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Ethical implications of fighting malaria with CRISPR/Cas9
  1. Maria Patrão Neves1,
  2. Christiane Druml2
  1. 1Faculty of Humanities and Social Sciences, University of the Azores, Ponta Delgada, Portugal
  2. 2UNESCO Chair on Bioethics of the Medical University of Vienna, Ethics, Collections and History of Medicine of the Medical University of Vienna, Vienna, Austria
  1. Correspondence to Dr Christiane Druml, UNESCO Chair on Bioethics of the Medical University of Vienna Ethics, Collections and History of Medicine of the Medical University of Vienna Waehringerstrasse 25A-1090 Vienna, Austria; christiane.druml{at}meduniwien.ac.at

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  • Genome editing is a new, cheap and versatile technique which has great promise to combat vector-borne diseases. The current ethical debate worldwide is mainly concentrating on the dangers of germline intervention and less so on the potential for fighting vector-borne diseases.

  • Gene drive technology has been significantly boosted by the CRISPR/Cas9 gene editing tool which may be able to combat malaria by targeting specific stretches of vector DNA and editing genomes at precise locations, working like a molecular scissors. However, CRISPR/Cas9 is currently not a ‘silver bullet’ and needs further research and consideration of the ethical aspects and consequences of its use.

  • In September 2016, the UNESCO Chair of Bioethics at the Medical University of Vienna convened a meeting entitled ‘Fighting Malaria with CRISPR/Cas9: Ethical Implications’, which gathered together infectious disease experts with a focus on malaria, entomologists and ethicists to discuss the advantages and disadvantages of genome editing applied to mosquitoes to fight malaria.

  • Although there was no formal consensus, some general conclusions were reached, in particular that any ethical debate needs to involve African stakeholders living in malaria areas and  to consider future generations and the environment. The precautionary principle should be taken into account in any discussion, as should be the human cost of doing nothing.

The burden of vector-borne diseases

In 2014, WHO dedicated its World Health Day to vector-borne diseases as they account for more than 17% of all infectious diseases, causing more than 1 million deaths annually, with a high economic impact.1 About half a million people with Dengue fever are hospitalised each year, while Zika, responsible for an unprecedented rise in the number of children born with congenital brain abnormalities, and also triggering Guillain-Barré syndrome (a neurological disorder that can lead to paralysis and death), was estimated to cost US$ 3.5 billion globally in 2016, due to direct costs, lost productivity, deaths and avoidance measures.2

Insects, particularly mosquitoes, can transmit devastating diseases …

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