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“We are motivated to work toward a cure that can be accessible and affordable to patients worldwide,” Sickle Cell is prevalent in some populations because the

“We are motivated to work toward a cure that can be accessible and affordable to patients worldwide,” Sickle Cell is prevalent in some populations because the gene mutation is protective against malaria. (Probably only beneficial if you have one copy, not two.) I hope they will keep this in mind and work to eradicate malaria hand-in-hand with trying to eradicate the genes that are protective against it when they look to take it global.

XorNot 6y ago
We're a hair's breadth away from using genetic engineering to make the mosquito extinct. We have the technology (gene drive) but scientists just aren't sure if we should do it.
- DoreenMichele 6y ago
  They are right to have concerns. There was an island where they used poison to kill all the mosquitoes because it was a big problem. All the mosquitoes dies and then all the things that ate the mosquitoes died. And then all the things that ate things that ate mosquitoes died. And it went through a few more layers of this, like some modern day version of the Biblical plagues. That doesn't mean we shouldn't do it. It just means it is correct to not take the decision lightly. (Unfortunately, I've never found a good write up of this true story on the internet. I read it long ago back when dinosaurs roamed the earth and I had a bright yellow rotary phone and got information printed on dead trees.)
  - est31 6y ago
    You don't have to extinguish all mosquito species. It's enough to only target those which can carry diseases. Ideally one would engineer mosquitos to avoid humans because of their smell.
    - bamboozled 6y ago
      Maybe we could also considering modifying ourselves to be less susceptible to mosquitos. Including helping people who live in poverty to have better housing and medicine so their less susceptible to Malaria ?
      - jackson1442 6y ago
        Modifying ourselves leads into the messy territory of bodily autonomy and consent. You can see this pretty well in the anti-COVID-vaccine crew. I feel like it'd be much more popular to modify mosquitos than apply some modification to humans. Not to mention the ethical (regarding equity) concerns: disease from mosquitoes affects poverty-stricken areas the most, yet the people with the most access to these bodily modifications or procedures are going to be from wealthy countries.
        jcims 6y ago
        Mosquitoes are a rather distinct element in the natural world and it just seems unlikely that we are capable of understanding the full set of downstream effects of eradicating them entirely.
        bamboozled 6y ago
        I actually was talking about our behavior, not our actual genetics or biology. My understanding is that a lot of the diseases we want to kill mosquitoes for are also more likely to affect people in developing countries.
        andreareina 6y ago
        There are few developed countries in the tropics. Singapore is one, and dengue is a concern here. I understand that the way it's mostly kept under control is through a lot of spraying, which isn't exactly great.
      - incompatible 6y ago
        Perhaps it would be possible to modify mosquitoes so that they don't need blood to reproduce. Other insects manage it somehow.
    - grapecookie 6y ago
      obviously this mutation would not last.
    - Turing_Machine 6y ago
      Right. There are thousands of species of mosquito, most of which don't carry human diseases. Of the ones that do, many of are of African origin -- they evolved there along with us (and the diseases they carry). They are thus essentially invasive species in the rest of the world. The nice thing about potentially using CRISPR-based gene drives to extirpate (e.g.) Aedes aegypti is that it would affect only that species, unlike our current pesticides which tend to kill insects of many different species indiscriminately.
  - bamboozled 6y ago
    Common sense must tell people that whether we like mosquitos or not, they're part of the food chain. A food chain which is already stressed due to climate change. Scientist who are eager to take out mosquitos sound more like kids who are eager to play with their new gene drive rather than consider the actual impacts.
    - tylermw 6y ago
      No, scientists who are eager to take out mosquitos want to do it because it will save millions of lives. People have been dying of malaria for millennia—climate change has nothing to do with this particular issue/solution.
      - bamboozled 6y ago
        We're all very concerned, but we don't really spend very much money on Malaria treatments, relief and vaccines overall. Especially in the developing world. There isn't even really much urgency to do anything about it. No operation warp speed to help save hundreds of thousands of lives a year. It's almost just like a fun topic to make people feel better about themselves. I've read more about how transmission of malaria works and basically mosquitoes carry it from biting infected humans then pass it to other humans, it's not that mosquitos are evil, they don't even know what's going on. I think there is a question of ethics involved personally, that's because if mosquitoes had the power to wipe us out, we wouldn't be that happy if they decided to go ahead with the plan.
    - mNovak 6y ago
      While I agree it's likely, 'common sense' is also not science and we shouldn't take as a given that they are an integral part of the food chain. Pest species do exist. Saving lives is generally a strong motivator, so it's worth considering the possibilities.
  - Salgat 6y ago
    Do you have a source for this? I linked below the best I could find, which makes no mention of any issues with them wiping it out. https://www.cnn.com/2019/07/18/health/asian-tiger-mosquitoes-guangzhou-intl-hnk https://www.cnn.com/2019/07/18/health/asian-tiger-mosquitoes...
    - DoreenMichele 6y ago
      Possibly Sardinia: The eradication of malaria helped Sardinia improve its public health programs and also paved the way for socio-economic development. But at a huge environmental cost that is incalculable. Some farmers accused the DTT of killing their livestock, bees and also fish. https://totalsardinia.com/malaria/ https://totalsardinia.com/malaria/ Sheepherders, fish farmers, and beekeepers blamed their dead sheep, dead fish, and dead bees on DDT spraying. https://www.wanderingitaly.com/blog/article/785/sardinia-and-the-history-of-malaria https://www.wanderingitaly.com/blog/article/785/sardinia-and... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2819864/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2819864/ Edit: Odds are good I read about it originally in Reader's Digest in the late 1970s or early 1980s if you want to find a dead tree copy at a library.
  - yardie 6y ago
    Except there are multiple species of mosquito. Only 1 of them is a primary carrier for malaria. And if it disappears another mosquito in the family will replace it.
  - Jedd 6y ago
    This seems alarmist. The citation you provided elsewhere (for Sardinia) was for some DDT spraying - which was obviously not targeted exclusively at mosquitoes, and explains why lots of other things died. Targeting the very small set of mosquito species (that carry malaria) with something that will wipe them out within a few generations (under 12 months) seems tremendously safe, because a) it's a small subset of the total mosquito population, b) you can test this in isolated (eg. island) environments, and c) by the very nature of this, rollback is easy -- once the species has died out locally, if needed you can quickly & safely re-populate with non-modified specimens.
    - DoreenMichele 6y ago
      It's not alarmist. Not by any stretch of the imagination. I'm an environmental studies major and I have a genetic disorder. I'm getting healthier when that is supposed to be impossible and it's in part because I'm an environmental studies major and I think of the body as a complex ecosystem. You kill one thing or change one thing and there are always myriad knock on effects. Always. Anytime you do anything that's actually at all effective, there is hell to pay. I am getting better by trading short term costs for long term gains, the exact opposite of what Western medicine typically does. We monetize disease by trading short term gains -- that doctors can claim credit for, justifying their fees -- for long term costs which we politely admit to with multi-page warning materials included with all drugs and then normalize largely ignoring that stuff and taking it anyway. Then when your condition gets worse, they blame it on your genes instead of on the side effects of the harsh drugs they have been poisoning your system with for years and years. It's possible to make targeted changes to an ecosystem, but it's not easy and even if you get it right, there are costs involved. Managing such change is hard and there tends to be hidden costs that the experts want to disavow responsibility for and they can generally get away with it because cause and effect can be hard or impossible to prove. I hope they cure Sickle Cell. I hope they eradicate malaria. Parasitic infections are pretty awful. I hope they do it in a way that doesn't involve millions of Africans being thrown under a bus so Westerners can feel like heroes while hand waving off the human costs for the locals which Westerners have a long history of running rough shod over on the excuse that we imagine we are superior to them or something.
- Dig1t 6y ago
  I think about this a lot. What's to stop some random, non-scientist, group of people from just doing this? Mosquitos are pretty evil..
  - maxerickson 6y ago
    If you make a gene drive you are a scientist. Hopefully whoever decides to just go do it has the sense to only target mosquitoes that preferentially feed on humans. Much less ecosystem impact that way.
    - danielheath 6y ago
      > If you make a gene drive you are a scientist. These days, introducing a known mutation via a CRISPR gene drive is engineering. The hard part is scaling it so your mutation doesn't die out, testing to ensure that it is actually propagating, etc. > Hopefully whoever decides to just go do it has the sense to only target mosquitoes that preferentially feed on humans. You have to repeat a considerable amount work for every single target species. I highly doubt they'd target more than one.
      - maxerickson 6y ago
        There's several species that preferentially feed on humans and we've done a banger spreading them around.
- grishka 6y ago
  The frogs gotta eat something.
  - XorNot 6y ago
    The general consensus at the moment is that there's no apparent food chain where mosquitos are the primary source.
    - AlotOfReading 6y ago
      Except for places like the arctic, where they're basically primary pollinators and a food of choice for most predatory insects.
      - learc83 6y ago
        Do all the species of mosquitoes your talking about feed on humans, and do they carry malaria?
        AlotOfReading 6y ago
        Yes and yes?
        Turing_Machine 6y ago
        No, they don't. The (many) species of mosquito found in the Arctic do not carry malaria. Malaria is largely a tropical and subtropical disease.
        AlotOfReading 6y ago
        Avian malaria is endemic to Alaska, and both Finland, and Siberia formerly had endemic human malaria, especially the more southern regions. Something up there is definitely capable of being a vector for it.
- BurningFrog 6y ago
  What's talked about is only making the 30-40 of the 3500 mosquito species that carry malaria extinct. Ecologically, they can normally be replaced by some of the 3460 others.
toomuchtodo 6y ago
There is a candidate mRNA malaria vaccine in the pipeline. https://blogs.sciencemag.org/pipeline/archives/2021/03/01/a-malaria-vaccine-candidate https://blogs.sciencemag.org/pipeline/archives/2021/03/01/a-...
maxerickson 6y ago
It's fine if they just figure out how to cure sickle cell anemia. Great even. No one will force people in areas where malaria is endemic to have sickle cell anemia treated, and a treatment for sickle cell anemia won't slow down treatment/eradication of malaria.
- DoreenMichele 6y ago
  I'm sure no one actually forced mothers in developing countries to buy Nestle baby formula either. Babies died anyway. There are lots of sources out there. Here are just a couple. https://en.wikibooks.org/wiki/Professionalism/The_Nestl%C3%A9_Infant_Formula_Scandal https://en.wikibooks.org/wiki/Professionalism/The_Nestl%C3%A... https://www.ranker.com/list/nestle-baby-formula-boycott/melissa-sartore https://www.ranker.com/list/nestle-baby-formula-boycott/meli...
  - maxerickson 6y ago
    It's certainly not impossible that governments of African countries would spend thousands of dollars per person to prematurely cure sickle cell anemia, but I think we can say that it's unlikely.
    - DoreenMichele 6y ago
      The actions of African governments is not what concerns me here.
      - maxerickson 6y ago
        What other actors are going to give people unwanted bone marrow transplants? I guess medical companies testing the technology might do things to get people to participate in trials, but I'm not real sure people with sickle cell anemia would be mad about having to use modern anti-malarials instead of suffering with sickle cell.
    - f6v 6y ago
      > thousands of dollars per person to prematurely cure sickle cell anemia This cure is going to cost much much more. So highly unlikely.
IIAOPSW 6y ago
"I would die for 2 brothers or 8 cousins". -JBS Haldane https://en.wikipedia.org/wiki/Kin_selection https://en.wikipedia.org/wiki/Kin_selection
azernik 6y ago
This particular treatment does not affect the germ line. i.e. it corrects the defect in the patient, but they can still pass it on to their children, who would be (malaria-protected) carriers.
f6v 6y ago
That’s right, but the sad truth is that those who will afford gene editing and those who are at daily risk of malaria are two very different groups of people.
yarcob 6y ago
> Probably only beneficial if you have one copy, not two. One copy of the gene partially protects you from malaria; two copies of the gene make you very sick. That's why even in Africa only a small portion of the population has the gene. The gene is an evolutionary advantage as long as the prevalence in the population is low. As soon as the frequency of the gene in the population goes up, it becomes a disadvantage because if both you and your partner have the gene your kid has a 25% chance of getting two copies.

XorNot 6y ago

We're a hair's breadth away from using genetic engineering to make the mosquito extinct. We have the technology (gene drive) but scientists just aren't sure if we should do it.

DoreenMichele 6y ago
They are right to have concerns. There was an island where they used poison to kill all the mosquitoes because it was a big problem. All the mosquitoes dies and then all the things that ate the mosquitoes died. And then all the things that ate things that ate mosquitoes died. And it went through a few more layers of this, like some modern day version of the Biblical plagues. That doesn't mean we shouldn't do it. It just means it is correct to not take the decision lightly. (Unfortunately, I've never found a good write up of this true story on the internet. I read it long ago back when dinosaurs roamed the earth and I had a bright yellow rotary phone and got information printed on dead trees.)
- est31 6y ago
  You don't have to extinguish all mosquito species. It's enough to only target those which can carry diseases. Ideally one would engineer mosquitos to avoid humans because of their smell.
  - bamboozled 6y ago
    Maybe we could also considering modifying ourselves to be less susceptible to mosquitos. Including helping people who live in poverty to have better housing and medicine so their less susceptible to Malaria ?
    - jackson1442 6y ago
      Modifying ourselves leads into the messy territory of bodily autonomy and consent. You can see this pretty well in the anti-COVID-vaccine crew. I feel like it'd be much more popular to modify mosquitos than apply some modification to humans. Not to mention the ethical (regarding equity) concerns: disease from mosquitoes affects poverty-stricken areas the most, yet the people with the most access to these bodily modifications or procedures are going to be from wealthy countries.
      - jcims 6y ago
        Mosquitoes are a rather distinct element in the natural world and it just seems unlikely that we are capable of understanding the full set of downstream effects of eradicating them entirely.
      - bamboozled 6y ago
        I actually was talking about our behavior, not our actual genetics or biology. My understanding is that a lot of the diseases we want to kill mosquitoes for are also more likely to affect people in developing countries.
        andreareina 6y ago
        There are few developed countries in the tropics. Singapore is one, and dengue is a concern here. I understand that the way it's mostly kept under control is through a lot of spraying, which isn't exactly great.
    - incompatible 6y ago
      Perhaps it would be possible to modify mosquitoes so that they don't need blood to reproduce. Other insects manage it somehow.
  - grapecookie 6y ago
    obviously this mutation would not last.
  - Turing_Machine 6y ago
    Right. There are thousands of species of mosquito, most of which don't carry human diseases. Of the ones that do, many of are of African origin -- they evolved there along with us (and the diseases they carry). They are thus essentially invasive species in the rest of the world. The nice thing about potentially using CRISPR-based gene drives to extirpate (e.g.) Aedes aegypti is that it would affect only that species, unlike our current pesticides which tend to kill insects of many different species indiscriminately.
- bamboozled 6y ago
  Common sense must tell people that whether we like mosquitos or not, they're part of the food chain. A food chain which is already stressed due to climate change. Scientist who are eager to take out mosquitos sound more like kids who are eager to play with their new gene drive rather than consider the actual impacts.
  - tylermw 6y ago
    No, scientists who are eager to take out mosquitos want to do it because it will save millions of lives. People have been dying of malaria for millennia—climate change has nothing to do with this particular issue/solution.
    - bamboozled 6y ago
      We're all very concerned, but we don't really spend very much money on Malaria treatments, relief and vaccines overall. Especially in the developing world. There isn't even really much urgency to do anything about it. No operation warp speed to help save hundreds of thousands of lives a year. It's almost just like a fun topic to make people feel better about themselves. I've read more about how transmission of malaria works and basically mosquitoes carry it from biting infected humans then pass it to other humans, it's not that mosquitos are evil, they don't even know what's going on. I think there is a question of ethics involved personally, that's because if mosquitoes had the power to wipe us out, we wouldn't be that happy if they decided to go ahead with the plan.
  - mNovak 6y ago
    While I agree it's likely, 'common sense' is also not science and we shouldn't take as a given that they are an integral part of the food chain. Pest species do exist. Saving lives is generally a strong motivator, so it's worth considering the possibilities.
- Salgat 6y ago
  Do you have a source for this? I linked below the best I could find, which makes no mention of any issues with them wiping it out. https://www.cnn.com/2019/07/18/health/asian-tiger-mosquitoes-guangzhou-intl-hnk https://www.cnn.com/2019/07/18/health/asian-tiger-mosquitoes...
  - DoreenMichele 6y ago
    Possibly Sardinia: The eradication of malaria helped Sardinia improve its public health programs and also paved the way for socio-economic development. But at a huge environmental cost that is incalculable. Some farmers accused the DTT of killing their livestock, bees and also fish. https://totalsardinia.com/malaria/ https://totalsardinia.com/malaria/ Sheepherders, fish farmers, and beekeepers blamed their dead sheep, dead fish, and dead bees on DDT spraying. https://www.wanderingitaly.com/blog/article/785/sardinia-and-the-history-of-malaria https://www.wanderingitaly.com/blog/article/785/sardinia-and... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2819864/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2819864/ Edit: Odds are good I read about it originally in Reader's Digest in the late 1970s or early 1980s if you want to find a dead tree copy at a library.
- yardie 6y ago
  Except there are multiple species of mosquito. Only 1 of them is a primary carrier for malaria. And if it disappears another mosquito in the family will replace it.
- Jedd 6y ago
  This seems alarmist. The citation you provided elsewhere (for Sardinia) was for some DDT spraying - which was obviously not targeted exclusively at mosquitoes, and explains why lots of other things died. Targeting the very small set of mosquito species (that carry malaria) with something that will wipe them out within a few generations (under 12 months) seems tremendously safe, because a) it's a small subset of the total mosquito population, b) you can test this in isolated (eg. island) environments, and c) by the very nature of this, rollback is easy -- once the species has died out locally, if needed you can quickly & safely re-populate with non-modified specimens.
  - DoreenMichele 6y ago
    It's not alarmist. Not by any stretch of the imagination. I'm an environmental studies major and I have a genetic disorder. I'm getting healthier when that is supposed to be impossible and it's in part because I'm an environmental studies major and I think of the body as a complex ecosystem. You kill one thing or change one thing and there are always myriad knock on effects. Always. Anytime you do anything that's actually at all effective, there is hell to pay. I am getting better by trading short term costs for long term gains, the exact opposite of what Western medicine typically does. We monetize disease by trading short term gains -- that doctors can claim credit for, justifying their fees -- for long term costs which we politely admit to with multi-page warning materials included with all drugs and then normalize largely ignoring that stuff and taking it anyway. Then when your condition gets worse, they blame it on your genes instead of on the side effects of the harsh drugs they have been poisoning your system with for years and years. It's possible to make targeted changes to an ecosystem, but it's not easy and even if you get it right, there are costs involved. Managing such change is hard and there tends to be hidden costs that the experts want to disavow responsibility for and they can generally get away with it because cause and effect can be hard or impossible to prove. I hope they cure Sickle Cell. I hope they eradicate malaria. Parasitic infections are pretty awful. I hope they do it in a way that doesn't involve millions of Africans being thrown under a bus so Westerners can feel like heroes while hand waving off the human costs for the locals which Westerners have a long history of running rough shod over on the excuse that we imagine we are superior to them or something.
Dig1t 6y ago
I think about this a lot. What's to stop some random, non-scientist, group of people from just doing this? Mosquitos are pretty evil..
- maxerickson 6y ago
  If you make a gene drive you are a scientist. Hopefully whoever decides to just go do it has the sense to only target mosquitoes that preferentially feed on humans. Much less ecosystem impact that way.
  - danielheath 6y ago
    > If you make a gene drive you are a scientist. These days, introducing a known mutation via a CRISPR gene drive is engineering. The hard part is scaling it so your mutation doesn't die out, testing to ensure that it is actually propagating, etc. > Hopefully whoever decides to just go do it has the sense to only target mosquitoes that preferentially feed on humans. You have to repeat a considerable amount work for every single target species. I highly doubt they'd target more than one.
    - maxerickson 6y ago
      There's several species that preferentially feed on humans and we've done a banger spreading them around.
grishka 6y ago
The frogs gotta eat something.
- XorNot 6y ago
  The general consensus at the moment is that there's no apparent food chain where mosquitos are the primary source.
  - AlotOfReading 6y ago
    Except for places like the arctic, where they're basically primary pollinators and a food of choice for most predatory insects.
    - learc83 6y ago
      Do all the species of mosquitoes your talking about feed on humans, and do they carry malaria?
      - AlotOfReading 6y ago
        Yes and yes?
        Turing_Machine 6y ago
        No, they don't. The (many) species of mosquito found in the Arctic do not carry malaria. Malaria is largely a tropical and subtropical disease.
        AlotOfReading 6y ago
        Avian malaria is endemic to Alaska, and both Finland, and Siberia formerly had endemic human malaria, especially the more southern regions. Something up there is definitely capable of being a vector for it.
BurningFrog 6y ago
What's talked about is only making the 30-40 of the 3500 mosquito species that carry malaria extinct. Ecologically, they can normally be replaced by some of the 3460 others.

toomuchtodo 6y ago

There is a candidate mRNA malaria vaccine in the pipeline. https://blogs.sciencemag.org/pipeline/archives/2021/03/01/a-malaria-vaccine-candidate https://blogs.sciencemag.org/pipeline/archives/2021/03/01/a-...

maxerickson 6y ago

It's fine if they just figure out how to cure sickle cell anemia. Great even. No one will force people in areas where malaria is endemic to have sickle cell anemia treated, and a treatment for sickle cell anemia won't slow down treatment/eradication of malaria.

DoreenMichele 6y ago
I'm sure no one actually forced mothers in developing countries to buy Nestle baby formula either. Babies died anyway. There are lots of sources out there. Here are just a couple. https://en.wikibooks.org/wiki/Professionalism/The_Nestl%C3%A9_Infant_Formula_Scandal https://en.wikibooks.org/wiki/Professionalism/The_Nestl%C3%A... https://www.ranker.com/list/nestle-baby-formula-boycott/melissa-sartore https://www.ranker.com/list/nestle-baby-formula-boycott/meli...
- maxerickson 6y ago
  It's certainly not impossible that governments of African countries would spend thousands of dollars per person to prematurely cure sickle cell anemia, but I think we can say that it's unlikely.
  - DoreenMichele 6y ago
    The actions of African governments is not what concerns me here.
    - maxerickson 6y ago
      What other actors are going to give people unwanted bone marrow transplants? I guess medical companies testing the technology might do things to get people to participate in trials, but I'm not real sure people with sickle cell anemia would be mad about having to use modern anti-malarials instead of suffering with sickle cell.
  - f6v 6y ago
    > thousands of dollars per person to prematurely cure sickle cell anemia This cure is going to cost much much more. So highly unlikely.

IIAOPSW 6y ago

"I would die for 2 brothers or 8 cousins". -JBS Haldane https://en.wikipedia.org/wiki/Kin_selection https://en.wikipedia.org/wiki/Kin_selection

azernik 6y ago

This particular treatment does not affect the germ line. i.e. it corrects the defect in the patient, but they can still pass it on to their children, who would be (malaria-protected) carriers.

f6v 6y ago

That’s right, but the sad truth is that those who will afford gene editing and those who are at daily risk of malaria are two very different groups of people.

yarcob 6y ago

> Probably only beneficial if you have one copy, not two. One copy of the gene partially protects you from malaria; two copies of the gene make you very sick. That's why even in Africa only a small portion of the population has the gene. The gene is an evolutionary advantage as long as the prevalence in the population is low. As soon as the frequency of the gene in the population goes up, it becomes a disadvantage because if both you and your partner have the gene your kid has a 25% chance of getting two copies.