Direct Talk

Mosquitoes.

By transmitting various infectious diseases,

they kill more people every year
than any other creature,

taking around 700,000 lives.

Australian entomologist Scott O'Neill

has been fighting mosquitoes
for nearly four decades.

Scott O'Neill
CEO, World Mosquito Program

He focused on the
Wolbachia genus of bacteria,

which are regarded as a game-changer

because they obstruct the growth of viruses
in a mosquito's body.

His aim was to prevent the spreading
of dengue fever and other diseases

by increasing the number in the wild
of harmless mosquitoes

unable to transmit viruses.

The pilot project in Indonesia
showed epoch-making results –

a nearly 80% reduction in dengue incidence.

The latest project taking place
on the Indonesian island of Bali,

one of the world's
worst dengue fever hotspots,

aims to make the island dengue-free
in just a few years.

Elimination is a very big goal.

We were able to take an idea

into having an impact, a positive impact in
the lives of millions and millions of people.

And so, I just feel like I'm incredibly
fortunate to be in that moment in time.

This is the story of one scientist

who has been fighting
to bring a new dimension

to the human battle against the mosquitoes.

Battle Against the Mosquito

Bali, Indonesia

The Indonesian island of Bali,

one of the world's
most famous sightseeing spots.

But recently the island has faced
a serious rise in dengue-fever incidence,

with more than 10,000 cases every year.

This is my second time to be infected with dengue.
Last time was 3-4 years ago.

Probably I was infected in the market I work.

Today, Scott O'Neill is
visiting a residential area

in Denpasar, the capital of Bali.

Any luck huh?

Catching mosquitoes here
to study their growing conditions

are staff of the
World Mosquito Program, or WMP,

a not-for-profit company
of Monash University in Australia.

According to O'Neill, WMP's CEO,

people living in densely
populated areas in tropical climates

always face risks from mosquitoes.

There's a lot of people
living in a small space and

it's like a buffet
for the mosquitoes to bite.

We have such high levels of disease
in communities like this.

Mosquitoes living in the house,
biting people every day.

And if it gets the virus, then it just keeps
transmitting it on to people every day.

Often for the diseases I work on
like dengue, chikungunya, zika...

it's an indirect problem as well.

It's a social and economic problem
in poor communities.

Where people don't have
good living conditions,

good housing to prevent themselves
from being bitten by mosquitoes.

In some of these huge tropical cities
at the moment, we see rapid development,

we don't have good infrastructure
for water and waste management

which provides great conditions
for mosquitoes to breed.

One of the most threatening mosquito
species in urban area is Aedes aegypti,

which transmits various types of
infectious diseases – especially dengue.

Climate change has widened
the habitat areas for this mosquito.

According to the World Health Organization,

the number of global dengue fever patients

has increased more than
10 times in two decades.

We see cities or elevations where
typically there weren't disease,

we think now disease is starting to appear.

For example, with dengue, in Nepal,

it's showing large amounts of disease
where 10 years ago we wouldn't see that.

Even in Tokyo, you had some dengue recently,
which typically you wouldn't see.

And this year too in Europe...
we're seeing dengue transmission in Europe.

Clearly, it's getting worse.
We see it very clearly.

Outbreaks are bigger.

More people are getting sick.
Hospital systems are more strained.

You know, when we had Covid start,

everybody was very fearful that
Covid would cause hospital systems to break.

Well, that's what happens
all the time with dengue.

You want to try and avoid
being bitten by mosquitoes if you can.

But it's very difficult.

I'm a mosquito expert.

And I was living in Ho Chi Minh City
recently for three years.

I couldn't control the mosquitoes
around my house in Ho Chi Minh City.

I was being bitten.
My child was being bitten.

My wife was being bitten.

And we were using insecticides
to spray around the house.

But they were very ineffective.

They're becoming less and less effective

because the mosquitoes
are becoming resistant

to the chemicals in the insecticides.

In my opinion, spraying insecticide
is not an ideal thing.

Insecticides are nerve poisons.

They don't just target the mosquito,
they target all insects,

and fish and other animals.

So, when you're applying insecticides
into the environment,

you're having a massive impact
on the ecosystem.

O'Neill has established a unique way
to eliminate the threat of mosquitoes

after nearly 40 years of research.

He has focused on Wolbachia, the naturally
occurring genus of insect bacteria

found in an estimated 50% of insects,
including moths and butterflies.

O'Neill discovered that when Wolbachia
are injected into mosquito eggs,

viruses such as dengue cannot grow
in the adult mosquito body.

WMP has been breeding
massive numbers of "Wolbachia mosquitoes"

to release into nature.

When those "Wolbachia mosquitoes"
mate with the wild mosquitoes,

their young are born with Wolbachia bacteria.

As the total number of harmless
mosquitoes increases in the wild,

it will prevent epidemics
of infectious diseases.

When the mosquito has the Wolbachia,
the virus can't grow in the mosquito's body.

So, if the virus can't grow,
then it can't be passed between people.

So, you have a system with this bacteria,

where the bacteria could spread
into the wild mosquito population

and make the mosquitoes harmless to people.

Not kill them, but make them
unable to transmit virus to people.

They mate with the wild mosquitoes.

The Wolbachia spreads into
the wild mosquito population.

And when you have
enough mosquitoes with Wolbachia,

you'll see human disease stop.

Because there's no transmission
occurring between people of the viruses.

The mosquitoes will still bite us,
but they won't cause any disease.

And so, it goes from being one of our biggest
enemies to being ineffective at killing us.

The new approach invented by O'Neill was
tested via pilot projects in many countries.

Notable results were found in Yogyakarta,

Central Java's major city, where
the mosquito release was launched in 2014.

Wolbachia deployment reduced
dengue incidents in the area

where the mosquitoes were released by 77%.

The results were published in the prestigious
New England Journal of Medicine

and attracted great attention globally.

When we got the results from it,

I think I was just relieved.

I think I'd been doing this
for so long by that point

that I was relieved that it was working
the way we thought it was going to work.

Once we get Wolbachia up above 80%,

in the 80% of the mosquitoes
in the city have Wolbachia.

We're measuring reductions anywhere
between 80%, 75 to 80% reduction in disease

to up to 98% reduction in disease.

Some of the stories we heard from
the communities were interesting.

Mothers were bringing their children
into day care to be looked after

in locations where we had done our pilots
because they were convinced themselves

that their children would be
safer in those locations.

But the price of housing had gone up
in an area where we had treated it

because people considered it safe for dengue.

They could see with their own eyes
the impact it is having.

And I think at that point we realised that,

you know, this was going to
have a big, big impact.

O'Neill was born in Australia in 1962.

His father was a teacher
and his mother a florist.

He says surfing was more important
than studying in his boyhood.

At graduate school,

his professor told him about
the potential of the Wolbachia bacteria.

This attracted his attention,

and he continued researching Wolbachia
while teaching at university.

However, the research project
faced many difficulties,

technically and financially.

We actually had to put the Wolbachia
into the mosquito,

and that was really difficult technically.

If you could imagine
if you had a balloon,

and you filled the balloon with water
and then you had a knitting needle.

You know, for knitting a big long needle,

you had to stick that needle
into the balloon full of water.

And then pull it out again
without the balloon exploding.

It's a little bit, you know, difficult to do
something that doesn't work for 10 years.

Being a scientist is like
being a professional beggar.

And so, you spend a lot of time
asking people for money.

And it can be difficult to keep asking
for something if it's not working.

I think it's probably my personality
and maybe some mental illness

that you know, I can't let it go.

I would always come back to it and
I could never let it go even if I wanted to.

I seem to not be able to let it go.
It became an obsession in my life.

In 2004, to accelerate his research project,

O'Neill established an NGO
named "Eliminate Dengue."

This was the moment for the
very first release of the special mosquitoes

into the wild in an Australian city.

Bravo, mate!

The projects have expanded mainly
in Asian and South American countries,

often working with government agencies.

WMP's newest facility on Bali Island
started operating in 2023.

It is currently breeding
one million mosquitoes every week.

Listen to the sound...

Can you hear?

This is the main strains
we use around the world.

There were huge amounts of work
to produce these mosquitoes.

But now, we have millions of them.

It's great to see them.
I like them.

Eggs collected in the breeding facility
are put into these capsules.

And the capsules are
put into the breeding buckets

that WMP staff distribute
to residential areas.

It takes around 10 days after hatching
from the eggs for mosquitoes to become adult.

They fly out from the breeding
buckets one after the other.

But challenges remain on how to gain
the understanding of local communities.

Some residents feel uncomfortable about
having a mosquito release in their area,

so local WMP staff repeatedly engage
with the community to explain the project.

In Bali, local engagement
took more than a year,

but the mosquito release is now welcomed.

We are briefed those mosquitoes are safe.

We will cooperate so that
there are no harmful mosquitoes anymore.

For this project to be successful,
it has to be locally led.

So, you need to spend time with people
and visit many times and talk.

And as we start to actually do the releases,

the community becomes much more interested
and more attentive and want to know more.

What we are wanting to do here
is to essentially make Bali dengue free

so that there is no
local transmission occurring

and use Bali as a demonstration of
the power of the method for the region,

for Indonesia,
but also neighbouring countries.

WMP's projects have expanded in 14 countries

and they produce
billions of mosquitoes every year.

The next goal is
to accelerate global activities,

including in Africa,
which hasn't been touched much so far.

The next challenge is
what is the best way to scale this up?

So, the maximum number of people can benefit
from it in the shortest period of time.

13 million people we've protected so far.

I would be very happy
if we could move that number

from 13 million to 500 million
in the next 10 years.

After decades of challenges and struggles,
here is O'Neill's life motto...

Never give up.
Never.

I think many things in life...

it's easy to give up
if it doesn't work initially.

But if you believe in yourself
and you believe in the idea

and you believe in the people
that you work with,

don't give up.

Keep going to get what you're looking for.

Believe in yourself.
Stay with it.