In 2016, academics from the Massachusetts Institute of Technology (MIT) published a white paper providing the scientific community with a thorough explanation of the Convergence in Healthcare movement. Besides illuminating the ways in which convergence is already benefitting the medical sector, the report also included specific examples of pressing healthcare needs that could be met through convergent research.
One such urgent need is for better protections from contagious diseases — specifically those diseases that continue to run rampant among populations in developing countries. One of the foremost issues scientists are attempting to address through convergent research is mosquito-borne contagious illness.
In summer 2018, major news outlets including CNN, the BBC and NPR reported on convergent research that yielded promising results in obliterating mosquito vectors for life-threatening illnesses such as malaria and dengue virus. Below is an overview of the history of these mosquito-borne diseases, the issues the medical community faces in overcoming them and how Convergence in Healthcare is changing the future of these diseases.
Mosquitoes have caused human health crises for all of recorded history.
Diseases caused by mosquitoes aren’t a recent development. While discovery of the first incidences of more modern viruses such as West Nile and Zika occurred in the 20th century, others such as yellow fever and dengue have a longer history of causing illness, defects and death in humans — by some estimates, at least 400 years. In the case of malaria, historians suggest it is an ancient disease, the symptoms of which were reported in China as far back as 2700 B.C.
Of these three long-standing mosquito-borne illnesses, malaria alone killed 445,000 people in 2016, according to World Health Organization (WHO) estimates. Most of its victims were children under the age of five. Altogether, 216 million peopled contracted malaria through mosquito bites that year. The illness causes fever, chills and other flu-like symptoms that can cause death or severe permanent damage if left untreated.
Dengue fever causes an additional 50 to 100 million cases of mosquito-borne illness every year, with around 22,000 deaths. As with malaria, the majority of its victims are children. Based on the most recent statistics from WHO, yellow fever, the third of these serious mosquito-borne illnesses, causes between 84,000 and 170,000 cases of illness and 29,000 to 60,000 deaths every year. The disease affects the kidneys and liver, causing jaundice and bleeding from the mouth, nose, eyes or stomach. Death can ensue in just seven to 10 days.
Scientists have struggled to address these issues due to several key factors.
The serious impact of mosquito-borne illnesses has prompted many researchers in the science community to act and speak out in the interest of developing a comprehensive strategy to end the crisis. Among them is Microsoft founder and philanthropist Bill Gates and his wife, Melinda Gates. The couple advocate for a focus on what Mr. Gates calls “the deadliest animal in the world” on his personal blog.
Though modern health practices and technologies have allowed the medical community to develop more effective strategies to combat these diseases, the crisis has, at times, seemed desperate and at risk of intensifying in spite of promising developments. This is due in part to factors of increased rates of international travel and extreme population increases in urban areas without adequate water, waste management and sanitation infrastructure. Another pressing issue in terms of controlling vectors for mosquito-borne illnesses is the threat of climate change. Many scientists believe climate change will increase mosquito populations due to wetter, more humid conditions in many regions, and more standing water left over as extreme storms become more common.
Scientists employing convergent research tactics reached a major breakthrough in the fight against mosquitoes.
In the 2016 report on Convergence in Healthcare, MIT lists the elimination of mosquitoes through convergent solutions as a key step in the effort to improve immunity and combat infection around the world. The report details an “engineered approach known as gene drive” — a convergent tactic the authors consider one of the most promising methods for eliminating vectors for major mosquito-borne illnesses.
September 2018 marks the first time the convergent gene drive approach resulted in the complete elimination of a population of mosquitoes in a laboratory setting. Scientists from the Imperial College of London published research utilizing this technique in the journal Nature Biotechnology. It only required seven to 11 generations to collapse an entire caged population of the mosquito species Anopheles gambiae, known for its role in the spread of malaria.
To accomplish this remarkable feat of genetic engineering, the scientists used the innovative new tool known as CRISPR to alter the so-called “doublesex” gene of Anopheles gambiae, which determines whether a mosquito is male or female. The alterations ultimately caused mating pairs to produce female offspring without reproduction capabilities; these mosquitos carried two copies of the altered gene and displayed both male and female characteristics. After approximately eight generations, females were no longer produced and the entire population collapsed.
This example of gene drive is being heralded by the science community as noteworthy due to the fact that it represents the first time a laboratory has overcome mosquitoes’ natural resistance to gene alteration. In past experiments, the genes targeted to suppress by CRISPR instead developed mutations to overcome scientists’ efforts. The mosquitoes passed the mutations to their offspring, allowing populations to continue to thrive.
While the new method of fighting disease-carrying mosquito populations likely still has five to 10 years before it can be tested in the real world, the success of this new discovery demonstrates the power of Convergence in Healthcare to improve global human health.