How To End Malaria Once and for All | Abdoulaye Diabaté | TED - Legendas Bilíngues
I don't know about you, but I don't have a good relationship with you.
them.
A friend of mine said one day,
if you think that you are too small to make a big difference, you've never spent a night with mosquitoes in a room.
But, I don't have any mosquitoes in my pocket to release tonight.
So it's going to be fine.
So let's start.
As unbelievable as it may sound, malaria as old as humankind.
And once was the public health issues all over the world.
But then it has been successful to tackle in the US.
and Europe.
And yet, decades later, malaria still kills millions of people in Africa and in Asia.
Why?
I'm Abuela Jabhati,
a medical entomologist from the Institute of Research and Science,
I'm here today flying all the way from Burkina Faso to tell you that we might be closer than ever to eliminate Malera in Africa.
Thank you.
Malera is tightly linked to poverty.
But then, you have no idea of how much expensive is it to be poor.
There are 200 million cases worldwide that hand up suddenly every year with about 600,000 deaths.
And this is not a random collection of statistics on a piece of paper.
Behind each of these 600,000 deaths, There is a personal, tragic story, sometime behind closed doors.
Most of these deaths happen in Africa.
Children and pregnant women bear the highest burden.
And I'm a fortunate childhood malaria survivor.
When I was a kid, I used to think that my dad was a superhero.
I could see him leaving the house every morning at six.
Riding his bicycle to the farm, working very hard all day long.
We did not have much for leaving.
But who said you need more to be happy?
But when happiness hangs by a thread, it doesn't take much to turn your life around.
My certainty and my doubt got deeply shaken the day I got struck down by malaria.
I was three or four years old.
As we used to say in my country,
kids may not understand the complexity of suffering but pay as no age and gosh
I I can still clearly see myself laying down there on the bed with high fever and suffering.
I could not eat anything, throwing up all the time, will survive, will not.
The psychological trauma my parents were going through was unbearable.
I survived, but can we say today that we are done with malaria because Jabato survived and made it all the way down to Vancouver?
If I say yes, no one can blame me, but it's a lie because many children are still dying of malaria.
The real question then is, Why have we not been able to defeat it so far?
Well, because malaria is a complex parasytic disease that plays on three grounds, plus modium departusion, anophilus, and the vector, and human, the victims.
Each of these elements is very complex.
And the interaction makes it even more complex to devise interventions that are really effective.
But course, we are trying.
Currently, there are two vaccines to humanize people.
But the heavy logistics to deliver this vaccine may not allow us to reach the full potential.
Badness.
And the first-hand treatment.
are both threatened by insecticide and drug resistance, meaning that our best interventions have started to fail.
And there is a general consensus today that without additional neutrals,
we never cross the last mile of malaria elimination,
and this is exactly where My colleagues and I,
a target malaria are working on something called gene drive, a way to control mosquito population and alkylara transmission.
So what is gene drive?
It's a natural molecular mechanism that augment the frequency of a certain gene in the population beyond the Mendelian inheritance.
So what that means?
If you take energy,
in natural circumstances it has only 50%
of chance of being transmitted to the next generation,
meaning that if the parents have hundred babies, like in mosquitoes, only 50 of them will get the gene and the other 50 will not.
But not all genes behave this way in nature.
Some gene have found a very clever way to bypass this law and can augment their own prospect to up to 90%,
such gene are set to drive.
And so the name gene drive.
How we must promising strain affect female fertility by targeting a gene called double sex.
This gene is responsible for the sex determination in mosquitoes.
And so, disrupting the double set gene may affect the sexual development for adult mosquitoes and their reproduction.
Now, it may sound counter-intuitive to affect female fertility and spread a gene of interest in multiple populations at the same time.
Let me show you how.
We a specific region of the gene called double sex that affects only females.
Male bearing, these modified genes are not affected at all.
Female with just one copy of the Ultra gene are fully fertile.
However, Female bearing two copies of the modified gene cannot lay eggs, fail to bite and also have
the physical characteristic of both male and female.
It's called a suppression strategy.
Once these mosquitoes are released...
They're going to spread the gene of interest, the wild population, and this is going to reduce dramatically their reproductive capacity.
Fewer mosquitoes mean less malaria transmission until it's stopped.
Mathematical modern predict that releasing such mosquitoes in the field is going to stop malaria transmission in just 20 generations.
That's mean in two years, and the technology is sustainable, cost-effective, and easy to deploy.
As the release mosquitoes will do the job themselves by finding the last hiding pocket of a wide mosquito to convert, fantastic.
The only problem, gene drive has never been tested anywhere in Africa.
And while the technology brings a lot of hope, it carries its share of fear and skepticism.
The pathway from the bench to the field is not straightforward, and is full of pitfalls.
Maybe the mosquitoes in the field will develop resistance to the spread of the transgene or maybe two countries don't agree.
But the police mosquitoes do not respect the human borders.
Also, maybe there are risks to the environment.
And the community that we are working with, need to feel comfortable about this technology and give us the green light, you know, to operate.
And so for such,
Target Malera has adopted an incremental approach,
step by step whereby meaning that the gene of interest here cannot self propagate and will just go extend in a few generations.
The gene drive,
the exposure of this gene to the environment is incrementally augmented
in a way that we start first with small cages and big indoor cages in Europe,
And then these mosquitoes are sent to Burkina Faso,
where they are tested in a contained facility first and subsequently in a big in the small case field release.
Now, the general mosquitoes are going to be tested in an open field, only after this is a preliminary step and the potential risks.
risk been looked at very carefully and also additional research questions have been developed, you know, to address this risk if any.
Now, the question, how far are we from releasing Gindrai for two, five years?
But let me tell you this,
Gindrai muscros are already And releasing them in the field is not going to take us more than 30 minutes.
But we need five years to get ready for this 30 minutes.
And is that?
The answer is simple.
Because we need to engage the community and get the social license to operate.
If there is one thing that you cannot afford a to miss is the stakeholder engagement.
I cannot just pop up in a village with a bucket of mosquitoes on the assumption that I'm a scientist working for the public good.
It will not take anyone a PhD to understand if we are respectful or their value or not.
Now, we need to engage the community.
and then could develop the technology with them.
And so for that,
we've built our engagement strategy on the pyramidal structure,
starting with the villages where we operate all the way to the top with the government official.
The engagement is done step-by-step, is done in an inclusive way, and also is done in full transparency.
There is one more thing that needs to be done before gene drive can be released in the field in Africa, that is capacity building.
Gene drive holds a lot of promises, but it will not take us anywhere if we, African, are unable to run it on our own.
Sadly, The technical platform in Africa is really very poor.
And this has to be solved before we can really beat malaria.
And so for that, we've set up in Burkina Faso, a-being funded center of excellence on vector-borne disease, like malaria.
And also with additional fun from the Gate Foundation,
we are building a critical mass of next generation scientists
all over the continent to fill the knowledge gap and the know-how gap as well.
In April 1969, a child was born in a remote village of Burkina Faso.
Like any other child of the world, it has dreams.
and expectation.
Sadly, however, as you come to learn,
the place where you are born on this
planet very often affects your perspective on life and may even set the path you need to walk through into your future.
That shouldn't be the case.
We are all citizens of the world, our dreams and aspirations should not be constrained by the place where we are born.
And is the reason why I became a scientist,
to offer endless possibility to NHL anywhere on this continent so that they can see the future with hope.
But there is If you are cut short with malaria, but target malaria here to fix that.
The world free of malaria is our vision.
And I will say, yes, we can.
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