Inside a shipping container shaded by mango trees in the sleepy coastal town of Bagamoyo,Tanzania, research scientist Dr Brian Tarimo uses an ultra-fine needle to inject mosquito eggs lined up along a microscopic slide.
Grey and non-descript from the outside, the container holds a state-of-the-art research lab built in Spain and imported in its entirety to the Ifakara Health Institute, which is a leading research centre in Tanzania. The needle, meanwhile, contains genetic material precisely modified by CRISPR gene-editing – a scientific breakthrough thatwon the 2020 Nobel Prize for chemistry– which blocks the development of Plasmodium parasites that causemalaria.
It’s a process that could be game-changing in the millennia-long fight against malaria, whichcontinues to kill more than 600,000 people per year.
“In terms of the science, we have shown in the lab that we can block the spread of malaria in this way,” says Dr Tarimo, who reveals that there are around 10,000 mosquitos in the shipping container at any one time. “The big challenges we face now are around.... community engagement, so that we can move from lab to field testing, while meeting all the ethical guidelines that we need to follow.”
The lab in Bagamoyo is one of only a handful of facilities carrying out the genetic engineering of mosquitoes around the world. Its location in Tanzania is extremely helpful, says Dr Tarimo, as the genetic similarity of lab mosquitos to those that are outside means that the transition to field trials, which are set to begin in 2028, should be much smoother.
The original gene drive technology was, however, initially devised at Imperial College London. For Professor George Christophides, who leads the team in London, the project reflects how the UK has emerged as a powerhouse in critical global efforts to tackle malaria, at a time when cases are increasing due to threats likeclimate changeandanti-microbial resistance.
“The UK has played, and continues to play, a leading role in malaria research,” he says, pointing out that UK-based institutions are leading two of the three major international research programmes in the genetic engineering of mosquitos. “Many of the major advances in the field, from early discoveries on disease transmission to more recent developments in vaccines and [mosquito] control, have involved strong UK research leadership,” he adds.
Similar to genetic engineering, a malaria vaccine has for decades been considered something of a holy grail in the fight against malaria. Finally, a vaccine known as RTS,S that was developed British pharmaceuticals giant GSK was approved for use in 2021 by the World Health Organisation (WHO). Then, just two years later, a further vaccine from Oxford University’s Jenner Institute called R21 - which is around twice as effective, and around a third of the price - was also approved by WHO.
According Professor Adrian Hill, the director of the Jenner Institute - which also developed the vaccine‘Oxford Astra Zeneca’vaccine during the Covid-19 pandemic - malaria was a “much tougher nut to crack” than something like Covid-19, because malaria is a parasite that is thousands of times larger than a virus.
“There have been I think 150 candidate vaccines for malaria, all of which have failed apart from two,” he says. “So that’s a UK company and a UK research institution at a rather large university producing two vaccines, which most of the world has had a crack at making previously, without success.”
Both Prof Christophides and Prof Hill highlight the strength of the UK biomedical sciences sector, as well as consistent government funding as key reasons why UK research in malaria has been world-beating. Indeed, the UK public fundinghit £52m last year, which is the highest level in four years, shows data from Impact Global Health, cementing the country’s long-held position as the second largest country funder after the US.
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Both professors also attest to the UK’s colonial legacy leaving British universities with research partnerships with institutions in other parts of the world - such as Tanzania’s Ifakara Health Institute - as well as a long-standing interests in understanding tropical diseases. “That legacy helped establish a strong tradition of internationally oriented research, which today continues in a more collaborative and equitable form,” says Prof Christophides.
Prof Hill adds that with all such scientific breakthroughs there is also an element of “luck” involved. “I’ve been doing malaria for 20 years when it wasn't the right time… then suddenly all the technologies improve, and you’re in a position to supply them,” he says.
Back in Tanzania, Ifakara’s Dr Sarah Moore - a specialist in mosquito-control products like bed nets and repellants, who originally hails from Wales - also points to the increasing accessibility, often through scholarships and reduced fees, of UK higher education institutions to Global South students as a key factor in malaria research success.
“We have these incredible academic institutions in the UK, which are helping to develop products that save lives day in, day out,” she says. “But there has also been an important shift towards the decolonisation and decentralisation of research, which means that most of my students here at Ifakara were at some point either trained in the UK or in Switzerland.”
The London School of Hygiene and Tropical Medicine, Glasgow University, and the Liverpool School of Tropical Medicine are institutions regularly mentioned by the world-beating scientists at Ifakara when asked where they trained. Dr Tarimo - the genetic engineering specialist - was trained in both Glasgow and Liverpool (as well as Tanzanian universities), and he shares fond memories of going to see Liverpool FC, the football team he has supported since childhood, play at Anfield.
Dr Moore believes that there is a level of bashfulness in the British psyche that means most Brits will not know that the country has been so consequential in saving millions of lives from malaria. But perhaps it is time to change that: “The scientific achievements of British academia are truly outstanding, and we should be celebrating them far more,” she says.
Gareth Jenkins, managing director of advocacy charity Malaria No More, agrees – and points out that it was actually a Brit called Sir Ronald Ross who first discovered the malaria parasite and proved that it was carried by mosquitoes over 125 years. “The UK has long been a malaria science superpower, and this is something we as a country should hold our heads high about,” he says.
Given the government’swide-ranging cuts to the aid budget- as well as polls that suggest cutting aid isa lower priorityfor the public - generating a greater appreciation of the value of UK-backed malaria research may prove critical if funding is to continue long term. That value is not only in lives saved, but also economic:one study, for example, found that investment in neglected disease R&D could generate £7.7 billion in additional GDP for the UK, while anotherreportsuggested that cutting malaria by 90 per cent by 2030 could boost the economies of malaria endemic countries by $142.7bn.
For now, UK development minister Jenny Chapman tellsThe Independent thatforeign aid for scientific R&D - as well as spending on global health programmes - will continue to be a priority for the government. But with a weak economysqueezing government budgets, and a political party planning to “dramatically cut foreign aid” leading in the polls for the next UK general election, there is no guarantee that this will continue unless there is greater public recognition of what UK support for malaria actually brings.
“Investing in malaria can in the long term build a healthier workforce that can in the long term totally transform African countries,” says Dr Moore. “People will be sick less and save more money, they will be encouraged to stay in situ and work instead of migrating, things like family planning will be encouraged, and ultimately you will build stronger economies that can trade and do business back with the UK.”
This article has been produced as part of The Independent’sRethinking Global Aidproject
Inside a shipping container shaded by mango trees in the sleepy coastal town of Bagamoyo,Tanzania, research scientist Dr Brian Tarimo u...
