Abstract

Malaria remained a devastating parasitic disease, with Anopheles mosquitoes serving as obligate vectors for 
Plasmodium transmission, accounting for approximately 249 million cases and 608,000 deaths globally in 2022. 
Traditional vector control strategies faced increasing challenges from insecticide resistance and operational 
limitations, necessitating innovative genetic approaches. Gene drive systems represented a revolutionary molecular 
technology capable of biasing inheritance patterns to spread desired traits through wild mosquito populations at 
super-Mendelian frequencies. This narrative review critically synthesized current evidence on gene drive 
mechanisms, ecological safety considerations, and malaria elimination potential in Anopheles species. A 
comprehensive literature search was conducted across PubMed, Web of Science, and Embase databases (2015–2025) 
using keywords related to gene drive, CRISPR-Cas9, Anopheles, malaria control, and ecological risk assessment. 
Current evidence demonstrates that CRISPR-based gene drives can achieve population suppression through female 
sterility mechanisms or population modification through anti-Plasmodium effector genes, with laboratory trials 
showing transmission rates exceeding 90% within 10–20 generations. However, significant challenges persisted 
regarding drive resistance evolution, off-target ecological effects, containment strategies, and regulatory 
frameworks for environmental release. Gene drive technology held transformative potential for malaria elimination 
but required rigorous field validation, comprehensive ecological monitoring, and transparent community 
engagement before operational deployment.