Charlotte Swim: Playing God: Navigating the Ethical Dilemmas of Genetically Modified Mosquitoes

Abstract

Genetically modified mosquitoes (GMMs) represent a promising innovation to combat vector-borne diseases (VBDs) like malaria and dengue, which continue to pose significant global health and economic challenges around the world. However, their deployment raises profound ethical questions concerning environmental safety, long-term consequences, and community consent. By critically examining the ethical, social, and cultural dimensions of GMMs, this article advocates for a balanced approach to using genetic engineering to mitigate the devastating impact of VBDs while upholding ethical principles and prioritizing public trust.

Introduction

As a child, I clearly remember reading the newspapers and being scared out of my mind of dengue and the deaths it induced within my community. I also recall my father’s episode of dengue that left him in bed for weeks and anxiously plastering mosquito repellent patches and sprays all over myself every time I prepared to go outside.

My personal experiences with mosquitoes are far from unique. In many parts of the world, they are all too common—families everywhere are familiar with the anxiety and precautions that come with living in areas where mosquito-borne diseases, also known as arboviruses, are prevalent. The fear of falling ill, the disruption to daily life, and the economic burdens of treating these diseases are shared experiences for billions globally.

However, with the advent of genetic engineering and biotechnologies, a new solution has emerged: genetically modified mosquitoes (GMMs). This article explores the bioethical implications of using GMMs to combat vector-borne diseases (VBDs), considering the benefits, risks, and the ethical, social, and cultural considerations involved in their deployment.

The Impact of Vector-Borne Diseases (VBDs)

According to the World Health Organization (WHO), vector-borne disease (VBDs) such as dengue, malaria, and yellow fever pose a significant health risk that more than 80% globally, amounting to over 6 billion people, live at risk of (“WHO takes a position”). For instance, in 2021, there were an estimated 247 million malaria cases, and around 619 thousand died (“World malaria report 2022” 21). The majority of these deaths occurred in Africa, and were children (“World malaria report 2022” 21). However, these diseases not only cause suffering and death but also take heavy tolls on economies, hindering development both in urban and rural areas.

Beyond immediate health concerns, VBDs contribute to long-term economic strain and social disruption. For instance, malaria is estimated to cost Africa around 12 billion USD per year and also slow economic growth by 1.3% annually—this is the result of both death and slower worker productivity (Resnik). Over the years, this accumulated damage has left a substantial impact on economic development. The loss of workers to illness, healthcare costs, and the need for continuous disease control measures all burden affected communities, emphasizing the urgent need for solutions to effectively control and prevent VBDs—and GMMs may just be a potential solution.

Genetically Modified Mosquitoes (GMMs)

Genetic engineering is the modification and manipulation of an organism’s DNA. Precise changes can be made to the genetic material of an organism, enabling the development of organisms with specific, beneficial traits. The first genetically modified organism (GMO) was a bacterium generated in 1973 by biochemists Herbert Boyer and Stanley Cohen—and since then, the field has taken off.

The use of genetically modified mosquitoes is one of the most promising applications of genetic engineering. GMMs are mass-produced in laboratories to carry two types of genes: a fluorescent marker gene that glows under special light, which aids researchers in the identification of GMMs, as well as a self-limiting gene that prevents female offspring from surviving to adulthood (“Learn More about Genetically Modified Mosquitoes”).

The most well-known type of GMM is the Aedes aegypti, which is a known transmitter of several arboviruses including yellow fever virus, dengue virus, chikungunya virus, and the Zika virus (Meghani and Boëte). By releasing genetically modified male A. aegypti mosquitoes into the wild to mate with wild-type females, the self-limiting gene ensures that the majority of the mosquito offspring die before reaching adulthood, resulting in a gradual reduction of the mosquito population over time (“Learn More about Genetically Modified Mosquitoes”). Since male mosquitoes do not bite, they do not transmit these vector-borne diseases, helping limit their spread (“Learn More about Genetically Modified Mosquitoes”).

Recently, Oxitec, a UK-based biotechnology company, has also developed Anopheles stephensi mosquitoes that are also genetically modified in the same manner as modified A. aegypti (Resnik). Similarly to A. aegypti, A. stephensi mosquitoes are also transmitters of vector-borne diseases, specifically transmitting malaria (“Oxitec Malaria Program”).

Considerations in the Deployment of GMMs

While the potential benefits of GMMs in controlling the spread of VBDs are significant, their deployment raises important bioethical questions. These include concerns about the safety and long-term effects of releasing GMOs into the environment, the ethical considerations of manipulating animal genomes for our benefits, and the need for informed community engagement and consent in areas where GMMs are set to be released. Addressing these concerns is crucial to ensure responsible and effective use of GMM technology.

Many ethical considerations surrounding the genetic modification of animals, including mosquitoes, involve broader questions about our right to alter other living beings for human benefit. Genetic engineering allows for a form of biological intervention that can be perceived as “playing God” by controlling the life and death of affected organisms like GMMs. Although these modifications can offer significant benefits towards us by reducing the spread of taxing vector-borne diseases such as malaria, they raise significant ethical concerns about the limits of these biological interventions and animal welfare.

A central ethical issue is the concern that genetic modification reduces affected animals to mere instruments for human benefit and the sole purpose of making our lives as comfortable as possible at any cost. This perspective views GMOs not as entities and living organisms, but as tools. By manipulating organisms, we impose our will on their biology and who GMMs are, how they’ve come to be, and who they will be in the future. This can be seen as an overreach of human authority and an attempt to manipulate nature in a possibly exploitative manner.

Furthermore, although the Environmental Protection Agency (EPA) has not found any risk from GMMs to people, animals, or the environment, there are still concerns about releasing GMMs into the wild. One of the primary ethical concerns regarding their release is the potential for unintended consequences on the environment. The release of GMMs could result in future generations of mosquitoes having traits that allow them to survive and reproduce despite carrying these traits. As self-limiting genes do not have a 100% rate of success, the surviving GMM females could proliferate, later undermining the effectiveness of the modification and leading to a resurgence of mosquito populations that continue to spread disease. The uncertainty around the long-term effects of genetic modifications raises questions on the responsibility for the outcomes of these interventions—if they lead to negative or unintended consequences, should we continue to pursue these technologies in the hope of increasing chances of success or give up to prevent the negative effects from compounding; moreover, should we continue to pursue these technologies knowing that we may be causing irreversible harm to the natural world?

The ethical considerations involved with GMMs also extend to the involvement of affected communities. For GMMs to be implemented ethically and with the highest chance of success, robust community engagement and informed consent are crucial. Competent authorization with full disclosure is crucial in several fields, notably medicine. It arises from the fundamental ethical principle of autonomy—the right to self-determination and respect of an individual's right to make informed decisions—and basic human rights, demanding that individuals must fully understand and voluntarily agree to participate in interventions that may affect them or their environment (Macer). As such, affected communities must be actively involved in honest discussions about the potential risks and benefits of GMMs. This requires clear communication and transparency, ensuring that all community members, regardless of social status, levels of literacy, and level of income, fully understand the implications of the technology and have opportunities to clearly voice their concerns and preferences. This community involvement helps to address concerns about potential manipulation or lack of genuine consent, ensuring that the voices of those who may be the most affected by the technology are heard and considered in decision-making.

Even so, achieving effective and successful community involvement can be challenging. There are many concerns about the potential for manipulation, wherein developers of genetic modification technologies might work with government officials or leaders to influence community perceptions to secure approval (Macer).

Conclusion

In conclusion, the ethical implications of modifying mosquito genomes do not just affect mosquitoes–-they can transform the world around them. Carefully considering these consequences are central to the responsible development and deployment of genetic engineering technologies, and possibly the eventual elimination of these deadly vector-borne diseases.

About the Author:

Charlotte Swim is a 16-year-old 11th-grade student at DeBakey High School for Health Professions in Houston, Texas. She is passionate about public health, biomedical research, and bioethics, with a particular interest in patient autonomy and reproductive ethics. Charlotte is actively involved in research projects related to bioethics and strives to spread education on these issues, promoting a better understanding of healthcare ethics.

Works Cited:

Lavery, James V., et al. ‘Ethical, Social, and Cultural Considerations for Site Selection for Research with Genetically Modified Mosquitoes’. The American Journal of Tropical Medicine and Hygiene, vol. 79, no. 3, American Society of Tropical Medicine and Hygiene, Sept. 2008, pp. 312–318, https://doi.org/10.4269/ajtmh.2008.79.312.

“Learn More about Genetically Modified Mosquitoes.” Orange County Mosquito and Vector Control District, https://www.ocvector.org/learn-more-about-genetically-modified-mosquitoes.

Macer, Darryl. “Ethical, legal and social issues of genetically modifying insect vectors for public health.” Insect Biochemistry and Molecular Biology, vol. 35, no. 7, 2005, p. 11. ScienceDirect, https://doi.org/10.1016/j.ibmb.2005.02.010.

Meghani, Zahra, and Christophe Boëte. ‘Genetically Engineered Mosquitoes, Zika and Other Arboviruses, Community Engagement, Costs, and Patents: Ethical Issues’. PLoS Neglected Tropical Diseases, vol. 12, no. 7, Public Library of Science (PLoS), July 2018, p. e0006501, https://doi.org/10.1371/journal.pntd.0006501.

“Oxitec Malaria Program.” Oxitec, www.oxitec.com/oxitec-malaria-program. Accessed 17 Dec. 2024.

Resnik, David B. “Ethical issues in field trials of genetically modified disease-resistant mosquitoes.” Developing world bioethics vol. 14,1 (2014): 37-46. doi:10.1111/dewb.12011

“What Mosquito Control Programs Do | Mosquitoes.” CDC, https://www.cdc.gov/mosquitoes/mosquito-control/mosquito-control-programs.html?CDC_AAref_Val=https://www.cdc.gov/mosquitoes/mosquito-control/community/what-mosquito-control-programs-do.html.

“WHO takes a position on genetically modified mosquitoes.” World Health Organization (WHO), 14 October 2020, https://www.who.int/news/item/14-10-2020-who-takes-a-position-on-genetically-modified-mosquitoes.

“World malaria report 2022.” World Health Organization (WHO), 8 December 2022, https://www.who.int/publications/i/item/9789240064898.