Developing innovative genetic technologies for malaria control in Uganda 

Malaria is a significant global public health challenge in Africa with the region carrying the burden over 90% of malaria cases and deaths. In the World Malaria Report 2023, Uganda is part of a group of five countries, including Ethiopia, Nigeria, Pakistan and Papua New Guinea, as collectively responsible for an increase in global malaria cases and deaths in 2022. Despite all the efforts to control the disease, WHO reported that there were an estimated of 12,7 million malaria cases and over 17,556 estimated deaths in Uganda. It also significantly strains our healthcare systems, as evidenced by the high rates of outpatient visits, hospital admissions, and deaths. 

This devastating impact of malaria in my country necessitates the need to design and deploy novel tools to supplement existing ones, whose effectiveness is being compromised by the emergence and spread of insecticide and drug resistance, changes in mosquito behaviour, and climate change.  

Target Malaria is working to develop genetically modified mosquitoes to complement existing vector control tools. Our objective is to develop gene drive mosquitoes to reduce the population of malaria mosquitoes and stop the transmission of the disease.  

The Uganda Virus Research Institute (UVRI), a department in the Ministry of Health, and constituent member institution of the Uganda National Health Research Organisation (UNHRO) is Target Malaria’s collaborating partner In Uganda. Since 2012, Target Malaria Uganda has been involved in characterizing mosquito populations in selected villages within Mukono and Kalangala districts to explore mosquito populations: species diversity, medical importance, seasonal population dynamics among others. Sustained stakeholder engagement has been taking place in these regions to consult local communities and to explain the purpose of the collections, the studies and the objectives of the project.  

This year in May, the UVRI team imported a strain of non gene drive genetically modified mosquitoes, called “male bias” strain. This is the same strain that was imported in 2022 in Burkina Faso. The male bias mosquitoes were imported from our partner institution, the Centers for Disease Control and Prevention (CDC) in the United States of America.  

Approval for this importation and contained use studies was obtained from the competent national regulatory authorities in Uganda, specifically the Uganda National Council for Science and Technology-UNCST (supported by technical review of the National Biosafety Committee-NBC) and the National Environment Management Authority-NEMA. Agreement was also obtained from the local communities around the UVRI campus. 

The studies on the male bias mosquitoes have been taking place these past months in UVRI’s Arthropod Containment Level 2 (ACL-2) insectary, the first of its kind in Uganda, inaugurated in 2019. The insectary was built and operates strictly following recognized international guidelines. It also meets national guidelines for biosafety.  

The insectary team is currently carrying out experiments on both local wild-type and genetically modified mosquitoes. UVRI researchers will conduct several studies on the male bias mosquitoes and will report the results to the regulatory authorities and stakeholders. The objectives of the studies are to confirm that the modification is working as intended, namely that it produces more male than female offspring; and collect information on the development and behaviour of the male bias mosquitoes. 

The male bias strain does not carry the gene drive technology. It is genetically modified to produce mainly male offspring (up to 95% under laboratory conditions). The male bias strain is not a vector control tool. The purpose of this phase is to understand this new fertile strain (compared to the sterile strain imported, studied and released in Burkina Faso), develop capacity, train Target Malaria teams at UVRI and engage with regulatory authorities and stakeholders in Uganda. 

Our current containment studies are part of our step-by-step development pathway taking us one step closer to finding long-lasting solutions to fighting malaria in Africa. Our objective in the near future is to develop gene drive mosquitoes that could be used as a vector control tool to supplement existing interventions.