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Stakeholder engagement is an essential part of responsible gene drive research and of Target Malaria’s work to develop genetic technologies to modify mosquitoes and reduce malaria transmission.

Introducing Delphine Thizy, Stakeholder Engagement Senior Advisor for Target Malaria. She provides strategic support for stakeholder engagement activities linked to the project’s research work on novel genetic approaches for malaria control.

Continue reading to learn why Delphine and the team created their latest Open Letter, published on Gates Open Research, and the future impact of this research.

The challenges

Since gene drive approaches, such as the one the project is working on, are new technologies in the field of vector control, many theoretical and practical components of engagement strategies remain subject to debate. Engagement professionals face the question of the appropriate agreement framework for communities directly impacted by the release of genetically modified mosquitoes to express their decision. Who should decide, how should they decide, on what information basis, how should this decision be recorded? These are some of the basic questions that require a specific response that addresses both the ethical and implementation challenges.

The World Health Organisation (WHO) Guidance framework for testing genetically modified mosquitoes clarifies that individual consent will apply only when the study involves the collection of clinical specimens or identifiable data. As such it is not the appropriate mechanism for the decision-making related to open release of genetically modified mosquitoes, including those incorporating gene drive. WHO calls instead for “community authorisation” to be sought prior to the release.

A cross-partnership workshop

While there is extensive guidance in other fields on the topic of community agreement, in public health there is currently no established consensus on how to implement this concept of community authorisation in gene drive research, or on how research teams should approach these issues in preparation for field evaluations.

To address this gap, Target Malaria, together with the Kenya Medical Research Institute (KEMRI) and the Pan African Mosquito Control Association (PAMCA), hosted a workshop and consultations over the summer of 2020 bringing together researchers, bioethicists and academics from Africa, Europe and North America.

The ambition was for researchers and practitioners to reflect on their experience and attempt to lay down potential best practices for seeking community agreement for gene drive research in Africa, as well as to identify areas of uncertainty where further investigation would be required.

You can read about the five main findings of this workshop in the Open Letter: https://gatesopenresearch.org/articles/5-19/v2. In addition, workshop participants identified the following areas for further consideration:

• How is ‘community’ defined?
• What if the geographical scope of a field trial encompasses a large enough number of people that they would be considered multiple communities?
• How will the right criteria and benchmarks be selected and by whom to ensure a monitoring evaluation process is useful?
• What parameters will ensure that a monitoring evaluation will be sufficiently independent?

What does the future look like?

This work helped to identify potential best practices and key considerations that Target Malaria can incorporate into its stakeholder engagement activities moving forward and represents a crucial step in the process of building a legitimate and appropriate model of community agreement for gene drive research. After the workshop, several participants volunteered to be consulted again in the future about the model or about its specific aspects which remain open for consideration.

For Target Malaria, KEMRI and PAMCA, this was a chance to start creating a community of practice with experts from the African continent and beyond, who could be further consulted on this issue in the future and who through time are building a shared understanding of the subjects at hand.

As Gates Open Research is read by a wide range of researchers in various disciplines from different countries, it is our hope that this article will provide valuable insight to other researchers in the field.