Perspectives of African Stakeholders on Gene Drives for Malaria Control and Elimination: A Multi-Country Survey

Abstract

Abstract Background Gene drive modified mosquitoes (GDMMs) have the potential to address Africa's persistent malaria problem but are still in early stages of development and testing. Continuous engagement of African stakeholders is crucial for successful research and implementation of these technologies. The aim of this multi-country study was therefore to explore the insights and recommendations of key stakeholders across Africa on the potential of GDMMs for malaria control and elimination in the continent. Methods A concurrent mixed-methods study design was used; involving a structured survey administered to 180 stakeholders in 25 countries in sub-Saharan Africa, followed by 18 in-depth discussions with selected groups and individuals. Stakeholders were drawn from academia, research and regulatory institutions, government ministries of health and environment, media and advocacy groups. Thematic content analysis was used to identify key topics from the in-depth discussions, and descriptive analysis was done to summarize information from the survey data. Results Despite high levels of awareness of GDMMs among the stakeholders (76.7%), there was a relatively low-level of understanding of their potential applications for malaria control (28.3%). The majority of respondents (92.9%) also expressed support for field trials or implementation of GDMMs in their respective countries. When more information about GDMMs was provided to the stakeholders, they readily discussed their insights and concerns, and offered several recommendations to ensure successful research and implementation of the technology. These included: i) increasing relevant technical expertise within Africa, ii) generating local evidence on safety, applicability, and effectiveness of GDMMs, and iii) developing country-specific regulations for safe and effective governance of GDMMs. This study also identified significant misconceptions regarding the phase of GDMM testing in Africa, as numerous participants incorrectly asserted that gene drive mosquitoes were already present in Africa, either within laboratories or released into the field. Conclusion Incorporating views and recommendations of African stakeholders in the ongoing research and development of GDMMs is crucial for instilling stakeholder confidence on their potential application. These findings will enable improved planning for GDMMs in Africa as well as improved target product profiles for the technologies to maximize their potential for solving Africa’s enduring malaria challenge.