Abstract

Malaria remained a leading cause of morbidity and mortality globally, with Anopheles gambiae serving as the 
primary vector in sub-Saharan Africa where 95% of malaria deaths occur. Traditional vector control methods face 
increasing challenges from insecticide resistance and behavioral adaptation, necessitating innovative approaches. 
This narrative review examined the molecular mechanisms, population dynamics, and translational potential of gene 
drive technologies for A. gambiae suppression. A comprehensive literature search was conducted across PubMed, 
Embase, and Web of Science databases from 2015-2024, focusing on CRISPR-based gene drives, population 
modeling studies, and field trial data. Current evidence demonstrated that engineered gene drives can achieve 
theoretical population suppression through mechanisms including fertility reduction, sex-ratio distortion, and 
homing endonuclease systems, with laboratory studies showing inheritance rates exceeding 90% in some constructs. 
However, significant challenges persisted including resistance evolution, ecological risk assessment, and regulatory 
frameworks for environmental release. Mathematical models suggested that gene drive efficacy requires sustained 
inheritance rates above 85% and careful consideration of population structure and migration patterns. The 
technology represents a promising complementary tool to existing vector control strategies, though comprehensive 
safety assessments and community engagement remain prerequisites for field implementation.