Krystal Birungi is a malaria advocate and entomologist at Target Malaria, working on one of the most promising innovations in the fight against malaria: gene drive. This breakthrough tool is designed to stop mosquitoes in their tracks and could change what’s possible in malaria prevention. We spoke with Krystal to understand how gene drive works, what gives her hope, and how science is bringing us closer to a malaria-free world.

Congratulations on being named a 2025 Goalkeepers Champion by the Gates Foundation! What does this acknowledgement mean to you personally and professionally as an advocate for malaria elimination? 

BIRUNGI: It was pretty exciting and also very validating. Malaria has been around for so long that, for many people, it can seem like it’s no longer a big deal. It’s incredible how it can be glossed over that we’re losing over half a million people a year to a disease that we’ve been fighting for decades. You don’t often get recognized for work in this field, so it means a lot to have something I’m working towards be acknowledged. 

I was also delighted that this brought such a large platform to the fight against malaria. It has helped draw more attention to what we’re doing, why we’re doing it, and the potential it holds to defeat the disease. This year’s Goalkeepers event and being named a champion, is something I’m incredibly grateful for – not just for myself, but for the impact that it can have for malaria.

Was there a defining moment in your life that drove you to dive deeper into malaria and entomology as a career?

BIRUNGI: Yes, there was a defining moment that set me on this path. That moment came when I was about 10 years old and my little brother had malaria. He was five, and I remember my mother sponging him off with a cool cloth all night, trying to keep his temperature down. By then, there was medication for malaria, but we could not afford it. At the time, I felt like there was nothing we could do about it, except pray.

That all changed when I was about 14 years old. The Global Fund stepped into action and began funding free mosquito nets, medication, and village health workers so people in our community could diagnose and treat malaria. Suddenly, this disease was not such a boogeyman after all. That’s when I decided that I was going to find a way to combat malaria. 

What progress have you seen in the communities you work with that gives you hope for continued malaria elimination?

BIRUNGI: There’s been so much progress. If you look at what my world looked like when I was growing up and what you see today, the difference is massive – and a lot of that is due to organizations like the Global Fund. 

In Uganda, when I was a child, about one in three children didn’t make it to the age of five. Today, that number is about one in 25. That’s a massive difference. I work in rural communities now where every household has at least one mosquito net. Growing up, I did not own a single mosquito net until the Global Fund distributed them – and even now, most people couldn’t afford one without a subsidy.

What we have now is hope. If you look at someone like me, who couldn’t afford medication or bed nets as a child, I would have faced repeated bouts of malaria. But because of the Global Fund, I was able to go to school instead of spending money on treatments. And because of that, today, I can afford healthcare for my children and contribute to the fight against malaria – not only to save lives, but to work on a technology with far-reaching applications beyond malaria. You don’t just save a life; you’re saving a future. We still have a way to go, but the difference is absolutely visible.

Could you briefly explain what gene drive is and how it works?

BIRUNGI: To explain gene drive, I must begin with genetic modification. The challenge with malaria elimination is the sheer scale of the issue – there are just so many mosquitoes spreading the disease. 

We have over 3,500 species of mosquitoes in the world, but only one is responsible for almost all malaria cases in Uganda, and three for nearly all malaria in Africa. If we could reduce those mosquito populations, we could reduce transmission.

We can do that by modifying the mosquito’s genetics, so it lays only a few eggs instead of the 300 eggs it would normally lay. That is genetic modification. The problem is that genes are only passed down about half the time, which means they are wiped out pretty quickly.

That’s where gene drive comes in. To make the modification more effective, we add what we call a ‘gene drive’ which makes sure that this modification is passed down almost 100% of the time, so all offspring inherit the change. That means you can release fewer mosquitoes, and each generation spreads the modification further. It’s more efficient, sustainable, and cost-effective. 

What potential does gene drive have in the fight against malaria?

BIRUNGI: Gene drive has the potential to add a complementary tool to those that are already doing a great job. Nets and sprays are protecting people when they’re home, but gene drive can fill the gap these tools can’t reach. It means that when you’re outside, there are fewer mosquitoes to spread malaria. 

It could be especially helpful in remote areas where health systems are weak, in areas where mosquitoes have developed resistance, or for migratory communities that prefer to sleep outdoors so a mosquito net may not be as practical. Gene drive can still work because it only depends on mosquito mating. 

Most importantly, it gives us a chance to get ahead of malaria. If we can combine existing tools, and then gene drive allows us to reduce the mosquito population that spreads malaria, then ideally, we could diagnose and treat people with malaria and wipe it out before the mosquito population could recover. And then if it recovers after that, it won’t matter – we would have eliminated malaria. So that’s what’s really cool about gene drive: it’s ability to work with our current tools to fill the gaps the toolbox can’t reach yet. And that could give us a real shot at elimination.

What are your thoughts on any concerns or criticisms that have been raised about gene drive?

BIRUNGI: It’s important to remember that gene drive is a very heavily regulated field of research. There are strict regulatory requirements you must meet to be able to conduct the research, and eventually, to use it. I think if people understood more about how gene drive works and how carefully it’s being managed, they might be less nervous about it. 

The other thing I’d tell people is to think about the cost of inaction. We can’t afford not to try something new. We’re losing up to half a million people to malaria every year, most of them are children, so we should use every tool we’ve got in the box. A lot of research has gone into developing these tools and making sure they’re safe. We owe it to the people whose lives depend on this to remember that the real risk is doing nothing. 

If you could leave people with just one takeaway about the potential of gene drive to eliminate malaria, what would it be?

BIRUNGI: Now is a really exciting moment. We’ve been in a race against malaria evolving and resisting – and sometimes it has looked like we’re in danger of losing that race. But we’ve reached a moment where innovation gives us a real chance to cross the finish line. Everything from next-generation nets to new insecticides, vaccines, and now gene drive – they all bring us closer. Gene drive has the potential to be a powerful addition to that toolbox. And we’re going to need everything to cross that finish line.

We also owe it to the people that fought this fight before us and all the resources that have gone into this effort. If we stop now, we not only risk going back, we risk possibly facing something worse. For the first time in decades, we’ve seen local malaria transmission in the U.S.A, and I don’t think people see how alarming this is. As someone who works in malaria, I’m concerned. I don’t want to see us go back. We cannot be the generation that lets that happen after all the work it took to get us here.

Watch Krystal’s segment at the 2025 Goalkeepers event: