Case Study - Malaysia

1. Case Study - Malaysia ISBGMO11 Workshop on GM Mosquitoes

2. Dengue and chikungunya in Malaysia • Dengue (serotypes 1 to 4) and chikungunya are 5 viral fevers effectively • US$133 million/year cost to Malaysia (Lee et al. 2009), 78% on clincial healthcare • Up to another US$ 171 million tourism loss if there is a severe outbreak Aedes aegypti is not native to Malaysia; It is an African mosquito which spread around the tropics due to human activity (e.g. used tyres) only a century ago.

3. Malaysia: reported and projection in 2010 with existing vector controls

4. Oxitec Dengue Project in Malaysia • Dengue costs Malaysia mean $133m pa in vector control and healthcare • Govt Dengue Strategic Plan calls for 10% reduction in cases per year • Oxitec invited to trial OX513A (A. aegypti) by Ministry of Health – collaboration since 2006 • 3 years independent evaluation by the Institute for Medical Research (IMR) • Laboratory trials • Field house Purpose built quarantine field-house

5. Laboratory No significant difference between OX513A and control wild type strain in all life history parameters • Field House No statistical difference in mate selection between wild type and OX513A of either background Minimum standard for Medfly

6. Field site selection • Over 50 potential sites identified and entomological surveys conducted • Field site criteria • 2-8000 human pop • geographically isolated • cooperation of local authorities and community • stable mosquito population • 3 sites with > 1 year of mosquito population monitoring data • 1st Site Bentong • 2nd Site Melaka

7. Decision process – Open field release Oxitec Limited Malaysian Biosafety Act 2007 (implemented Dec 2009) • Institutional Bio safety committee June 2009 • Ethics committee August 2009 • GMAC – June 2010 • National newspaper advertisements Aug 2010 • Public comment period Aug –Sept 2010 • NBB – Oct 2010 • Cabinet Approval –Oct 2010 • State Approvals ongoing

8. Risk Assessment • UNDP sponsored Risk Assessment Workshop >70 Malaysian Scientists • Published outcome • Follow up risk communication workshop Oxitec Limited

9. Community Engagement in Malaysia – Reactions to Dengue “Sad to see loved ones suffer, in pain and yet don’t know how to help…” Sad “Scared of losing loved ones…” Scary “Doctor said my son only had 50% chance of survival…” “Don’t know what to do… high fever not subsided after days or despite completed full course of medications, after seeing so many doctors” Helpless “Don’t understand what is happening…confused…” Confused “Can’t bear to see loved ones in pain…” Painful “Have to stand the pain…” “Can’t eat or sleep at night…” Not able to care for kids/ family “Feel sorry for my kids, for not having mom around them…” Not able to work

10. Community Engagement in Malaysia Oxitec Focus Group: reactions to GM Mosquitoes breakthrough! good news kills larvae good – something worth trying going forward provides immediate solution / result in preventing Dengue seen as a long term solution compared to other methods which are all seen as short term Some welcomed the research team to test the technique in their community Community engagement

11. Press – Neutral to positive coverage Malaysia to carry out landmark GM mosquito trial (Oct 10, 2010) Oct 10, 2010 M'sia's GM mosquito trial Field testing approved for GM mosquitoes ( 11 Oct 2010) War on dengue: No decision on genetically modified mosquitoes (10 Sept 2010) Don't reject GM Aedes mosquitos just yet ( 24 Aug 2010) Monstrous mosquitoes? (6 Sept 2010) New hope to eradicate dengue fever worldwide (10 Aug 2010) Oxitec Ltd