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 Speaking at the Malaria Forum conference in London, the billionaire
Microsoft co-founder and philanthropist said that while gene editing
raises "legitimate questions", that should not jeopardize
exploration of tools such as CRISPR gene editing and so-called "gene
drive" technologies.
"I'm very energized about the potential of gene drive. (It's) the
kind of breakthrough we need to support," Gates said.
"It may prove critical here."
Gene drive technologies alter DNA and drive self-sustaining genetic
changes through multiple generations by overriding normal biological
processes. CRISPR technology enables scientists to find and modify
or replace virtually any gene.
The techniques are being explored across science - from human
medicine to livestock- and crop-breeding. In mosquitoes that
transmit malaria, genetic alterations can be used to induce
infertility to reduce populations, or alter the insects' ability to
carry and pass on the malaria parasite.
The technologies can be extremely powerful, but they are also
controversial, since such genetically engineered organisms released
into the environment could have an unknown and irreversible impact
on the ecosystem.
Asked in a interview with Reuters about that controversy, Gates said
there were understandable concerns about safety and efficacy that
would need to be addressed in research and trials.
But he countered: "Malaria itself is quite controversial - it kills
about 400,000 kids a year. So we're definitely not on the side of
malaria."
He also noted that at their summit in January, leaders of the
African Union endorsed gene drive research as part of the fight
against a disease that continues to kill their people.
"They spoke out to say that, for them, getting rid of malaria is
worth using innovative science," Gates said.
MOMENTUM
The World Health Organization (WHO) warned late last year that
global progress against malaria had stalled and could be reversed if
momentum in the fight to wipe it out was lost.
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The disease infected around 216 million people in 91 countries in
2016, an increase of 5 million cases over the previous year. It
killed 445,000 people, about the same number as in 2015, with the
vast majority of deaths occurring in babies and young children in
sub-Saharan Africa.
Gates told the Forum that his almost 20 years of involvement in
global efforts to beat malaria had been both gratifying, in terms of
progress, and tough, in terms of suffering he witnessed.
He described seeing a child in a hospital in Tanzania convulsed with
seizures due to cerebral malaria.
"With the state of science and the wealth of the world, that really
should be an affront," he said. "We really shouldn't accept that
this disease can continue."
Gates said that ending malaria for good would take many years and a
range of tools both new and old - from bednets and mosquito traps to
a new vaccine and next generation gene tools.
He said he thought it unlikely that creating gene drives in
malaria-spreading mosquitoes would have a major impact on the wider
ecosystem because it would only target a few species and suppress
their populations for a period of time.
"None of these (gene technology) constructs will actually wipe out
the species," he said. "It will evolve back. After all, evolutionary
pressures always push back."
Dramatically reducing mosquito populations with such technologies
could, however, give a window of opportunity to help limit the human
reservoir of disease so that transmission of the disease among
people is stopped, he said.
Gates also said genetic information and data, gathered in the field
and transmitted swiftly to sophisticated surveillance systems, is
allowing scientists to identify evolving strains of malaria
parasites and track drug and pesticide resistance, helping them stay
one step ahead of the disease.
(Editing by Mike Collett-White)
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