“Malaria, one of the most ancient and deadly diseases of humankind, can and should be eradicated before the middle of the 21st century,” kicks off the introduction to a new report by the internationally acclaimed medical journal, The Lancet.
A monsoon disease, Malaria is mosquito-borne. It’s typically transmitted through the bite of an infected Anopheles mosquito, which carries the Plasmodium parasite. Thereby, when this mosquito bites, the parasite is released into the bloodstream.
The Lancet report outlines how the 86 countries with endemic malaria can achieve ridding themselves of the disease within one generation.
The report says that India is a tropical country which has a high risk of Malaria. With the fourth-highest number of malaria cases in the world, India is likely to be one of the focal points of this effort.
Improving the state of public health system and strengthening of private health care system in India is an important recommendation as per the Lancet study.
The National Strategic Plan for Malaria Elimination, launched in 2017, aims to scale up diagnostic testing, treatment, and surveillance, and improve the drug and diagnostics supply chain, training of community workers, and distribution of bed nets, according to a Hindustan Times report last year.
However, these are generalized improvements aimed at controlling the malaria infection, improving diagnosis and treatment, and targeting efforts — not eradication. This is why The Lancet report also offers a unique recommendation to eliminate the disease, taking into account India’s increasingly urbanized malaria scenario: gene drives.
Gene drive is a method of involving genetically modified mosquitoes — either to become resistant to infection by P falciparum or to produce male offspring only, as female mosquitoes are the only ones who bite and thus transfer the parasite. They are a promising measure in the fight to eradicate malaria, and Target Malaria, a non-profit research consortium, is developing one of these gene drives, which offers “the potential to address urban malaria in India,” the report notes.
However, the report writes that gene drives are a controversial step; tweaking the DNA of a living organism — with the goal of reproduction to spread that tweaked DNA until it becomes the organism’s norm — is a fraught topic.
In light to this, Target Malaria, a non-profit research consortium which aims to develop and share technology for malaria control, has currently working with Burkina Faso — the country with the second-highest per capita incidence of malaria, according to The Lancet report. This is to release mosquitoes genetically modified to be sterile. These mosquitoes will do nothing to stop the spread of malaria, but are intended as an initial show of good faith and no harm. It will, in turn, will dispel myths about genetically modified organisms and build public support for a future gene drive.
Gene drives may be an opportunity for India in more ways than one — a chance to eliminate malaria, and a chance to be a leader within an unprecedented ethical debate.
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