The following is a transcript of a conversation between some of the world’s most eminent scholars of ethics, ecology and governance who, amongst other work, are tackling societal challenges that have arisen as a result of unprecedented technology change in the fields of genetically-modified mosquitoes and artificial gene drive technology. The journal posed questions that were formulated by Imperial College students and journal staff. In particular we would like to thank Imperial students Georgina Carson, Helen Panteli and Grace Charlesworth for their assistance in putting this issue and interview together.
The formula of the discussion was to present a number of intentionally naive statements in order to reflect views of an uninformed audience, and we asked the participants to discuss the issues that would need to be resolved in order to provide more complete answers to those statements.
Participants:
James Collins
Virginia M. Ullman Professor of Natural History and the Environment
Arizona State University, School of Life Sciences
Claudia I. Emerson
Director, Institute on Ethics & Policy for Innovation
Associate Professor, Department of Philosophy
McMaster University, Canada
Elizabeth Heitman
Professor, University of Texas Southwestern Medical Center, Program in Ethics in Science and Medicine, Dallas, Texas, USA
Kenneth Oye
Professor of Political Science, Professor of Data Systems and Society, Director of the Program on Emerging Technologies (PoET)
Massachusetts Institute of Technology
PGH: Gene drive technologies offer the best possibility to develop a sustainable vector control measure
KO: What do you mean by ‘sustainable’?
JC: And what do you mean by ‘measure’?
KO: And what do you mean by ‘vector control’?
EH: And I’ll just say that there is a lot of debate about how we use words differently across disciplines. ‘Best’ may mean one thing to an entomologist in a laboratory, and it may mean something very different to a social policy critic who is looking at broader effects. So, we may come back, time and time again to ‘what do you mean by’ because what we’ve seen, just in the two and half years that there’s been broad policy discussion, is that we do not all mean the same thing. And unfortunately early on we didn’t all mean the same thing by ‘gene drive’. Different people have used the term ‘gene drive’ in different ways, depending upon their perspective.
PGH: Is there a definition of ‘gene drive’ that you could all agree on?
JC: It would be a system in which you modify the genome of an organism in a way that you wind up with biased inheritance. That’s simply put.
KO: With a well-defined target sequence and substitute sequence as well as the cut-and-paste machinery associated with it, and we have not made statements on whether that system is stable or unstable over many generations or whether it could be localized or modified, which I hope will be some of the issues we’ll talk about later, but I think that purpose-designed gene drive is what we need to describe here because gene drives exist in nature as well.
JC: Right. Regarding ‘sustainable’, we’re typically thinking of that as a system-level view in which you want to have whatever the entity is that you’re thinking about or whatever the system is you’re thinking about it, in some sense perpetuate itself. We can think of a gene drive technology as sustainable in that you could introduce a modification into a population and it would spread throughout the population. As a result of the original molecular variant that you introduced, you wouldn’t have to keep introducing anything, so in that sense it would be sustainable.
KO: Yes, ‘self-perpetuating’ would be another way of looking at it.
JC: That would be the synonym for ‘sustainable’.
KO: Exactly right, because the word ‘sustainable’ also has the environmental connotations as well.
EH: It also raises the question of whether there would be any resistance, either within the organism itself or from environmental factors.
KO: So, framing this as a question it would be something like ‘are purpose-designed gene drive technologies, defined as we have discussed, do they offer a promising possibility for developing self-perpetuating vector control measures?’
CE: I would agree with the question as Ken has restated it. Given the caveats and qualifications we have made, the original statement is not something you could agree on as it’s very firm and leads to an answer which says that we don’t know if it’s the best possibility; there may be other technologies that could be under development in the next two or three years. Who knows.
KO: So, the answer to that question is yes, it is a promising technology but we need to have a discussion on alternatives, and why it is promising but there are other ways people are trying to control vectors. Every one of the approaches, including gene drive, has liabilities as well as benefits.
EH: I don’t want to talk about ‘alternatives’ in those terms because I don’t know of anyone talking about gene drive as if it were the only approach to vector control. Instead there the idea is that gene drive modified organisms would be a piece of a multi-factor approach to vector control.
JC: That makes a lot of sense too because, as Liz said earlier, we know that you can get resistance to the gene drive and therefore the notion of using some sort of multivariate, multifactorial strategy is more likely to be successful because without that you’re likely to get a failure or have only partial success with one approach.
KO: Also, the statement as supposed, assumes that you’re beginning with release, there’s much that we need to understand before proceeding to that point, and the characteristics of the drives themselves: are they with or without threshold mechanisms or daisy gene mechanisms to try to limit diffusion to locales, that is something that we’re going to have to talk about because our evaluation, I would guess amongst us all, in responding to vector control in this context, that first question requires consideration of what we mean by gene drive with or without technological safeguards that are under development now.
PGH: The implementation of gene drive systems is a decision for people that are exposed to mosquito-borne diseases
KO: It’s certainly a statement that I think I would say, yes.
EH: And I would say yes.
CE: I would agree with that. Certainly the people who bear most of the risks and burdens have to have a substantial input into this. But with gene drives, these are systems that are going to have wide-ranging impact, you can’t just confine it to one place, and quite honestly, everyone has a stake in it. So I think there has to be input from people, in general, globally; and obviously those who are local to the site of release should have a large say, if not the biggest say. But it can’t just be about that. All of us here are having this discussion because we have a stake in it too.
JC: I would say yes, and I would agree with Claudia that the issue expands beyond just those who would be affected by any particular mosquito-borne disease. To expand the discussion beyond infectious disease for a moment, the same response would apply to removal of pest species on Pacific islands that are endangering local bird populations. It’s a question that conservation biologists face all the time. For example if populations of polar bears are declining, do only the people living in regions with the bears have a say in conserving the populations? Or, do people sitting in New York City, Santiago, Chile or elsewhere also have a stake, and therefore a say, in the welfare of those organisms?
I’d also say, if it’s a universal gene drive then, definitely, it has the possibility of moving well beyond the local areas, so a much-wider conversation is needed in order to deal with the introduction of those sorts of modifications.
EH: That is also one of the conclusions that came from the National Academy of Science’s report on gene drives. On page 132 of that report, we made the claim, and a fairly strong argument I think, that there are multiple levels at which people might have a say in how gene drives would or would not be used. At the broadest level there are multiple publics that might have an interest, there are stakeholders who are affected in a concrete definable way, and then there are the communities who are most affected, physically and otherwise, by the potential release or the presence of gene drive modified organisms. Each one of those groups might overlap. There may be publics who might have a very keen interest in what goes on in a particular part of the world, but only because they have been reading about it for a long time or because they visited there once many years ago and have kept up with the situation. Others might work in that environment, or are caregivers for various medical conditions. These are all stakeholders who might have a concrete reason to be interested in the release of gene drives or how they might be used. As for the communities who live in that environment, they perhaps would have the strongest case for their opinions and values to be respected, and to have input into how gene drives might be governed.
KO: Two quick comments on whether the people affected and should they have a voice, the answer is unequivocally yes. When Jim and I, Kevin Esvelt, and a bunch of other people did a little piece in Science at the start of all of this I made the mistake of going on to a talk show. I hedged my bets, this was a National Public Radio talk show, so a civilized one. But a caller, Kelly from Mulberry came in and said ‘malaria is nature’s way of controlling human population, gene drive shouldn’t be developed’, and I got quite incensed that Kelly from Mulberry should be sitting there ignoring the fact that people who are potential dying from disease, are simply to be allowed to go their way, nature’s way. This really offended me, partly because my daughter was living in a malaria region, but it goes beyond family. And that’s the first point, obviously the people who are most affected, in terms of being exposed, should have a voice, the problem that I have with the wording of the statement is that ‘a decision’ and ‘implementation’, do you mean by implementation: research? Or do you mean field release in a quasi-experimental way? Or do you mean the start of a wholesale eradication program? And there are important differences across them, although the differences also depend on the technologies that are being adopted.
Second, in terms of ‘decision’, people don’t just have voices they have voices through political institutions and processes and the statement as posed allows us to get away without moving to explicit discussion of how decisions can be made. What is the role of governmental entities? Of funders? Of researchers themselves? And people who are susceptible to or who are exposed to the diseases, how is their voice to be expressed? I’m not being picky, the details, the institutions and the processes matter, particularly because in this space, the institutions are not well developed. If we looked at the United Nations’ institutions and the convention on biodiversity, the debate on these issues will continue for a long time. If you turn to national regulations and policies, we do not have much in the way of gene drive specific regulations. Jim, is the Netherlands still the only country that has something specific in terms of the conduct of gene drive research?
JC: I believe that’s right.
EH: I have heard that Germany was working on something.
KO: I know they’re working on it, yes. And then Claudia, the funders have been working on developing guidelines, not as a substitute for the UN system or as a substitute for national regulation, but would it be fair to say that the funders and the researchers have been working on trying to figure out how to govern ‘implementation’ because, in part, there are such huge gaps in these more traditional ways of addressing potential benefits and risks?
CE: That’s exactly right. The other piece of it is that there are a lot of stakeholders with shared responsibilities. So the funders have responsibility, scientists have responsibility, regulators, members of the community and so on. This is a shared responsibility and new technology has a lot of great potential but it’s not without its risks, and until all those things are well understood and have been worked out, everyone has a part to play in terms of executing their responsibility to ensure that whatever happens, it’s done in the most responsible way.
JC: The question raises this question associated with governance. When thinking about these universal gene drives, they will not stop at the borders of any country. That means you’re automatically in an international situation, and as Ken suggested, institutions are not well developed to handle those sorts of things. So where would you go for governance, especially governance that has a certain sort of leverage for individuals who might not be ‘playing by the rules’?
PGH: The advancement of gene drive technology doesn’t change the ethical arguments for or against releasing genetically modified mosquitoes into the wild, it only accelerates its prospect for success.
KO: The word ‘only’ here is I think all of us latched on to. ‘Only accelerates its prospect for success’. When you go from Mendelian inheritance to universal gene drive inheritance, at some point acceleration becomes a change in fundamentals, and going from 50/50 to 99.5 even with degradation of capacity is a significant change, it’s not ‘only’, it substantially accelerates, as we understand the mechanisms and their stability now. So ‘only’ trivializes the significance of the technology, but I don’t know if my colleagues would agree with that.
EH: So I have a more basic question: what is the antecedent to ‘success’ in that phrase? Are we talking about the gene drive or are we talking about the ethics? Or are we talking about the advancement? ‘Its success’, in the biological sense or in the sense of the application in the larger goal of eradicating diseases? This statement becomes difficult to unpack in terms of the ethics component because the goal of the question is not clear.
I would say, from how I read this question, evidence only makes the ethical questions clearer, it doesn’t answer them. So, while the advancement of gene drive technology doesn’t change the ethical arguments, it does change the ethical responses, if the evidence is clearer one way or another. So, the advancement of gene drive technology doesn’t necessarily mean, to me, that it’s working better but it may simply mean that we have more evidence to know how it works.
JC: Historically, the release of genetically-modified organisms and releasing organisms modified by a gene drive technology have at their root an ethical question that has to do with intervening in ecosystems, with ‘what counts as nature’. In that sense there is a commonality there is a commonality relative to the question, ‘How should we think about intervening in nature?’
EH: And that’s a very basic kind of ethical question. Some of the other ethical questions and answers will change – and whose answers will change – relate to questions about the effects of modifying nature through any kind of genetic technology. For that, the more evidence you have, carefully gathered and with as little impact in the direction of the harms that you might be worried about, the better the assessment you can make. Unfortunately that already puts the onus on those people gathering evidence to be very careful in the way in which they gather it, to avoid the harms that are foreseeable. The basic values question about whether one should mess with nature is a very theoretical question, and one which when applied in practice becomes very messy. That’s why those of us in practical and applied ethics tend to focus more on the practical impact, not a utilitarian argument.
CE: The statement didn’t make any sense to me. When I break this down into propositions to try to grasp what it is saying it feels like the second part of the statement is a non-sequitur. I find myself asking: why would the advancement of gene drive technology change or not change the ethical arguments? It presupposes that if you are advancing gene drive technology then to some extent the ethical arguments for, have in some ways, risen because you are continuing. There is a case to be made – scientifically, ethically, politically – and there are different sorts of arguments that have allowed and enabled the advancement of technology. But putting that aside, if you advance the technology, why would that change the arguments because you could just continue to advance the technology and it wouldn’t impact it either way; you’re still going to have arguments for or against. It all really depends on, as Liz was speaking to, what specific things you are assigning arguments to. Is it about impacting nature? Is it about the tampering of species? Is it about how you regulate? And so on. There are so many different pieces, and so I didn’t understand why one thing would somehow impact the other. And the last bit, ‘accelerating its prospect for success’, I just didn’t understand how that followed from the first half of the statement.
KO: Claudia, I share your confusion, particularly when we look at both halves of that sentence. I’m also going to say that I think I know what they’re trying to get at. None of that statement is defined clearly and I think we all agree that basic and fundamental arguments on control of nature are not going to be, in a sense, affected by or altered by almost any technology. There are big questions out there, and here’s where the ‘but’ comes in. When the statement talks about the acceleration, and ‘only’ acceleration, and what’s meant by that, what effects does it have, I think I know what they’re getting at. So if you take Oxitec mosquitoes, genetically modified and released in large numbers, you have to re-release them again and again and again to have any prospect of ‘success’, defined in terms of conditions of release. They’re not going to propagate. You might be able to do some population suppression, you might be able to have some effects, but there’s a real difference between those and a universal gene drive with potential globalized genetic effects. And then come the issues of isogenetic (will they remain discriminating, what happens if the target sequence mutates) and lots of other questions that look different.
PGH: The genetic modification of an entire species or its suppression to extinction are consequences that have been considered.
EH: We must ask from the outset, since the question is in passive voice, considered by whom? Yes, the four of us have thought about it but who are you interested in consideration from?
What I will go back to the point that we don’t have evidence about what suppression to extinction might look like. This was one of the conclusions of the National Academy’s report: we don’t have good data. The work has not been done on the effects of intentional extinction of a species. We do not that might look like, whether it can be done intentionally or if it’s something that happens unintentionally by carelessness or overlooking good practices. We don’t know what the process of intentional extinction would look like from a gene drive.
KO: So, I think that we would all agree, and tell me if I’m not speaking for you as well, that the consequences should be considered, that additional information is required, that the answer is going to vary by species and application, and that all of us want to know more.
JC: Certainly this question, the notion of using gene drives for the purposes of, for example, driving malaria-bearing mosquitoes to extinction is something that came up from time to time in the conversations associated with the report. The question of deliberate extinction is an interesting one that, even aside from genetic modification, really hasn’t been well addressed by either the ecological community, the conservation biology community, and I would argue the biomedical community. So for example, at the moment the control of guinea worm in Asia and in Africa is a program that has as an objective of deliberate extinction of guinea worm. The program’s aim is to remove that species because of its consequences, as far as human populations are concerned. It’s an interesting thought experiment to raise the question of who gets to make that decision at any particular time and once you think it through in that kind of case you can perhaps learn some things that would be also helpful in thinking about gene drives, and whether or not you’d like to drive a species to extinction. Conservation biologists are faced with the dilemma of balancing three extinction-related ideas. First, what we might call ‘inadvertent extinction’, something like the passenger pigeon in the United States. The species wasn’t deliberately hunted to extinction, but hunting ultimately reduced populations to such small sizes that it went extinct. Second, is the possibility of deliberate extinction as proposed for guinea worm or malaria–bearing mosquitoes. And third is de-extinction, that is bringing species back. There is a set of complex ethical, legal and social implications that go along with the biology of extinction that need to be thought through.
EH: There have been public surveys in the United States, which perhaps someone can quote better than I, but they say something like ‘sure, get rid of all of the mosquitoes’. If we were simply to ask people about pest species there are plenty of species that people seem to think they wouldn’t miss. Even without the profound medical effects of guinea worm people would love to get rid of whatever they consider pests. So, to think about the ethical consequences of those choices and the grounds on which we make them – that’s a significant question that warrants consideration.
JC: To build on that, while we might see our way through to extinction of a malaria-bearing mosquito species because of all the negative consequences of contracting malaria, it puts us on a slippery slope in terms of what we might consider a pest. Not that we would say that malaria-bearing mosquitoes are just a pest, they are much more than that, but then you can pretty easily slide from there, it seems to me, to other kinds of species that you prefer not to have around. Once you get into the area of ‘preference’ for a species – or not – the arguments for or against preservation really begin to change.
CE: This brings us back to the question of the moral status of species. So if koala bears became pests tomorrow, I think there would be a lot of resistance to any program that tried to eliminate them, but people don’t seem to have problems with the guinea worm, with mosquitoes, or screwworm which was eliminated in the United States years ago because of the economic impact on agriculture. So I think when it starts to hit home there is little resistance. If somebody wanted to start a program to eliminate bedbugs I’m sure everyone in the hotel industry would jump on top of that because it’s a pest and no good can come from preserving these species. So there’s definitely going to be a slippery slope, and there’s definitely a value that we ascribe to species and the role that they play.
When I read this statement I had a question around the use of ‘extinction’. It’s something I see a lot in the literature and especially in the media. I’ve been thinking about this subject, perhaps wrongly, as if we were talking about suppression or elimination of species so at least in the case of malaria, the anopheles gambiae or various other mosquito species that we’re going after, it never occurred to me that we’re going for extinction. You might eliminate it, potentially eradicate it in a particular region, but extinction would represent, at least in my mind, that it would be wiped off the entire planet, and I don’t see it that way – at least in the context of anopheles gambiae – but I could be wrong about that. But the notion of deliberately driving something to extinction, or even to elimination, I think is a question that all of us here have been thinking about but I don’t think it’s one that’s been widely considered. For example, we don’t contextualize in terms of how many other species we are driving to extinction without these deliberate forms; so all the other things we do to the environment that are pushing species away in more rapid, and in some ways, even more deliberate ways, but it’s not conscious (since we haven’t gone into modifying the organism for extinction). Why is the genetic modification or the insertion of a gene drive somehow worse than all the other things that we do that already drive other species to extinction?
KO: Claudia, you’re point on cute is certainly accepted. Warm, cuddly mammals are distinct from guinea worm, which don’t really get you in the heart the same way.
EH: I would completely agree with what Ken just said. We get confused, too, I think with some of the language that people use. Suppression, sounds as if it could pop back up at any moment, so maybe that’s not enough for some people. The distinction between elimination and extinction is one where I haven’t seen a lot of nuance, but I think the question of localization is very important. You could eliminate a species in a certain locality where there is a profound harm and not necessarily lead to its extinction. We haven’t talked much about the moral distinction between those two, and whether there is a discernible one, independent of whatever the technology offers.
PGH: Malaria eradication depends upon gene drives.
CE: I wouldn’t agree with that statement right now. Earlier in the conversation we spoke of the toolkit that we have with various instruments or weapons in the arsenal to go after a disease, and I don’t think that we could say with any certainty that gene drives are going to lead to malaria eradication, which then highlights Liz’s prior point that we don’t have clear distinctions between control, elimination and eradication in terms of species and we don’t have that in terms of disease. There’s been a lot of argument of how you move from one to the next, and all of that conversation was revisited in 2010, and so my understanding is that the WHO’s global program is on elimination. Eradication has a slightly different connotation. I don’t think gene drive is going to be the panacea and I would be reluctant to say ‘well here we are, we have this wonderful new tool’, and of course I certainly hope that it turns out to be all that it promises to be, but like Liz was saying, I think that we don’t have enough evidence to make that claim. The reality is that we are going to have to rely on a multiplicity of tools and approaches. There’s the scientific and the technical, and a lot of the success is also going to depend upon all the bits coming together. So the scientific and technical in addition to the political will, the ethical acceptability, the social acceptability, the cultural acceptability, I think all of these pieces need to come together in order for malaria eradication or elimination to actually come to fruition.
JC: I think the historical answer is clear. The answer is No. Malaria has been eliminated from parts of the world, in Southeastern United States, southern Europe and other parts of the world through draining marshes, controlling breeding areas, and so on. So you can eradicate, and Claudia’s point is exactly right, as well as Liz’s: What’s the definition of the word? What do we mean by that? You can get at malaria in ways other than gene drives. Gene drives are one technique among many that can be used, and historically some very straightforward methods have succeeded. Eliminate the breeding places and you can certainly suppress or eradicate mosquitoes.
EH: One critique of the search for technological silver bullets against various infectious diseases suggests that low-tech approaches to eliminating disease vectors are often underfunded and might be more fully effective if they received the financial support that new technologies like gene drive inspire.
PGH: Do you think the ethical distinctions that come about from whether suppression, elimination or eradication is pursued as a strategy is well understood, and, going forward, can you offer ways in which we can think about them?
JC: Well, relative to the latter, as an ecologist, it’s going to be defined with respect to relative abundance to the species in any particular area, and then you’d let the words follow from exactly what kind of effect you want to have. If you’re thinking about just suppression, in a traditional sense you might think about reducing population size by some percentage. One of the advantages of that approach is that you still retain the organism as part of the ecosystem. That’s in contrast, with extinction where you’re eliminating the organism from the ecosystem with all the potential consequences of doing that, which in most instances aren’t very well understood. So if you’re goal is extinction, you need much more information before you go down that route, as opposed to just suppression. Suppression, of course, will have influences as well. Reducing a population size by half or by 90% will have consequences for the rest of the ecosystem. But if you have enough information about the ecosystem, then you can begin to model what’s going on.
CE: From the ethics side, I think these distinctions are important because once you have targeted a species, whether it’s for suppression or for elimination, for regional eradication or global extinction, I’m not sure what the difference will be in terms of what it means. On the acceptability side, I have no evidence for this, but we could surmise that someone might more readily accept a suppression technology because you’re winding the mosquitoes down until there’s still a few of them left. And regional elimination, well that’s OK because Malaria is such a big problem and mosquitoes are still going to exist elsewhere; whereas with global extinction people might start thinking about the finality of that choice. So in terms of acceptability, and unless we actually have empirical evidence for this, I’m just speculating, but I would suppose that there are tiers of acceptability in terms of what might resonate with folks.
On the moral side, if we start mounting logical arguments about ‘what does suppression mean’? Well, we might get different answers: some people might be opposed because it means we are deliberately eliminating a species, while others might be supportive because we aren’t modifying the organism and allowing it to persist. But people’s willingness to accept this and the implication of what it might mean in terms of the intention and motivation of what we’re doing, I’m guessing the moral difference is actually going to be quite small. That’s my initial take, but I think Ken disagrees with me.
KO: I think what we agree on is that reaction, debate and the intensity of discussion will vary as you go from one extreme, global extinction of a species, and extinction means global, to local modification of a species. So two dimensions there, and then add in warm, cuddly and fuzzy versus guinea worm or mosquito. I think we agree on that. In terms of talking about our ethical frames and arguments on these issues, here I would go back to the old fashioned deontological versus utilitarian, deontological versus consequentialist, and I would argue firmly that under conditions of uncertainty, pushing local, and maybe even modification over population suppression, makes a difference. The utilitarian/consequentialist arguments I make would partially be in terms of environment, and partially in terms of do you have a reserve and, partially if you screwed it up and are wrong, what are the consequences – assuming these are partial screw-ups and error. But again, the difference between those two very fundamental ethical perspectives matters enormously in debates over these technologies. So I’m not sure we even disagree.
CE: I think you’re right. With a consequentialist lens, looking across, there’s going to be significant differences. From a deontological perspective, at the end of the day, it’s not going to matter because if you determined that you don’t really care all that much about the mosquito, then you can modify or suppress it or eliminate it, i.e. you’re treating it as a means to an end. So, from a deontological view, its intrinsic value is gone. Does it have extrinsic value? Sure, it might have some niche that it occupies in the ecosystem. Is it an unassailable niche? We don’t know. Some early reports seem to suggest that it’s not but there’s so much uncertainty baked into all of this right now.
Principles and values are clearly important. You need to understand which ones you want to uphold, which ones you want to promote and preserve, but at the end of the day, it’s got to be practical.
KO: And the difference between those categories helps us maneuver in these debates. We actually agree, it’s astonishing.
EH: It’s also promising.
JC: The other thing we want to keep in mind in these issues relating to suppression and extinction is that we have a lot of history to draw upon. We’ve eliminated wolves, for example, at least locally, and regionally we suppress insects in agricultural fields all the time. These are cases to draw on to put some context on what’s going on with gene drives. What might make them so special or so different? How do we have to think about them differently – or not – than has been the case up until now?
CE: The motivations and the end goal aren’t new, it’s the means that’s new, and I guess the question then becomes – what is so unique about the means, and are the implications so different? That’s what we need to grapple with.
PGH: Finally let’s revisit Ken’s point about how defining whether we’re talking about gene drives in terms of the global or the local and how other current research into gene drive impacts the statements we’ve heard so far. What effect do they have on your responses?
JC: If you can think just in terms of a ‘local’ as opposed to a ‘universal’ gene drive, it potentially minimizes a variety of other things that have to be considered related to governance. When you’re thinking about ‘local’ you have, as Ken suggested, the gene drive technology refined to the point that you can be using it with the kind of precision that is being suggested, so local drives could be very helpful in that regard.
KO: So the technical and the broader ethical engagement issues come together right here. The precision Jim is talking about as an environmental geneticist is well taken, it works maybe better if you can actually focus the applications on those areas that you really want to have an effect on. But, all of those questions on regulation, international conventions, who should be involved are affected by whether the effects are in fact local or global, and every issue, for example what is the role of advanced industrial countries that are not malarial, what is the voice of the patients or potential patients, those affected by the disease relative to others, all of those tricky issues are affected by whether you are talking local or global. It is highly desirable that safeguards be developed and that there be a broader discussion on their significance and credibility.
EH: And because the science of gene drive is not a simple matter, engaging in that broad-based discussion of regulation is even more challenging than if it were simply a question of values.
JC: And we don’t have exceptionally clear ways forward in terms of how handle these issues. The National Academies’ report on gene drives suggests some ways to move forward, but we need a lot of research in this area.
KO: In terms of timing, it needs to be sooner than later, both in terms of the technology development but also the broader discussion on evaluation of the technologies, their credibility and their significance.