Fourteen years after co-inventing CRISPR, Jennifer Doudna checks in on what it's become. The Nobel Prize-winning biochemist walks through the technology's biggest moments — the 2012 discovery, the 2018 CRISPR babies announcement, and today's $2 million but functionally curative therapy for sickle cell disease — alongside newer applications like reducing methane emissions from cattle farming.

Doudna also admits there is unfinished work ahead: the cost still keeping that cure out of reach for most patients, and the responsibility of guiding a technology she describes as a genie that can't go back in the bottle.

JENNIFER DOUDNA: I do remember the day we were talking about an experiment with CRISPR and we recognized right then that, you know, CRISPR was going to be a powerful technology. I went home and I was cooking dinner for my son, who was about six years old at the time. I was standing at the stove, I was boiling water for spaghetti or something like that, and I just burst out laughing in my kitchen and my son looked at me and he said, why are you laughing, mom? And I said, because bacteria have this crazy protein. They've evolved this incredible system for DNA binding and cutting.

We knew right away that the technology would be exciting, but I did not anticipate how much my life would change.

We published the paper reporting this finding in the summer of 2012. I started getting notes from my colleagues in different parts of the world, and they were starting to use CRISPR in different kinds of cells and organisms. So it was clear that there were a lot of people that had read this paper and recognized immediately the potential of this.

So CRISPR, it's a great acronym, but what does it mean? CRISPR, it stands for Clustered Regularly Interspaced Short Palindromic Repeats. I like to use the analogy of a word processor. It allows scientists to literally change the letters and words in the code of life to make alterations to cells and organisms. And that means that we now have the potential to do things that are quite profound, like changing disease-causing genes, and that's already being done. But it also means that we have the opportunity to change the course of human evolution if we choose to do that.

The announcement of CRISPR babies — these were babies that had actually had their genomes edited as embryos — was a really shocking thing at the time. Many people were caught off guard. It's one of those technologies that once the genie is out of the bottle, you can't really put it back. It's a moving target. And so I've had to figure out how to navigate that with CRISPR, you know, how to encourage responsibility among scientists around the world, and to wrestle with a powerful tool that has a lot of great potential, but it comes with some real risk.

When I first started talking about CRISPR for climate, I got a lot of quizzical looks, you know, people saying, what does CRISPR have to do with climate change? What does it have to do with the environment? Because of the nature of this technology, the way that it allows manipulation of genomes of any type of organism — microbes, plants, insects, all of the creatures that have to come together for agriculture to work. That means that we can manipulate the genes that are in microbes in the cow gut that are responsible for producing methane. Methane is a powerful greenhouse gas. A lot of the methane that's produced around the world from human activities comes from cattle farming. Imagine that we could mitigate that by using CRISPR to dial down the production of methane in those microbes. Sounds a bit science fiction-y, but we're doing it, you know, this is actually happening.

There's also an application that's called a gene drive. There are ways to set up CRISPR so that it can be passed quickly to other organisms in a population, like, for example, mosquitoes. People are thinking about this in terms of mitigating the impact of diseases that are mosquito-borne, which obviously would have tremendous public health impact if it could be done safely. There's also the flip side of it, though, of asking, could this lead to an undesired or uncontrolled spread of a trait in a population that might be dangerous in the environment in some way, or wipe out a population of insects that are actually providing food for something else in that ecosystem?

So it just means that we can't ever sit back and say, well, our ethical work is done. We have to continue to look into the opportunities and the risks and grapple with them to encourage responsible use of CRISPR both in human health applications but also in environmental uses.

Well, it's interesting, in the CRISPR field, there's always something going on, whether it's creating dire wolves or the latest breakthrough in human embryo editing. But I don't think there's anything that gets attention as much as helping people that have incurable disease. I think that's something that speaks to every one of us. We've all had health challenges in our families, and I hear almost daily from people that are dealing with health challenges, often with their children. There's something very deep and visceral about a technology that can truly change the course of the life of a person that would otherwise be doomed to a terrible course of disease.

I'm incredibly excited about the FDA approval of a drug based on CRISPR. We're using that now as a therapy for patients that have sickle cell disease. This is a devastating disease. It really was disruptive to people's lives. And, you know, this CRISPR therapy is a one-and-done therapy, and it provides what looks like a functional cure to the disease. So it's amazing for patients. Now, are we done? Can we just say, great, we'll give everybody this therapy that needs it? Unfortunately not, because it's expensive. You know, it's a $2 million price tag right now for this therapy. And so thinking about how to bring down the price tag there is something that we work on a lot. It's going to require some technical advances that we don't have today, but also I think it's working with manufacturers to figure out how do we make these molecules in a more efficient way that's been done before. So I think there's some really interesting opportunities there to scale up a therapy so that we can treat hundreds of thousands or millions of people.

But it is happening. There's never been more going on in science than there is right now. Technical breakthroughs are extraordinary. The advances in AI are accelerating biology. We have more opportunities now than ever before to not only understand the causes of disease, but actually deal with them. How are we going to immunize people against Alzheimer's? I mean, that would be extraordinary. CRISPR could potentially do that. Prevent people from having heart attacks — CRISPR can potentially do that. I think the longer-term challenge is how do we apply science in ways that will be truly meaningful? In terms of human health, in terms of our environment, and to manipulating other kinds of organisms that are going to affect our life on the planet Earth.