OPINION

OPINION
Allow Golden Rice to save lives
Felicia Wua,b,1 , Justus Wesselerc,1 , David Zilbermand,2 , Robert M. Russelle,f , Chen Chena,g , and
Adrian C. Dubockh

Vitamin A deficiency (VAD) has killed millions of declining, it was estimated to be 266,200 (4) at the
children in less-developed countries for at least the start of the millennium.
last three decades—roughly 2 million annually in The consumption of the genetically modified rice
the early 1990s alone (1–4). Although the number is variety known as Golden Rice (GR) offers a potent and
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Widespread consumption of the genetically modified rice variety known as Golden Rice offers a potent and cost-effective
strategy to combat vitamin A deficiency. Image credit: International Rice Research Institute; photo licensed under CC BY 2.0.

a
Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824; bDepartment of Agricultural, Food, and
Resource Economics, Michigan State University, East Lansing, MI 48824; cAgricultural Economics and Rural Policy Group, Wageningen University
6708 PB Wageningen, The Netherlands; dDepartment of Agricultural and Resource Economics, University of California, Berkeley, CA 94720;
e
Tufts University School of Medicine, Boston, MA 02111; fTufts University School of Nutrition, Boston, MA 02111; gSchool of Public Health,
Shandong University, Jinan, Shandong Province, China; and hGolden Rice Humanitarian Board, Binningen 4102 Switzerland
Author contributions: J.W., D.Z., and A.D. designed research; F.W., J.W., C.C., and A.D. performed research; F.W., J.W., and C.C. analyzed
data; and F.W., J.W., D.Z., R.R., C.C., and A.D. wrote the paper.
Competing interest statement: A.D. is a member and the Executive Secretary of the Golden Rice Humanitarian Board. He is a volunteer,
unpaid and without grants. R.R. is a member of the Golden Rice Humanitarian Board. He is a volunteer, unpaid and without grants. The
Golden Rice Humanitarian Board ([Link] holds the rights for humanitarian applications of the nutritional technology
created by Professors Ingo Potrykus and Peter Beyer and related licensed technology. The Board is not legally incorporated in any way. It is
a group of individuals who voluntarily share the objective of making Golden Rice available to resource-poor populations as a public good,
delivered by the public sector in locally adapted and preferred rice varieties, at no greater cost than white rice and with no use limitations
except export. All other authors declare no competing interests.
Any opinions, findings, conclusions, or recommendations expressed in this work are those of the authors and do not necessarily reflect the
views of the National Academy of Sciences.
This open access article is distributed under Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND).
1
F.W. and J.W. contributed equally to this work.
2
To whom correspondence may be addressed. Email: zilber11@[Link].
Published December 15, 2021.

PNAS 2021 Vol. 118 No. 51 e2120901118 [Link] j 1 of 3

 cost-effective strategy to combat VAD. But this innova- 6% and is applied to only about 1 million metric tonnes
tion has been cast aside owing to fear or false accusa- of rice of the roughly 25 million metric tonnes pro-
tions, resulting in numerous lives needlessly lost (1–3). duced in Bangladesh per year (11). GR, by contrast,
With the recent exception of the Philippines, govern- poses no extra cost to governments, growers, or con-
ments have not approved the cultivation of GR (5). We sumers in comparison with white rice.
believe it should be broadly approved and given the Meanwhile, VAD has continued to cause severe ill-
opportunity to save and improve lives. ness and death among certain populations worldwide,
In high-income nations where populations have especially children (12). The total estimated deaths
access to a diversity of foods, VAD is rare. In many from VAD-related diarrheal diseases and measles in
low-income nations, however, populations have limited children under five years of age in 2013 was 94,500 and
access to foods rich in vitamin A or beta-carotene, a vita- 11,200, respectively, totaling 105,700 deaths across
min A precursor; hence, VAD rates can be dangerously the world (4). Had GR become a part of diets in vulnera-
high in children. There have been recent improvements: ble populations worldwide, a portion of these lives
from 1991 to 2013, the VAD rate among children in low- might have been saved. Hopefully, approval of the
and middle-income countries declined from 39% to commercialization of GR in the Philippines will provide
29%, with notable improvements among children in East impetus for Bangladesh and other nations with high
and Southeast Asia (4). However, children in sub-Saharan VAD rates to provide poor consumers with an option
Africa and South and Southeast Asia continue to dispro- that may save lives and improve health.
portionately experience VAD and its associated risks:
infectious and diarrheal diseases, irreversible blindness Unnecessary Delays
and other sensory losses, and premature death (1, 4, 6). Those who oppose transgenic or genetically modi-
VAD has not been eradicated despite a variety of fied organisms raised concerns that led policymakers
strategies used globally, including education on the to delay the approval of the technologies (13). One
value of dietary diversity, promotion of home gardens argument relates to biotechnology company profits.
and maternal breastfeeding of infants, and community But because the GR technology to the public sector
health programs including vitamin A supplementation is available at no cost for humanitarian uses, this con-
with syrups or capsules (7). Principally, VAD is caused by cern is irrelevant. There are no limitations, except
insufficient dietary diversity, a result of poverty and export, on GR use: replanting or selling or giving
agronomic and market constraints. Animal source foods away seed, or polishing for consumption or sale.
and many kinds of produce are unavailable or expen- Greenpeace summarized a food security-related
sive in local markets. Conversely, white rice or other objection to GR in a 2012 statement (14): “If introduced
on a large scale, GR can exacerbate malnutrition and
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cereal grains are easily available and inexpensive but

primarily contain carbohydrates while lacking sufficient ultimately undermine food security.” The implication:
micronutrient levels. GR will worsen malnutrition because it leads to a diet
GR, developed first in the 1990s and then modi- based on one staple. However, the replacement of tradi-
fied in 2004 with transgenes from maize and a com- tional rice with GR would not exclude the development
mon soil bacterium Erwinia uredovora, could be an of diversified diets; in the meantime, vitamin A status
important public health intervention for VAD popula- could improve for many in the population. And optimiz-
tions worldwide. This transgenic, or genetically modi- ing vitamin A delivery could improve public health in
fied, rice produces beta-carotene, a precursor to at-risk populations.
vitamin A, in the normally white endosperm (8) and A reasonable objection concerns possible human
has proven an effective source of vitamin A in or environmental health risks. The United Nations
humans (9). GR* is now awaiting final approval in Ban- (UN) Cartagena Protocol on Biosafety (15) provides a
gladesh. In July 2021, it was approved for cultivation framework for the regulation of genetically engi-
in the Philippines. Other countries will likely follow. neered crops in many countries, emphasizing the
A recent study has estimated that substituting Precautionary Principle in assessing risks, and leaving
GR for conventional rice could provide 89% to 113% out assessment of benefits. This Protocol was signed
and 57% to 99% of the recommended vitamin A in 2000 and became effective in 2003, in the rela-
requirement for preschool children in Bangladesh tively early days of agricultural genetic engineering.
and the Philippines, respectively (10). Even if there Since then, multiple studies have reported on bene-
were no other sources of vitamin A in the diets, this fits of genetically modified organism (GMO) adop-
boost in dietary beta-carotene could do much to tion through increased yields, reduced pesticide use,
prevent diseases associated with VAD. improved farmer income, reduced prices to consum-
GR is also financially viable. In Bangladesh, the cur- ers, and in some cases even improved food safety
rent practice of fortifying rice with vitamin A and zinc (16). Meanwhile, there have been no confirmed inci-
using food additives, although supported by the World dents of adverse human health or environmental
Food Programme, increases the cost of rice by 5% to effects from genetically engineered crops during
nearly three decades of global use (16).
*Many transformation events were produced (8), from which Transgenic crops are subject to many required reg-
event GR2E has been selected on the basis of molecular struc- ulatory tests before approval, including animal feeding
ture and insertion in the rice genome, together with agronomic
performance. It is the basis of the regulatory data generated and in vitro studies for toxicity and allergenicity. Yet
and is the only form of GR which is offered for approval and use. opponents of these crops have continued to amplify

2 of 3 j PNAS Wu et al.
[Link] Allow Golden Rice to save lives
 suspicion on the long-term health effects of genetically based on emotion and dogma contradicted by data
engineered crops (17). Protection against such risks must be stopped” (18).
can be achieved through monitoring of the perfor-
mance and the impacts of technologies and interven- Questioning Science
ing when setbacks occur. However, the food safety The arguments used by organizations to delay adop-
assessments for transgenic crops in many countries are tion of GR often resemble the arguments of anti-
more demanding than for conventionally bred varie- vaccination groups, including those protesting vaccines
ties. In fact, often less is known about the properties of to protect against COVID-19. Some of the opponents
plants developed by conventional mutagenesis than of GR and agricultural biotechnology more generally
those developed by transgenic methods. see the introduction of GR as forcing the consumption
Another concern is that GR genes may intermingle of GMOs on the population. However, for the case
with those of conventionally bred rice varieties. This of GR, consumers have the option of easily avoiding
uncertainty, however, applies not just to GR but also to consumption because GR is very easily identifiable
any other new rice variety. Humans have consumed rice by its color.
for more than 4,000 years, including varieties that have The tragedy of GR is that regulatory delays of
been crossed genetically across multiple strains. Trans- approval have immense costs in terms of preventable
genic methods of introducing novel genes is not inher- deaths, with no apparent benefit (13). The approval
ently of greater concern, unless those genes produce of GR is even more urgent with the ongoing pan-
proteins with potential adverse health effects—someth- demic, which has made access to healthcare services
ing that food safety tests for approval can determine. more difficult in vulnerable populations worldwide.
Clearly the lives saved with VAD outweigh concerns The World Bank has recommended that micronutri-
about these so-called unknown risks. In response to ent biofortification of staple crops, including specifi-
such criticisms, in 2016 more than 150 Nobel Laureates cally GR, should be the norm and not the exception
have signed an open letter to the UN, governments of in crop breeding (19).
the world, and Greenpeace, urging a more balanced Golden rice can effectively control VAD. Delaying
approach toward genetically modified crops in general the uptake of a genetically modified product shown
and GR in particular: “Scientific and regulatory agencies to have clear health benefits has and will cost numer-
around the world have repeatedly and consistently ous lives, frequently of the most vulnerable individu-
found crops and foods improved through biotechnol- als. Policymakers must find ways to overcome this
ogy to be as safe as, if not safer than, those derived resistance and accelerate the introduction and adop-
from any other method of production. … Opposition tion of Golden Rice.
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for enhancing micronutrient intake. Agric. Food Secur. 6, 59 (2017).
4 G. A. Stevens et al., Trends and mortality effects of vitamin A deficiency in children in 138 low-income and middle-income countries
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14 J. Cotter, Golden Illusion: The Broken Promises of “Golden” Rice (Greenpeace International, Amsterdam, The Netherlands, 2013).
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Text and Annexes (Secretariat of the Convention on Biological Diversity, Montreal, Canada, 2000).
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