives can be used to prevent the spread of malaria in sub-Saharan Africa by dramatically reducing, and possibly driving to extinction, the mosquito population responsible for spreading the disease. This would be done by spreading genes that sterilize, and ultimately drive to extinction, certain mosquito populations which spread malaria. The genes spread would bias sex ratios to create more males, leaving fewer female mosquitoes to bite people and causing a population crash. Genes that do this are called suppression genes because they suppress the population. A paper released by London team in September 2018 shows that the suppression gene drive they designed reached 100 percent prevalence among mosquitos in a lab after 7-11 generations (MIT Tech Review). The technology would not make all mosquitoes extinct — only the three main species which are responsible for spreading malaria: Anopheles gambiae, Anopheles coluzzii, and Anopheles arabiensis.
It is important for us to consider both the environmental and health consequences that would occur as a result of using engineered gene drives to drive mosquito populations to extinction before looking at the ethicality of the solution. Since this has never been done before, the effects on ecosystem are virtually unknown. Usually, the extinction of a single species has far-reaching effects. A recent study published in the Journal of Biological Conservation outlined the effects that the extinction of certain endangered insects, such as mayflies and caddisflies, could have on the environment around them. The study showed that major declines or extinctions of insect species have impacts far beyond those species themselves. Not only do these declines have the ability to endangered animal species like trout, they have the ability to disrupt entire food webs. It stated that “the essential role that insects play as food items of many vertebrates is often forgotten. Shrews, moles, hedgehogs, anteaters, lizards, amphibians, most bats, many birds and fish feed on insects or depend on them for rearing their offspring” (Shmukler). However, the species of malaria-carrying mosquitoes do not seem to be an exception. So far, not much evidence seems to show that these species of mosquitoes are key species in the ecosystem since they are not a significant portion of any predators diet. Scientists acknowledge that the ecological scar left by a missing mosquito would heal quickly as the niche was filled by other organisms. “It’s difficult to see what the downside would be to removal, except for collateral damage”, says insect ecologist Steven Juliano, of Illinois State University in Normal. Medical entomologist Carlos Brisola Marcondes from the Federal University of Santa Catarina in Brazil states that a world without mosquitoes would be “more secure for us” and that“the elimination of Anopheles would be very significant for mankind”. A possible adverse effect is that a particular altered trait could cause unexpected and potentially harmful side effects on other species. Releasing modified mosquitoes into wild will quickly spread the modified gene to the entire mosquito population in a few generations, which would have an impact on human health. Mosquitoes will be less likely to spread malaria, and malaria rates would hopefully decrease. However, there are many questions that arise. Is there a possibility for the modified mosquitoes to mutate and become even deadlier than before? If the use of gene drives become common practice, is there a possibility for them to be used for negative purposes (ex. inserting a gene into a biting insect which allows it to deliver toxins)? The acknowledgement of these potential consequences will prove to be crucial when the discussion of the value of safety is later discussed in considering the ethicality of genetically modified mosquitoes.
The first value to consider is responsibility, beginning by looking at the human responsibility to preserve the environment, and the argument that humans do not have the right to drastically alter the environment for their own benefits and needs. It is unrealistic to argue that this responsibility to preserve involves ensuring that the environment remains completely unaltered by humans. Instead, the word “preserve” in this case suggests that humans should not change the environment in drastic ways, for example, by changing an entire ecosystem. The theory of deontology comes into play here. It states that is it is not the consequences that matter, but the carrying out of the action itself. In this case, the intent is to modify an entire environment for the benefit of humans. Whether or not this action results in consequences, the motive is unethical. There is a difference between genetically modifying a singular organism and genetically modifying an entire ecosystem. By putting human health over environmental preservation, we are playing into the idea of anthropocentrism, which is the human mindset that the entire environment is here for our own benefit and use. Even if there are no negative consequences, the action itself of modifying nature is unethical because it perpetuates the dangerous mindset that the entire environment is here solely for our benefit. Who will speak on behalf of the mosquitoes? Or the ecosystem? How do we give a voice to those who don’t have one? Research has shown that humans are more likely to give a voice to certain animals over others. Charismatic megafauna are large animal species with symbolic value to humans. These animals possess similar features to those of humans, which is why we find them to be more attractive, and are more likely to “give them a voice”. This further fits into the idea of anthropocentrism. Mosquitoes are not characteristic megafauna, in fact they are the opposite. Therefore, we would likely be far more opposed to the idea of a different animal being eradicated, for example, the sterilization of deer to stop the spread of lyme disease. Our implicit biases play a role in our decisions. The theory of consequentialism is also important to consider when looking at this side of the argument. Genetically-modifying mosquitoes could actually have detrimental effects on the environment which are currently unknown. It is our responsibility to preserve the environment. This means refraining from releasing powerful environment-altering technology until scientists have confirmed its effects on the environment.
When looking at the value of responsibility, there is also an argument that humans have a primary responsibility to help one another. It is important to consider the fact that there is a huge disparity in socioeconomic class between the people who are making this decision and those who are being affected by it. In many ways, it is paternalistic to go against a decision which could save thousands lives because of the “greater good” of saving the environment and protecting species. Communities being affected by malaria also do not have a voice. Most of the people who are actually being affected by malaria are not the ones making these ethical decisions. Therefore, it is the responsibility of the educated individuals making this decision to take into account the value of empathy, and to consider the viewpoint and experiences of those being affected, ultimately coming to a decision which will ultimately help them. The next argument that plays into this argument is fairness. It is not fair that half the world is malaria-free and the other half is not because of financial differences; we have a responsibility to help all people and level the playing field. Using gene drive mosquitoes is a cost-efficient way to carry out the same goal that was achieved in the US and Europe.
The final aspect of responsibility is the possibility of a slippery slope, and our responsibility to stop this technology from going too far. When do we decide if it is ethical to genetically modify a living organism? When do we cross the line from doing more good to doing more harm? It is easy to go down a slippery slope in which genetically modified animals are used for human benefit when not necessary. Recombinetics, a start-up firm, is working on using this technology to create Brazilian beef cattle with larger muscles for more meat, which may be more tender, while other firms are developing chickens that only produce female offspring for egg-laying and beef cattle that only produce males for more efficient feed-to-meat conversion (Montenegro). These are examples of situations where gene drive technology is being used for enhancement rather than necessity.
In summary, the use of genetically engineered mosquitoes causes a conflict between the human responsibility to take care of each other and preserve the environment, making it an ethical challenge.
The next value to consider is autonomy, specifically as it pertains to informed consent during experimental trials of this technology. Paragraph 20 of the World Medical Association’s Declaration of Helsinki — Ethical Principles for Medical Research Involving Human Subjects clearly outlines the requirement of informed consent of subjects, stating that “the subjects must be volunteers and informed participants in the research project”. However, the following of this regulation becomes blurry when the entire environment is being altered. This can lead to many problems. In 2009, genetically engineered mosquitoes were released in the Cayman Islands as part of a small-scale trial. The Cayman experiments were not revealed to the public until one month after the initial release and “no public consultation was undertaken on potential risks and informed consent was not sought from local people” (Easton 299).In this case, human involvement is indirect; the humans themselves are not being experimented on, and the impact on humans is expected to be positive. However, informed consent is still crucial, as those living in communities that are being experimented on should have the right to know if their environment is being artificially altered, and be given the opportunity to leave once this information is delivered. The potential consequences are largely unknown and could indirectly affect those living in the area of experimentation, for example, the release of genetically modified mosquitoes could lead to changes in the blood-feeding patterns of the mosquitoes in the area. However, many questions arise. To what extent should the participants know about the trial taking place so they can have the autonomy to make the decision to leave or stay? How can the process be explained despite culture and language barriers? An article released on the subject by MIT Technology Review states that “Not even most scientists yet know what a gene drive is, or how one works. And describing it to people in the Luo dialect is challenging, since the language lacks a word for DNA. Mukabana borrowed words from English and Swahili and used “blood” as a synonym for genes.” The implementation of this technology leads to a conflict of social consensus versus autonomy. In experimental trials, people are allowed to opt out at any time. But this changes when an entire community is being experimented on. If there are more than 100,000 persons in a region covered by a trial, it is unrealistic and unlikely that informed consent can be given by all people in the area. A procedure that is neither paternalistic (asking all citizens for their consent) nor paralytic (waiting for every single person in the community to agree) needs to be developed. This procedure must supply relevant information to all persons in the area, and the minority of people who disagree with the trial must be given the opportunity to leave.
Finally, I will be discussing the value of safety. There is a huge difference between modifying a singular organism or species in a lab environment and modifying an entire ecosystem, as would be done in the case of gene drives. Once it is in the wild, there is no way for it to be controlled. It is not possible to recall all of the genetically modified mosquitoes if there were to be adverse consequences, meaning that any negative effects could be irreversible. Gene-drive technology is distinct from more conventional forms of genetic engineering, because the goal is to let the new genes drift through a broader population, propagated by sexual reproduction, rather than have them remain confined to, say, a patch of corn or soybeans. In laboratory experiments, gene drives have been successful in fruit flies, yeast and mosquitoes, however, many concerns still remain. “You need to be concerned about what you don’t know,” said Ravi Durvasula, a professor of Medicine and Infectious Diseases at University of New Mexico School of Medicine. “The approach itself is fine, scientifically, but there are always the what-if scenarios. What if, for some reason, it doesn’t work—and reverts back to a wild-type state?” What Durvasula means is, what if the desired gene mutation doesn’t take, and people end up releasing mass quantities of new mosquitoes that end up making the Zika problem worse? Other possibilities are that gene modification ends up altering a mosquito’s behavior—making it more aggressive, or changing its host preference. Some scientists even worry that mosquitoes could begin transferring their altered genes horizontally—to other non-target species, rather than just to their own offspring (LaFrance). “One can’t be 100 percent certain that this is foolproof”, says Durvasula, “You can start to fantasize about every possible fate of that gene, but it’s impossible to test all of that in a lab. And once you’ve released a trait into a population, there cannot be a recall. This is what scares people. People get creeped out by these things”.Finally, there are safety concerns surrounding the possible abuse of technology, for example, the insertion of a gene into a biting insect which allows it to deliver toxins. The biotech watchdog ETC Group called the new report about gene-drive mosquitoes “disappointing” in a release headlined “Stop the Gene Bomb!” The organization stated that the new report failed to address many of the potential hazards and societal implications of the new technology, including possible use of gene drives for military purposes. For example, the organization said gene drives could be a biological weapon targeting the human microbiome (ETC Group). The counterargument is, however, that these possibilities are hypotheticals. Allowing hundreds and thousands of people to die is even more unsafe. Challenges in creating regulations when testing this solution out on an entire community and concerns about environmental and public safety further complicate and question the ethicality surrounding the use of genetically engineered mosquitoes.
The discussion of the ethicality of the use of genetically modified mosquitoes involves the consideration of the values of responsibility, autonomy, and fairness. In discussing the value of responsibility, one must measure the human responsibility to take care of and preserve the environment against the human responsibility to take care of one another. The value of autonomy is crucial in considering the complexity surrounding informed consent and communication with local communities in African countries as this solution is put into place.Finally, the value of safety allows for the discussion of potential hazards which could arise from the use of this technology, and open up dialogue for solutions and regulations which could be implemented.
Malaria is one of the most deadly diseases in the world, and despite global efforts, the socioeconomics of sub-Saharan Africa have made it difficult to eliminate the disease using the methods which have been successful elsewhere. It is important to consider the fact that the people making this decision are not those from the communities being affected, but those from richer, more developed countries, who had the financial means to eradicate the disease. As of now, there has been no research showing that malaria spreading mosquitoes are a major portion of any predator’s diet. Therefore, I believe that in this specific case, the responsibility of humans to each other should trump the responsibility we have to not dramatically alter the environment. While there is a possibility of a slippery slope, I believe that the issue should be approached with great caution to avoid going down this slope. With proper safety regulations and the designing of a system which can ensure that all experimental trials are done with informed consent of the participants, genetically engineered mosquitoes should be strongly considered as a solution to the malaria epidemic
SUMMARY & CONCLUSION
Malaria is a parasitic disease spread by mosquitoes which infects millions and kills hundreds of thousands each year. The release of genetically modified sterile mosquitoes into the environment is a promising solution which has the potential to stop the spread of malaria, but also has the potential to drive certain species of mosquitoes to extinction. While genetically modified organisms have been used for decades, they are usually confined, such as in the case of GM crops. Genetically modified mosquitoes would not be isolated; they would have the ability to spread their genes throughout an entire population, and modify an entire environment, which is what makes this issue ethically complex. When considering the ethicality of this new technology, I focused on the value of responsibility, looking specifically the tensions that between the responsibility that humans have to each other and the responsibility humans have to the environment, and the possibility of a slippery slope when deciding when it is acceptable to genetically modify the environment for human benefit. I also considered the value of autonomy, when considering the role that local people (who are directly affected by malaria) should have in this decision making process and what informed consent would look like when implementing this solution, since it would affect entire communities. Finally, I discussed safety concerns associated with the release of gene drive mosquitoes, such as the uncertainty of environmental effects, the possibility of mutations which could make the parasite more deadly, and the concern of this technology being used for malicious purposes, such as bioterrorism. Genetic modification is an inevitable part of our future and a cost-efficient alternative to medication and building of new infrastructure (in the case of malaria). This technology can also be used to stop the spread of other diseases such as Lyme and Zika.
While this solution has the possibility to transform communities and eradicate malaria, how do we stop genetic modification from going from beneficial use to abuse? What are some laws that can be put into place? It is important to draw a line on genetic modification to avoid a slippery slope in which genetic modification of the environment becomes a regular event, even when unnecessary. One possibility is to create a boundary in which genetic modification can only be used in cases where many human lives are at stake, the people being affected want the intervention, and experts tell us there are unlikely to be significant negative consequences. Another potential regulation is releasing mosquitoes in a lab environment first, which mimics the environment they will be exposed to when released in the wild, in order to ensure that the technology is effective and long-term safety concerns are not discovered. We also must emphasize the importance of communication between the large western biotechnology companies such as Oxitec that are carrying out research and members of the communities being exposed to this technology to ensure that they are fully informed of, and approve of the process taking place. There should be laws and regulations which require there to be full consent of a community before experimental trials take place, since the alteration of an ecosystem can have effects on the people living in the area. Since mosquitoes cannot be confined to governmental boundaries, the implementation of this technology will require communication and collaboration between countries and political leaders to establish universal regulations across borders and manage and divide the cost of the technology among governments. Finally, gene drive research should be made classified and high-security to ensure that it will only be used for safe, beneficial purposes.
The world of synthetic biology contains some of the most exciting new technologies of our age. While ethical considerations must be taken into account, the release of genetically modified gene drive mosquitoes have the potential to alter communities and eradicate a devastating disease.