Eradicating malaria: At the intersection of science progress, cognitive biology and society

CONTEXT

In the context of new technology to eliminate malaria, a Science News Explores article discusses the emphasis that scientists put on understanding human cognitive and social factors before even discussing new technology with the people having the highest stake. In my opinion, this is more evidence that, compared to a mere 20 years ago, scientists are much more aware of the human factor in both science progress, and sources of opposition to it.

The human factor includes both the scientists themselves and the people who will be affected by new technology. Key tactics of this enlightened science mindset include (1) doing a risk assessment of new technology that is as thorough as possible, and (2) understanding what people think they know about the areas that new technology will impact. The former tends to be a humbling exercise for the scientists. They are forced to admit that risk assessments are not certain. The latter identifies and then targets misinformation, myths and misconceptions among stakeholders in the public that miscreants now routinely use to attack new technology to serve their own corrupt interests and agendas.[1]

The new anti-malaria technology

Science News Explores writes:

Should we use a genetic weapon against mosquitoes carrying malaria?

The African public may get the final say on running one test of gene-editing tools

The weapon? A self-replicating bit of DNA known as a gene drive. It’s one of the most anticipated tools being developed to stop mosquitoes from spreading diseases like malaria to humans. It’s also one of the most controversial. 

The gene drive interferes with the insects’ ability to reproduce. [females cannot reproduce or bite people, and the species could go completely extinct] In one small lab study, it wiped out captive populations of mosquitoes in just eight to 12 generations. A larger study in outdoor cages in Terni, Italy, worked too. Within as little as five to 10 years, this gene drive could be ready to test in the wild.

Researchers are eyeing Africa for the first test release. There, malaria takes a huge toll. In 2020, it sickened close to 241 million people on the continent. And most of the globe’s 670,000 malaria deaths that year were in Africa. About eight in every 10 were children, the World Health Organization says.

Dealing with scientist bias, and public knowledge and misinformation

Scientist bias: Because gene drive technology in the wild could lead to the extinction of the target mosquito species, scientists did a detailed risk assessment. SNE writes:

As a first step, researchers tried to dream up potential drawbacks. That helped identify what they might need to plan for and test before releasing gene-drive mosquitoes into the wild. They could also weigh risks and benefits. They focused on four areas that African leaders said were most important to protect: biodiversity, human health, animal health and water quality.

Altogether, they came up with at least 46 possible harms that might come from releasing gene drives in mosquitoes. Might animals that eat mosquitoes struggle, for example, if the targeted mosquitoes disappeared? Might people develop allergic reactions to the bite of mosquitoes that had a single copy of the gene drive? Might large numbers of dying mosquito larvae worsen water quality? Might a gene drive even lead to more cases of malaria? For instance, could thinning out less-troublesome mosquitoes allow better disease-spreaders to take over? Malaria Journal published the full list of concerns in March 2021.

Keith Hayes leads a risk-assessment group at the Commonwealth Science and Industrial Research Organization’s Data61. It’s in Hobart, Australia. Experiments and simulations are useful to a point, he says. But, he adds, “We can’t know everything. There may be surprises.” So some questions won’t be answered unless and until gene drives get released.

In the end, any decision about a release will need to weigh risks against benefits. The potential benefits for human health and their costs may far outweigh the risks, Ruth Müller* argues. “If you have a high burden of malaria, that costs a lot,” she notes. “Children cannot go to school. People cannot go to work.” 

* Chief ecologist and entomologist at the Institute of Tropical Medicine in Antwerp, Belgium

Public knowledge and misinformation:
SNE writes:

Beyond the science concerns, researchers must also get public support for releasing the technology. Without that, even a gene drive that works perfectly could be a no-go.

Not everyone agrees on when and how to get input. Fredros Okumu* thinks it’s important to have more answers about the science first. “I would rather we know the true benefits, the true risks and gain a consensus around it,” he says. Then, he thinks, scientists could “start engaging the communities.”

* A mosquito biologist and director of science programs at Ifakara Health Institute in Tanzania

Not everyone agrees on when and how to get input. Okumu thinks it’s important to have more answers about the science first. “I would rather we know the true benefits, the true risks and gain a consensus around it,” he says. Then, he thinks, scientists could “start engaging the communities.”

Lea Pare Toe disagrees with that approach. She’s a social scientist at the Institut de Recherche en Sciences de la Santé in Bobo-Dioulasso. That’s in the West African nation of Burkina Faso. “We should listen to [the community],” she says, and then “develop the science together.”

Toe works with Target Malaria to engage local people in the research. At Bana, in her country, researchers didn’t start out talking about genes at all, she says. First, the team had to clarify the link between mosquitoes and malaria. They also had to dispel myths, such as that eating fatty foods or sweet fruit can cause the disease. The researchers led an intensive campaign from 2014 through 2019. Afterward, they found that such false statements were far less accepted. The researchers reported this in Malaria Journal in October 2021.

It is an open question as to whether such an approach to developing new technology, assessing it and dealing with public opinion like this is even possible in the US or in large areas of Africa. America is awash in misinformation, propaganda and distrust, e.g., distrust of science and scientists. It took five years of intense effort to reduce public misunderstanding in a single targeted area of Africa. In America, decades of warnings about climate change have not resulted in many meaningful government efforts to deal with the problem. Despite majority public concern about climate, America is paralyzed by corrupt politics, corporate propaganda, climate science denial and social gridlock. 

What SNE describes about malaria in Africa may be an ideal that is exceptional. Or, maybe this research has not yet triggered hoards of African miscreants into a frenzy of dark free speech akin to what has poisoned and paralyzed American politics and policy.

Footnote: 

1. My definition of corrupt here includes intentional use of dark free speech to deceive, divide, distract, misinform, polarize, and/or irrationally emotionally manipulate individuals and groups. Here, I define miscreants to be liars, demagogues, tyrants, cranks, crackpots, blind ideologues, grifters and the like. They almost always spew their poison to gain wealth and/or power-influence, which tend to run together.