Abdoulaye Diabaté and his team are betting on gene technology to protect children like his own from malaria. Along with a clutch of brand-new vaccines, the technology could help the world end malaria for good.
By: Bonface Orucho & Masbé Ndengar, Bird Story Agency
On a busy morning in the Nagrin district of Ouagadougou. Balkissa Wangrawa, a Burkinabe community-based health volunteer, keenly scouts through residential blocks for possible mosquito breeding areas.
He identifies a pool of stagnant shower water from an adjacent bathing area that allows water to flow into an open field. As he walks by, he gets a definite whiff of the unpleasant stench from stagnant wastewater and then he hears the buzzing of its a swarm of mosquitoes.
Wangrawa is one of some 15,000 healthcare workers and volunteers implementing Burkina Faso’s latest government-led seasonal malaria prevention campaign (CPS+).
The campaign involves the destruction of larval breeding sites in estates and residential areas and is supported by the free administration of more than 3 million doses of anti-malarial drugs to children aged from 3 months to 5 years of age.
However, this is only one of many campaigns and initiatives being advanced in the West African country in a bid to minimise malaria incidence.
According to Wenkouni Abdoul Aziz Ouédraogo, head doctor of the health district of Boulmiougou, the best way to get rid of malaria altogether is to get rid of the insect that spreads it – the mosquito.
“Future initiatives should focus on the total physical destruction of the mosquito and not just the larval destruction using chemicals,” he said.
It is this principle that world-renowned researcher Abdoulaye Diabaté is applying as he leads an innovative ‘gene drive’ research project that could wipe out the species of mosquitoes that carry the plasmodium family of malaria-causing parasites.
“Gene drive works by increasing the likelihood that a modified gene will be inherited by its offspring,” Diabaté explained.
“Normally, genes have a fifty-fifty chance of being inherited, but gene drive systems could increase that chance to upwards of 99 percent. For several generations, a selected trait will become increasingly common in a species,” he added.
Diabaté is also the Head of Medical Entomology and Parasitology at the Research Institute in Health Sciences, or, Institut de Recherche en Science de la Santé (IRSS)/Centre Muraz in Bobo-Dioulasso. There, the professor and his team of researchers are seeking to generationally reduce the chances of female mosquitoes being produced in subsequent mosquito generations, through this gene drive technique.
“Gene drive takes different forms… Some ongoing studies are focusing on suppressing the development of plasmodium parasites so that they are no longer transmittable,” he detailed.
Burkina Faso is among the countries most burdened with malaria globally, with the country’s Ministry of Health data showing it accounts for 43% of consultations with a health provider, over 60% of hospitalizations, and 30% of deaths.
“I suffered several episodes of malaria as a boy. Today, as a parent, I still witness these effects, especially in my children…When we talk about close to 100,000 deaths in Africa in 2021, it pains me because the majority are children,” Diabaté disclosed.
In his effort to reverse the impact of malaria, Diabaté works with the Target Malaria Organization, a not-for-profit research consortium that seeks to develop and share technologies to genetically modify mosquitoes and reduce malaria transmission.
Target Malaria has labs in Burkina Faso, as well as at the University of Ghana and the Uganda Virus Research Institute.
“Since we are all working in line with the gene drive technology, we partner on many areas and share information and research best practices,” Diabaté said.
While seemingly ambitious, the project has made substantial progress.
“The first phase involved releasing genetically modified mosquitoes in a small-scale field trial to understand their behaviour and mating capabilities…it was completed in July 2019,” he explained.
The second phase – the male bias construct – involving the modification of the genes of the male mosquitos, is ongoing.
“In normal circumstances, mating between male and female has a fifty-fifty chance of the offspring assuming either gender. But with modification, we aim to change the odds such that chances of the offspring being male are 95% while those of getting female offspring are only 5%,” he elaborates.
Since the malaria-causing plasmodium parasites are only spread by females, the research aims ot ensure that the number of females is reduced over several generations until they are nonexistent, wiping out the species in any given area where the altered gene-altered individuals are released.
Diabate anticipates completion of the second phase “soon”, before the project assumes the final phase, implementation at the community level.
“Up to now, no gene drive has been released anywhere in Africa…while we are still building this technology, we believe it will finally have an impact on reducing figures on malaria,” he explained.
Diabate has recently been named one of the 10 global winners of the prestigious Falling Walls Science & Innovation Prize, a testament to the significance of the project at the continental and global scale.
Being the only African winner in this category, the recognition highlights his exceptional contributions to science and underscores the critical role that African scientists and experts are playing in finding solutions to diseases like malaria.
While he describes this achievement as “a satisfying milestone” he looks forward to a time when this product is actually combating malaria.
However, even in developing the product, Diabate is building a community of researchers and medical experts who he believes will play a key role in advancing innovative technologies to solve problems and eliminate historical hard-to-abate diseases like malaria.
“As a continent, we have already made a lot of good progress in research … we have training initiatives in Burkina Faso and some are being advanced through regional organizations such as the Pan African Mosquito Control Association,” he said.
Diabate firmly believes that training and capacity-building initiatives have helped advance Africa as a research hub, especially for diseases that have hit Africa the most.
Efforts to curb malaria incidence have surged lately with the approval of the R21/Matrix-M vaccine, two years after the RTS,S malaria vaccine was approved.
Experts have hailed the latest R21 vaccine which was piloted in Kenya, Malawi and Ghana, as a game-changer because of its efficacy (reduces symptomatic malaria by 75%) and lower costs, which range from between US$2 to US$4 per dose.
Production and supply limitations have so far prevented African countries from fully benefitting from the RTS vaccine.
However, UNICEF in July revealed that the Vaccine Alliance, Gavi, alongside WHO and UNICEF, had allocated 18 million RTS,S vaccine doses to 12 African countries between 2023 and 2025, helping prevent close to 500,000 deaths.
Countries are now betting on the new vaccine, with WHO data showing that at least 28 countries in Africa plan to introduce the vaccine as part of their national immunization programmes.
Gavi has already approved providing technical and financial support to roll out the new vaccine to 18 countries beginning in 2024 when the first batch will be produced.
“Apart from the two vaccines that now stand recommended for use, when we look at the malaria vaccines on trial, we get even more encouraged because so much more is on the way,” Diabate explained.
However, he said, the world needs to keep researching and leveraging more innovative and diverse options to “effectively put an end to the malaria problem.”
At the heart of Diabate’s project is a robust community engagement program, an aspect that he believes is the most crucial to the success of the program.
“Everything we do as researchers and innovators is for the greater good of the community. There is every reason to incorporate them in all phases,” he said.
Diabaté’s team in Burkina Faso includes sociologists, anthropologists and engagement practitioners who have been engaging stakeholders from the village, district, regional and national level for over ten years, to build bridges between the science community and wider society.
According to Zerbo Madina, a community leader participating in the project, the project holds immense hope.
“When malaria affects your family, let’s say your child, it disrupts their health… if you are working and have savings you’ll spend it all on medication,” she explained.
She said she believes a more lasting solution needs to be found, which is why they are supporting the gene drive project.
“They have involved us in their meetings and we now understand what they’re trying to do … that’s why we come in to support where possible,” she explained.
Similar sentiments were shared in other communities by leaders like Komon Sanou, a village elder from Bana Village.
However, for Diabate, governments and stakeholders should, in the meantime, prioritize collaborative approaches that encompass multiple players.
“My vision is to eliminate malaria within my lifetime,” Diabate concluded.
bird story agency