Is genetic modification the future of fighting disease?

The ability to precisely edit DNA and swap genes in or out with unprecedented precision has the power to transform virtually every field.

People with haemophilia have come off life-long clotting medication, and the first genetically engineered corals could help these factories of the ocean survive rising temperatures and acidification.

But the application of this technology to create modified, or entirely new organisms that are then released into the environment and become fixtures of the gene pool carries a raft of ethical questions and uncertain risks.

While the boundaries of gene editing technologies such as Crispr Cas-9 and its successors have yet to be reached, scientists who have demonstrated their potential in the lab are now being limited by how to test it in the real world.

US researchers on Thursday showed a gene edited fungus which only targets mosquitoes and was able to essentially wipe out a population in trials in a controlled village setting in Burkina Faso, West Africa.

Crucially it worked against mosquitoes resistant to conventional insecticides, a growing threat which threatens to roll back progress made in controlling malaria which still kills nearly half a million a year.

But the village, enclosed in a 6,500 square foot net dubbed the MosquitoSphere, is about as close to a real world trial as we are likely to get for many years.

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“You can’t go releasing transgenics without consent, that’s the biggest thing,” said Dr Tony Nolan, a senior lecturer at the Liverpool School of Tropical Medicine.

Dr Nolan was not involved in the study, but he works on controlling mosquitoes with a genetic technique that could render the insects infertile.

To get as far as they did, the Maryland University researchers worked with central and local government, building the trust of local communities and sticking to protocols laid out by health and environmental agencies.

But in many cases GM research, such as blight resistant potatoes being developed in East Anglia, have faced staunch opposition and even sabotage.

These concerns centre on the unknown risks: of potential harm to humans; the impact of wiping mosquitoes out of an environment; of a supercharged fungus mutating and turning on friendly pollinators that underpin our food supply; or the corporate interests that stand to gain.

But many scientists, such as Dr Nolan, believe we cannot ignore the changes humans have already wrought with less sophisticated technology when weighing the risks of genomics.

Widespread use of insecticides that do not distinguish between mosquitoes, butterflies or beetles are causing a collapse in biodiversity in the UK and beyond.

“We can focus on what if here? What if there? But what if we don’t do anything? That’s the big question,” he said.

“Two hundred million people are infected with malaria, 400,000 to 500,000 deaths every year, many of them children under five.”

It is unlikely this will ever be satisfactorily solved to everyone’s liking.

But the recent scandal around Chinese scientist Dr He Jiankui –​ who claims to have edited the DNA of at least two children who have now been born in a bid to make them immune to HIV –​ shows that not everyone is willing to wait for permission to make their mark on the genomics frontier.

While increasingly large enclosures can help simulate the real world and understand this technology’s potential benefits and risks, there will come a point where the door will have to be opened and we all have a duty to see it is done for the right reasons.