Articulating ethical principles guiding Target Malaria's engagement strategy

Abstract

Progress in gene drive research has engendered a lively discussion about community engagement and the ethical standards the work hinges on. While there is broad agreement regarding ethical principles and established best practices for conducting clinical public health research, projects developing area-wide vector control technologies and initiating ambitious engagement strategies raise specific questions: who to engage, when to engage, and how? When responding to these fundamental questions, with few best practices available for guidance, projects need to reflect on and articulate the ethical principles that motivate and justify their approach. Target Malaria is a not-for-profit research consortium that aims to develop and share malaria control and elimination technology. The consortium is currently investigating the potential of a genetic technique called gene drive to control populations of malaria vectoring mosquito species Anopheles gambiae. Due to the potentially broad geographical, environmental impact of gene drive technology, Target Malaria has committed to a robust form of tailored engagement with the local communities in Burkina Faso, Mali, and Uganda, where research activities are currently taking place. This paper presents the principles guiding Target Malaria’s engagement strategy. Herein the authors (i) articulate the principles; (ii) explain the rationale for selecting them; (iii) share early lessons about the application of the principles. Since gene drive technology is an emerging technology, with few best practices available for guidance, the authors hope by sharing these lessons, to add to the growing literature regarding engagement strategies and practices for area-wide vector control, and more specifically, for gene drive research.

Operationalizing stakeholder engagement for gene drive research in malaria elimination in Africa—translating guidance into practice

“…The project has built its stakeholder engagement approach by adapting to the context and values of stakeholders. This approach is deeply rooted in the principles of co-development as well as engaging early and continuously[ 32 ]. In the absence of set rules, or established best practices, the engagement strategy was built on stakeholders' preferences and continuously adapted to their feedback and the changing context.…”

“…It does not result from a research study as such, nor does it describe the results of a specific protocol. Rather, it intends to provide a review of how Target Malaria elaborated and adapted its engagement approach, guided by its ethical principles [ 32 ] guiding [ 32 ] its response to[ 32 ] new guidelines and recommendations and the specific local context in which the project operates.…”

“…This positioning is deeply rooted in the ethical principles (Fig. 1 ) of the project's engagement strategy [ 32 ].

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Gene drive technologies: navigating the ethical landscape

“…Moreover, Monsanto has purchased a license to CRISPR patents from the Broad Institute of the Massachusetts Institute for Technology (MIT) and Harvard that came with the proviso that Monsanto could not develop a gene drive (71). Since the spread of gene drive organisms will not be limited by the borders of particular communities or nation-states (8,72), GDTs moreover invoke questions about how the interests of different communities, stakeholders, and publics should be balanced, who should be involved in related governance and decision-making, and in what way (8,(73)(74)(75)(76).…”

“…Increase genetic gain in breeding programs (10) Increase economic productivity in animal farming Change reproductive behavior of wild animals that give birth to large numbers of offspring, many of whom do not survive to adulthood, by decreasing the number of offspring they produce per cycle (26) Prevent wild animal suffering Veterinary medicine or animal sciences (10,11,19,21,34,57,59,(68)(69)(70)72,74,75,80,82,90,92,97,101,103,108,113,114,116,124,125,(128)(129)(130)133) Ethics (6,20,22,23,(28)(29)(30)(31)43,48,51,52,78,81,91,93,107,111,135,141) Philosophy (9,26,40,…”