Efficacy of Gene-Drive Modified Mosquitoes in Reducing Malaria Transmission among Children in Sub-Saharan Africa: A Controlled Review

Malaria remains a leading cause of morbidity and mortality among children in sub-Saharan Africa despite existing vector control and treatment strategies. Gene-drive modified mosquitoes have emerged as a novel approach to reduce malaria transmission sustainably by biasing inheritance to suppress mosquito populations or render them refractory to Plasmodium infection. This controlled review evaluated the efficacy of gene-drive modified mosquitoes in reducing malaria transmission among children in sub-Saharan Africa, synthesising evidence from laboratory, semi-field, and modelling studies. A controlled review approach was conducted by searching PubMed, Scopus, and Web of Science for articles published between 2010 and 2025 that assessed gene-drive mosquito efficacy in malaria control among children in endemic regions. Laboratory and semi-field studies demonstrate high inheritance rates of gene-drive constructs targeting mosquito fertility or parasite development, leading to rapid population suppression or refractoriness with minimal fitness costs. Modelling studies predict >90% reduction in malaria prevalence within 3–5 years of release, with significant declines in infection incidence, morbidity, and mortality among children. However, field-based efficacy data remain unavailable, and challenges such as resistance evolution, ecological impacts, regulatory preparedness, and ethical concerns regarding community consent and intergenerational effects persist. Gene-drive modified mosquitoes hold promise as a transformative vector control strategy to reduce malaria transmission among children in sub-Saharan Africa. Field trials, robust governance frameworks, and community-led ethical engagement are required to ensure safe, effective, and equitable deployment within integrated malaria elimination programmes.