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THE GOLDEN RATION:

A STUDY OF THE EFFECTIVENESS AND GLOBAL PUBLIC HEALTH IMPACT OF
GOLDEN RICE
Christopher John Jericho A. Balicanta

Micronutrients are crucial for all life, as they help maintain normal bodily structure and
functions. The human body, however, has lost the ability to synthesize sufficient quantities of
certain micronutrients, called vitamins, on its own and must therefore obtain nutrients from diet
(Fitzpatrick et al., 2012). One important micronutrient is Vitamin A an essential substance for
promoting the maintenance and proper functioning of various body systems, such as vision,
immunity, tissue structure, red blood cell production, and reproduction (Evert, 2013). Vitamin A
is a collective name for fat-soluble substances that exist in two major forms: retinal, the active
form of Vitamin A, and carotenoids, such as beta-carotene, which are found in plants and
converted into vitamin A inside the body (World Health Organization, 2009). Insufficient intake
of these vital substances may result to adverse and potentially fatal health conditions.
Vitamin A Deficiency, or VAD, is a condition in which a person receives chronically
substandard amounts of vitamin A. Individuals who are undernourished with vitamin A may
develop certain complications, such as dry eyes (xerophthalmia), inhibited growth, and anemia.
Vitamin A deficiency is also the leading cause for blindness in children, and increases the risk of
mortality due to severe infections. About half of the children affected by VAD die within 12
months of going blind. VAD also affects pregnant women by causing night blindness, and, in
some cases, increases the risk of maternal mortality (WHO, 2013).
VAD affects around 250 million children under the age of five, and is classified by WHO
as a moderate to severe public health problem in 122 countries, especially in the Southeast Asian
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and African regions, making it a global health concern (WHO, 2009). Over 90 million children
are affected by VAD in the Southeast Asian region alone. Nutritional research in the Philippines
has shown a national VAD prevalence of 5.9%, with children six months to five years of age
having the highest VAD incidence, with 15.9%, or 1.9 million (Food and Nutrition Research
Institute, 2008). Studies have estimated that the improvement of Vitamin A nutrition in children
could prevent 1.9 2.7 million deaths worldwide (Tang et al., 2012).
Community interventions have been conducted by health organizations in order to
alleviate this global problem. Educational programs on nutrition have been organized and
vitamin A-rich food have been made available for at-risk communities. Domestic cultivation of
vitamin A-rich food were also encouraged of those who do not have direct access to these crops.
High-potency vitamin A capsules and supplements have also been administered in communities
classified as having a high risk of acquiring VAD. Another approach is the fortification of staple
food and condiments. This strategy, however, has not seen popularity in lower-income countries
(World Health Organization, 2009). Moreover, the efficacy of Vitamin A capsules and
carotenoid-rich plants and crops in delivering vitamin A failed to meet expected supplementation
levels (Tang et al., 2012). In this regard, it was theorized that the fortification of staple food
crops should be a more effective and accessible approach for vitamin A supplementation in
lower-income areas.
Rice is the major staple food of nearly half of the worlds population and is produced
primarily in Southeast Asia and Africa regions with the highest proportions of Vitamin A
deficiency in children under 5 and pregnant women (Mayo-Wilson, Imbad, Herzer, Yakoob, &
Bhutta, 2011). The rice plant, while contains carotenoids in the leaves, is unable to synthesize
pro-vitamin A in the endosperm, the edible part of the crop. The lack of vitamin A in the staple
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crop, coupled with the inability to afford a more diversified diet, remain to be major factors in
the high prevalence of VAD in lower-income countries (Potrykus, 2010).
In an effort to address this problem, plant biologists Ingo Potrykus and Peter Beyer have
developed Golden Rice a rice variety with yellow-colored endosperm that is genetically
modified in order to biosynthesize beta-carotene, a vitamin A precursor. Golden Rice was
produced by introducing two genes (phytoene synthase (psy) and phytoene desaturase (crtl)) into
the rice endosperm in order to establish a beta-carotene biosynthetic pathway and activate the
production of pro-vitamin A in the rice grain (Tang et al, 2009). The golden color of the rice,
hence the label, is a side-effect caused by the significant presence of beta-carotene in the
endosperm, as opposed to regular, carotenoid-free, white rice (Schaub, Al-Babili, Drake, &
Beyer, 2005).
Since its inception in 2000, Golden Rice has been continually developed in order to
increase the pro-vitamin A content in its rice grain. Further improvements in genetic engineering
resulted to an enhanced version of Golden Rice that contains about 23 times more beta-carotene
in the endosperm (Paine et al, 2005). Recent studies have shown that Golden Rice provides
adequate amounts of vitamin A to humans and is expected to provide substantial nutrition to
populations with rice as a regular component of their diet (Tang et al, 2010, 2012).
Despite these proposed benefits and the acclaim of the scientific community and the
public sector, being a genetically modified (GM) crop, Golden Rice has met numerous
opposition, especially from various anti-GM organizations, such as Greenpeace and Friends of
the Earth, as well as militant groups. These groups claim that Golden Rice, as a GM food, may
cause unpredictable and possibly harmful effects on humans and the environment, as well as
food security. Greenpeace also promotes traditional supplements as the more stable and effective
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solution for VAD (Greenpeace, 2012). This conflict may have been contributory to the lengthy
process of regulation and testing which delays the distribution of this vital crop to
undernourished populations. This paper aims to dispel those claims and prove that Golden Rice
is a safe and effective approach for the alleviation of vitamin A deficiency, as well as a
sustainable intervention in lower-income populations affected by this potentially fatal, yet
preventable condition.
Golden Rice has been proven by numerous scientific research to provide significant
dietary amounts of Vitamin A in humans. While the prototype in 2000 has been criticized by
both the scientific community and anti-GM groups for having substandard vitamin A content as
compared to the average Vitamin A requirements in humans, researchers have continuously
conducted research in order to increase the amounts of carotenoids in the rice endosperm. In
2005, researchers Paine et al. have produced a Golden Rice variant, named Golden Rice 2,
which contains as much as 37 g/g of carotenoids, 31 g/g of which is beta-carotene, marking a
23-fold increase in provitamin-A content (Paine et al., 2005).
The impact of Golden Rice 2 in supplying vitamin A requirements in children was then
analyzed for a theoretical estimate based on the Vitamin A content of the grains and the
following assumptions: (1) The Recommended Daily Allowance (RDA) for children aged 1 to 3
is 300 mg vitamin A. (2) The retinol equivalency ratio is 12:1, which represents an ideal vitamin
A conversion in humans. A single serving was also defined to contain 60 g (about cup) of dry,
cooked Golden Rice, which was estimated to be lower than the typical serving in countries with
rice as their staple crop.
It has been shown from the results of the analyses that 72 g of cooked Golden Rice
supplies about 50% of the RDA in children. The data, however, may have been underestimated
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as beta-carotene bioavailability, or the rate in which beta-carotene is absorbed in the body, may
be higher as compared to fruits and vegetables in which the retinol equivalency ratio is defined
(Paine et al., 2005). This implies the viability of Golden Rice 2 in supplying Vitamin A
requirements in a three-meal daily diet in children.
Clinical research in succeeding years have reinforced this theoretical claim by Paine, et
al. In 2009, a pioneering study involving human volunteers showed a very efficient
bioconversion of beta-carotene to vitamin A in humans (Tang et al., 2009). In the study, the
participants were asked to consume Golden Rice grown and prepared in a controlled setup,
which was tested to contain 20-30 g/g beta-carotene. The participants had their blood samples
taken regularly, which were then analyzed for carotenoid and pro-vitamin A levels. The results
from the clinical analyses have shown that the conversion factor, or the amount of vitamin A
converted in the body from beta-carotene in the rice, is 4:1, which translates into a conversion of
500-800 g vitamin A from 100 g ( cup) rice. This, in turn, indicates an 80-100% attainment of
the estimated average requirement and supplies 55-70% of the recommended daily allowance
(RDA) for both adult men and women (Tang et al., 2009). Results from a separate study have
also shown that a 100-150 gram Golden Rice serving in children provides about 60% of the
Chinese Recommended Nutrient Intake for 6-8 year old children (Tang et al, 2012).
The potential nutritive benefits of Golden Rice on women and children, two of the most
VAD-vulnerable subgroups, were also presented in a study by Potrykus (2010). The study,
conducted in Bangladesh, a sample low-income country, shows that the incorporation of Golden
Rice into the standard diet could provide 60-120% of the WHO recommended daily intake for
Vitamin A. This figure places well-above the 50% daily requirement for the prevention of VAD,
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and marks a 60-80% increase in vitamin A nutrition, as compared to the standard diet of fruits,
vegetables, poultry and fish.
Apart from the effectiveness, determining whether Golden Rice is safe to consume for
humans is also a main priority for Golden Rice researchers. Concerns of potential toxicity and
allergenicity (property to cause allergic reactions) have been raised due to possible mutations
that may arise from genetic modification (Greenpeace, 2012). However, studies on the molecular
structure and beta-carotene content of Golden Rice, as well as clinical testing, have shown that
the consumption of Golden Rice is expected to cause very minimal toxic or allergenic effects.
Since the main additional feature in Golden Rice is its beta-carotene content, studies have
been conducted in order to ensure its safety in humans. A study by experts in the field of
carotenoids have examined the properties of beta-carotene and its effects in humans. Results
from the consensus conference conducted through examination of published data on carotenoids
have resulted to a scientific agreement that beta-carotene in Golden Rice is a safe and effective
source of vitamin A in humans (Grune et al., 2010).
A comprehensive bioinformatics study by Goodman & Wise (2006) inspected the
potential allergenic properties of Golden Rice. The proteins in the rice grain have been subjected
to a comparative assessment with 1,537 potential allergens from the Allergen Online database
and 2,529 allergenic protein sequences. Results have shown no structural or genetic similarity
between any of the Golden Rice proteins and all suspected allergens from the entire database.
These findings imply that the consumption of Golden Rice causes no allergic reactions in
humans and no possible scenario of heightened risks may be produced for any individual Golden
Rice consumer (Goodman & Wise, 2006).
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The safety of Golden Rice has also been corroborated by clinical trials on children and
adults. In two separate Golden Rice consumption trials on children and adults, participants were
monitored for possible side effects or anomalous reactions to the genetically modified rice grain.
Thorough post-intake evaluations have reported no manifestations of abnormal effects.
Furthermore, after a one-year follow-up assessment, no complaints or adverse effects have been
recorded from the participants (Tang et. al., 2009, 2012).
As discussed, research has well substantiated the safety and effectiveness of Golden Rice
in providing Vitamin A supplementation to humans. A broader perspective, however, will be
required in the examination of the economic advantage and sustainability of this program, more
specifically in low-income, rice-dependent countries, where vitamin A deficiency is most
prevalent.
A study by Stein, Sachdev & Qaim (2006) presents scenarios on the projected annual
impact of Golden Rice in India based on varying levels of beta-carotene in the grain. The high-
impact scenario, deemed realistic, predicts a reduced mortality of up to 40,000 out of the annual
burden of 71,600 a 55% reduction. This figure translates to 1.3 million disability-adjusted life
years (DALYs) saved (DALYs refer to the sum of all individual healthy life-years lost through
disease and is used as an economic quantifier for the impact of a health intervention). Even in a
pessimistic, low-impact scenario, an overall mortality reduction of at least 8.8% is expected
(Stein, et al., 2006).
In comparison, traditional intervention programs, such as subsidized Vitamin A
supplements and food fortificants, cost about $134 and $84 to save one DALY, respectively
(Fitzpatrick et al., 2012). Golden Rice, on the other hand, will provide the same amount of
nutrition for about $3 per DALY inclusive of all intermediate costs, such as government
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deregulation, marketing, research and development (Potrykus, 2010). This then implies savings
of $81-$131 per DALY. Furthermore, the World Bank standard defines an effective intervention
to cost less than $150 per DALY, thus making Golden Rice an exceptionally cost-effective
intervention on Vitamin A deficiency (Breithaupt, 2008).
Further economic benefits may arise from an increased adoption of other biofortified GM
crops, which may follow from the widespread implementation of Golden Rice. Consumption of
these nutritionally-enhanced crops is expected to lead to a four-fold increase in unskilled labor
productivity, which may then lead to an increase in real incomes of farm by 0.9% and 0.4% per
cent in China and in Asias other developing countries, respectively (Amin, Azlan, Ahmad, &
Ibrahim, 2011). An expected increase in worldwide welfare income from a model health benefit
analysis amounted up to $15 billion, with majority of these gains manifested in Asia (Qaim,
2009).
While the production and testing of Golden Rice may require high initial investments
bio-safety regulations could reach up to $100,000 in the Philippines long-term costs are
expected to be low once the crop is fully integrated into the agro-economic landscape (Beyer,
2008). Also, major financial support, amounting to nearly $20 million, by philanthropic
organizations such as the Bill and Melinda Gates Foundation and the Rockefeller Foundation,
should greatly help ease the economic burden of research funding on developing countries
(International Rice Research Institute, n.d.; Nayar, 2011). Moreover, Golden Rice, as any other
local rice variety, can be distributed through local trade channels. In contrast to vitamin A
capsules and fortified food, Golden Rice should, in principle, require minimal monitoring,
maintenance and logistic costs; only a marginal increase in the existing rice production
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investment should be able to sustain its continual deployment (Al-Babili & Beyer, 2005;
Potrykus, 2010).
Integration into the diets of rural populations is also expected to be much faster and more
sustainable than other vitamin A-rich crops, as local rice farmers may be able to produce the
Golden Rice themselves through conventional rice production methods without having to
allocate separate land for production of less marketable and non-dietary crops. Yield factors and
risks in Golden Rice are about the same as traditional rice crops, no additional fertilizers or other
crop yield enhancers are needed. The proprietary technology used for Golden Rice has also been
donated by its inventors for humanitarian use, which means farmers earning less than $10,000 a
year may freely produce, consume and distribute Golden Rice seeds and harvest within the
framework allotted by the proprietors. The economic factor of Golden Rice should only be
limited by costly deregulation procedures and development, but overall, the potential effects of
the biofortified crop is expected to outweigh its sustainable long-term costs (Fitzpatrick et al.,
2012).
Despite the discussed health benefits and cost-effectiveness, Golden Rice has faced
numerous opposition, which might primarily be due to the generally negative public opinion on
genetically modified organisms. Environmental and human health issues remain to be the
primary deterrents for the propagation of Golden Rice seeds, as well as other GM crops.
Greenpeace (2012) cites that Golden Rice could impose adverse effects due to the changes in the
genetic makeup of the plant, as compared to conventional breeding methods.
A primary concern expressed by Greenpeace (2012) is the possibility of a
contamination of traditional rice fields. Greenpeace believes that Golden Rice could
inadvertently fertilize non-GM rice varieties, irreversibly affecting their genetic information and
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then degrading their quality, potentially rendering both wild and domestic rice crops inedible for
future generations. However, it has long been known that rice, including GM varieties, is
ordinarily a self-pollinator, and thus the probability of cross-pollination is low, especially when
rice fields are separated by as little as a few meters. Wild rice varieties are also found to seldom
grow near domestic fields. Lastly, should cross-pollination occur between Golden Rice and non-
GM varieties, research has determined that Golden Rice genes do not strengthen or weaken non-
GM rice qualities, thus negating its potential of producing unwanted weed and affecting
biodiversity (IRRI, n.d.).
Scientific communities have also shown a consensus which affirms that GM crops pose
no novel risk as compared to conventionally produced crops (Potrykus, 2010). Moreover,
before Golden Rice seeds are approved for propagation, they undergo extensive testing and
approval in accordance to numerous international safety regulations, including the Cartagena
Safety Protocol, a global set of guidelines on handling, transfer and use of living modified
organisms in order to ensure adequate protection from potential risks to human health and
biodiversity (Secretariat of the Convention on Biological Diversity, 2000).
In the Philippine setting, GM crops such as Golden Rice are also subject to thorough
regulatory research in accordance to international standards. Risk-benefit assessments are
conducted by the Institutional Bio-safety Committee (IBC) on the proposed crop. The National
Committee on Bio-safety in the Philippines (NCBP) then studies the crop for potential harmful
effects. Upon the approval by the IBC and NCBP, an application for field testing is submitted to
the Bureau of Plant Industry, which then conducts additional risk assessments for gene
contamination, toxicity and other environmental effects. Lastly, an application for the permit for
propagation and commercialization should be secured and will only be approved once field
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evaluation is successful. This process ensures the safety and efficacy of all GM crops
implemented in the Philippines (Beyer, 2008).
Another point of opposition presented is the declining trend of global vitamin A
deficiency attributed to existing programs and supplements. It has been argued that governments
should focus their funding instead on well-proven traditional methods to combat VAD, such as
food supplements and dietary diversification. However, research has presented economic
disadvantages of this claim, especially in developing countries. Traditional food supplements are
projected to be less sustainable and affordable than Golden Rice, as previously presented, costing
about $130 more per healthy life-year saved than the biofortified staple crop (Breithaupt, 2008).
Also, in terms of delivery and logistics, Golden Rice provides better self-sufficiency as the crop
may be propagated in local farms and distributed through local formal and informal trade
channels without risk of endangering local crop competition (Qaim, 2009).
The establishment of Golden Rice as an effective and affordable intervention for VAD
could have immense impacts on developing countries affected with vitamin A deficiency,
especially the Philippines.
One such envisaged implication is the significant improvement of the countrys public
health sector. Rice is one of the central crops of Philippine agriculture, and constitutes a large
part of the average Filipino diet. The implementation of the program, submitted for approval in
2013, could greatly aid in the cost-effective delivery and accessibility of vitamin A
supplementation, especially in remote rural areas. Projections expect a 6-47% reduction of
DALYs lost per year in the Philippines due to the incorporation of Golden Rice into the average
diet (Amin, et al., 2011).
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Aside from the attainment of the crops proposed benefits, the substantiation of the safety
and effectiveness of Golden Rice could be an avenue for an improved agricultural research
landscape and a better understanding on how biotechnology may be utilized to improve public
health. The exploration of other crops like corn and wheat for biofortification may be involved in
future studies. The incorporation of other micronutrients such as iron and folate into crops may
also be possible areas of research and implementation (Qaim, 2009). More sound education on
GM organisms delivered by this project may then improve the reception of the government, as
well as the masses, on these products.
Results of this research may also be referenced to improve on the current government
regulatory policies on genetically modified crops. As exposed by several studies summarized by
Potrykus (2010), excessive and often unscientific regulatory practices such as the system
currently employed result in grave social repercussions. The annual cost of delays in
implementation amounts to around $15 billion of GDP in Asia alone and millions of healthy life-
years lost. A possible restructuring of the national assessment program on GM crops may aid in
the maximization of the benefits generated by GM products.
It should be acknowledged, even with the programs overwhelming health and economic
benefits, that Golden Rice is proposed to be neither the sole, nor the best, solution for the
alleviation of VAD. It is also campaigned neither to completely cure, nor fully prevent Vitamin
A deficiency, as the case in any other vitamin A supplement. The Golden Rice project, however,
seeks to effectively bridge the accessibility gap between proper micronutrient supplementation
and VAD-affected populations through staple crop biofortification. This paper, through a review
of research literature, determines that Golden Rice is a safe, effective and affordable supplement
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to existing interventions for the sustainable alleviation of Vitamin A deficiency. Golden Rice is
therefore highly recommended for propagation and consumption in the Philippines.

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