Science Writer Ed Regis has recently published a book, Golden Rice: The Imperiled Birth of a GMO Superfood, in which he tells the tragic story of golden rice. In his telling he does not come off as an ideologue, or someone who kept with an initial dramatic narrative regardless of the facts. Rather, he wished to find the truth, which is often messy and nuanced.

Golden rice is a genetically modified form of rice that is enriched with beta carotene, the precursor to vitamin A. It was developed by a non-profit humanitarian collaborative, is free of patents, and was produced with the intention of making it freely available to farmers in developing worlds. The first version of golden rice was produced in 2002, but this version had very low beta carotene levels. The latest versions, however, have sufficient levels that if current diets containing rice as the staple source of calories were switched to golden rice, it would be enough to avoid vitamin A deficiency.

Vitamin A deficiency is a global pandemic. According to the WHO:

An estimated 250 000 to 500 000 vitamin A-deficient children become blind every year, half of them dying within 12 months of losing their sight.

Golden rice has the potential to significantly reduce this disease burden by fortifying a daily staple with beta carotene. This sounds like a solid win for science, so what turns this into a tragic tale? Of course you know the answer, irrational resistance based on misplaced fears.

Greenpeace has lead the charge against the development and adoption of golden rice, mainly out of their generic resistance to all things GMO. Regis writes:

Over the years since the prototype version was announced, Greenpeace had issued a practically endless stream of press releases, position papers, and miscellaneous other statements about Golden Rice that were filled with factual inaccuracies, distortions, and wild exaggerations of the truth.

However, Greenpeace’s efforts did not directly impede the development of Golden Rice. Although, I think Regis may be letting them off the hook too easily – it’s impossible to quantify its indirect contribution through affecting public attitudes. What did delay its development was international law, borne out of irrational fear of GMOs. This is a case of the precautionary principle gone wild. Regis points out that it took 20 years to fully develop Golden Rice partly because the science of plant development is inherently slow. But – that was not the only reason:

The second reason why it took 20 years to develop the final version of Golden Rice is the retarding force of government regulations on GMO crop development. Those regulations, which cover plant breeding, experimentation, and field trials, among other things, are so oppressively burdensome that they make compliance inordinately time-consuming and expensive.

He estimates that irrational regulations delayed the ultimate approval of Golden Rice by a decade, resulting in millions of unnecessary deaths and preventable blindness. As the Guardian reports:

The Cartagena Protocol contains a highly controversial clause known as Principle 15 or, more commonly, the precautionary principle. This states that if a product of modern biotechnology poses a possible risk to human health or the environment, measures should be taken to restrict or prevent its introduction. The doctrine, in the case of Golden Rice, was interpreted as “guilty until proven innocent”, says Regis, an attitude entirely out of kilter with the potential of the crop to save millions of lives and halt blindness.

The Cartagena Protocol went into effect in 2003, just in time to slow the development of Golden Rice. It is an excellent example of the unintended consequences of government regulation – in the hopes of protecting the public, regulators have condemned millions of poor children to blindness and death. It is also an example of the inherent logical limitations of the precautionary principle.

The principle by itself is fine – first do no harm, and be careful. Fine. The problem comes from only looking at potential risks of doing something, and not looking at the potential risks of not doing something. This, unfortunately, is basic human psychology. We fear the negative consequences of our direct action more than the consequence of inaction. But the blind child does not care if they are blind because of someone else’s direct action or inaction – they only know that they are blind. (Or, if you prefer to quote Full Metal Jacket: “The dead only know one thing – it is better to be alive.”)

This concept is very familiar to me as a physician. This is part of the practical wisdom of the profession – you must consider the consequences of everything you do, and do not do. We take a risk vs benefit approach. What are the potential risks and the potential benefits of taking or not taking any specific action. We have to deliberately overcome our inherent squeamishness of potentially being the proximate cause of harm by taking action in order to avoid a greater risk of harm through inaction. All that matters (that is supposed to matter) is what is best for the patient (including informed consent), not protecting ourselves.

The regulators who foisted The Cartagena Protocol on the world and condemned millions of children to blindness and death neglected this bit of wisdom, and tragedy ensued.

So where do things stand now? The current form of Golden Rice has been approved, despite all the regulatory hurdles, by the US, Canada, Australia, and New Zealand. However, these are mostly symbolic approvals, because these countries do not need Golden Rice. The point was to facilitate countries like the Philippines and Bangladesh approving Golden Rice – and in fact they may by the end of the year. But until Golden Rice actually reaches people who need it, my optimism is tempered.

Amazingly, Greenpeace and other anti-GMO organizations continue their opposition. I have already dealt with their arguments here. However, to summarize a few of the most popular talking points:

They argue that Golden Rice does not work. However, this argument is 20 years out of date, and has collapsed with the newer cultivars of rice and latest studies showing that the beta carotene is of sufficient amounts, persists, and is absorbed adequately to supplement vitamin A levels.

They make general arguments against GMOs, but these largely don’t apply to Golden Rice. There are no environmental issues (no pesticides). Rice plants do not propagate on the wind. There are no patents (on the rice itself, existing patents for parts of the technology needed were granted free to the consortium), no corporate greed, no exploitation. Farmers will be given the seeds for free.

So they are left with two very bad arguments. The first is the precautionary principle, but it is really an irrational version of this principle which I already skewered above. They use this to make ever increasing demands for proof of safety, moving the goalpost forever.

The second bad argument is essentially the Nirvana fallacy – Golden Rice, they argue, is not a perfect solution, so we should not use it. They combine this with the false choice fallacy – instead of Golden Rice we should do other things. Some of these are things we are already doing, like providing supplements or access to other crops that provide vitamin A. But the vitamin A deficiency problem persists despite these efforts. Clearly another solution is needed.

Perhaps their worst argument is this false choice – vitamin A deficiency is really caused by poverty. Golden Rice will not fix poverty. Whatever resources we are spending on Golden Rice  would be better spent fixing poverty. Yeah – good luck with that. Let us know how that goes.  Even if we spent every dollar retroactively from developing Golden Rice on fighting poverty, it would not have made a dent. And most of the money was donated by Bill Gates and others specifically for this project.

It really is a desperate and unconvincing argument, that just shows the power of motivated reasoning. I do encounter this logical fallacy frequently – denigrating interventions that mitigate the negative consequences of an underlying problem because they won’t fix the underlying problem (often with the tired cliche of “that’s just putting a bandaid on the problem”). Of course, it is always best to fix fundamental problems, but we can’t always do that, or it will take a lot of time, and in any case there is already harm in the meantime. Mitigating harm is perfectly legitimate.

So while Greenpeace is busy fixing world-wide poverty, perhaps in the intervening decades and perhaps centuries, they won’t mind if other people mitigate the worst negative consequence of poverty. I’m sure the world’s poor won’t mind the help (or the, you know, not going blind and dying thing) in the meantime.