Last year, I wrote about the promise of gene drives to wipe out mosquito species and end malaria. In the time since my previous writing, gene drives have still not been used in the wild, and over 600,000 people have died of malaria. Although there are promising new developments such as malaria vaccines, there have also been some pretty bad setbacks (such as mosquitoes and parasites developing resistance to commonly used chemicals), and malaria deaths have increased slightly from a few years ago. Recent news coverage[1] has highlighted that the fight against malaria has stalled, and even reversed in some areas. Clearly, scientists and public health workers are trying hard with the tools they have, but this effort is not enough. Gene drives have the potential to end malaria. However, this potential will remain unrealized unless they are deployed – and every day we wait, more than 1,600 people (mostly African children) die. But who should deploy them? I’m well aware of the Unilateralist’s Curse, and before publishing this post, I asked, why haven’t existing groups already released gene drive mosquitoes? Academic labs, and the nonprofit organization Target Malaria, have been working on gene drives for several years already, but they have been taking a cautious, incremental approach.[2] There are several good reasons for this: * Unilateral release of a gene drive is likely to cause public backlash, because genetic engineering is widely perceived as scary. This is especially true if the organization releasing the gene drive does not have support from the local government. * The first version of any gene drive released into the wild is unlikely to cause complete eradication because mosquitoes may become resistant (either through natural or nuclease-induced mutations).[3] Therefore, updated gene drive versions will likely be required to overcome resistance. The number of potential gene drive target sites in the mosquito genome is big enough that I don’t think this wil