Gene Drive

Conventional malaria tools have cut deaths by two-thirds over 20 years, saving millions of lives. This is real progress, but current tools alone can't eradicate malaria.

To reach a malaria-free world, the Gates Foundation is working in partnership with endemic countries and investing in novel vector control tools that complement conventional approaches, creating a robust suite of options that could help reach the hardest hit places. The technologies target mosquitoes at the molecular level to disrupt disease transmission. Among them is gene drive technology, which could shrink populations of malaria-carrying mosquitoes or block their ability to transmit the malaria parasite altogether. When combined with existing tools, these approaches have the potential to be a game-changer in the fight against one of humanity's deadliest killers.

The Foundation's support in this space began in 2005 with one of the original Gates Foundation Grand Challenges in Global Health grants, supporting the Target Malaria team at Imperial College London to develop a gene drive that would reduce the population of Anopheles mosquitoes, the species that carries malaria. A decade later in 2016, the Foundation expanded its portfolio by investing in a second project called Transmission Zero, based at Imperial College and Tanzania's Ifakara Health Institute, with partnerships in the National Institute of Medical Research, Tanzania, and the Swiss Tropical and Public Health Institute. While Target Malaria focuses on reducing the number of female malaria-carrying mosquitoes, as females are the ones that bite, Transmission Zero takes a different approach: engineering mosquitoes that are incapable of transmitting malaria. Though different routes, both are working toward the same destination: the eradication of malaria.

Building on early laboratory success, both projects have moved beyond the lab, working with governments, regulators, and local communities to establish robust safeguards and strong policy frameworks to enable a research ecosystem capable of conducting trials in communities most affected by malaria. Since the start of their work together, and with Foundation support, Target Malaria's partners - Institute de Recherche en Sciences de la Sante (IRSS) in Burkina Faso and Uganda Viral Research Institute (UVRI) in Uganda - and Transmission Zero's partner, Ifakara Health Institute, have:

• Set up specialized laboratories with stringent safety protocols to breed and study genetically modified mosquitoes;
• conducted detailed field studies to observe mosquito behavior and reproduction in natural environments;
• and worked closely with local communities and government officials to explain this new approach and address questions and concerns.

In the past decade, gene drive for malaria control has achieved significant milestones: the technology was successfully tested in small UK insectaries and scaled up to larger facilities in Italy; IRSS in Burkina Faso conducted the first release of sterile male mosquitoes - a population unable to reproduce – allowing them to study how these modified mosquitoes interacted with wild populations; and Transmission Zero's Ifakara team created the first genetically modified mosquitoes engineered entirely in Africa, which are now undergoing testing in Ifakara's insectary. All of these developments are built on a pursuit of science and intensive multi-year reviews that include biosafety assessments, government agency input, community consultation, and monitoring protocols. Together, they marked important early steps in the careful, phased approach to developing and testing new genetic vector control methods, including future evaluations of genetically modified mosquitoes before any potential gene drive releases.

In the next decade, through the leadership, vision and determination of African scientists, in collaboration with local government, authorities and communities, and following cautious and rigorous safety measures, these projects are preparing for larger scale trials in malaria-endemic environments.

But breakthrough science needs equally strong systems to support it. While Target Malaria and Transmission Zero push the technology forward, the Foundation is also investing in other efforts that are building the scientific and regulatory backbone across the continent. For example, AUDA-NEPAD has established the African Union High-Level Panel on Emerging Technologies and launched the Integrated Vector Management Programme, working with the West African Health Organization to support efforts to ensure regulators are able make informed decisions about whether adopting gene drive suits their country context and needs. The goal: safely and securely scale new technologies – including potential gene drive – where they are needed on the continent over time.

In support of malaria endemic countries, the Gates Foundation is backing next-generation science, like gene drive, and the people behind it, because staying ahead of evolving threats demands bold new approaches. Gene drive technology represents a promising breakthrough that could complement the existing suite of malaria-fighting tools. As a potentially self-sustaining solution that could protect communities for generations, gene drive would enhance the impact of existing solutions like dual-AI bed nets, spatial repellents, sophisticated monitoring systems, and others which, in some regions, have their limits. The Foundation is proud to support the visionary scientists, institutions, communities, and governments pioneering this critical work. Together, we're racing toward a future where malaria is eradicated, and no one dies from this preventable disease.