Carolyn Ahlers 1 By establishing the United Nations Millennium Development Goals, the industrialized world made a commitment to bolster

poor countries and to push these regions towards a more prosperous future in which all people have access to proper nutrition, food security, and the many other fundamental components of a quality life. However, with much of the world living in stark poverty and with many people dying from very treatable diseases, barring a big change, these Millennium Development Goals will simply not be met. Fortunately, however, new technology involving genetically modified crops has been established and has the potential to have unparalleled impacts on developing regions. In fact, research from the implementation of genetically engineered crops in India has shown that these crops have the potential to place billions of dollars into the hands of small-hold farmers and to save thousands and thousands of lives (Qaim 552). However, even with this compelling evidence, genetically modified crops are still not being fully implemented into third-world countries. There should be more research and more support geared towards the development and implementation of genetically modified crops in developing countries because of their potential to improve human health and nutrition and their capacity to enhance the economic systems of these regions. I will start this report by elaborating on the prevalence of problems in unindustrialized countries, and from there, expand on the possible strategies that could be used to combat these massive problems. I will then explain why genetically engineered crops are the best option to fight these tribulations. Subsequently, I will show how beneficial genetically modified plants could be on developing countries by giving four examples. For the first example, I will elaborate on Golden Rice, a genetically modified plant infused with B-carotene that has the potential to combat the massive public health

Carolyn Ahlers 2 crisis of vitamin A deficiency (VAD), and for the second and third example, I will expound on the potential health benefits of folate-fortified grain and iron-fortified rice. Finally, I will expand on the potential economic benefits of Bacillus thuringiensis (Bt) cotton. Although these examples are clearly not indicative of all the genetically engineered crops currently being developed or implemented, they provide good evidence and insight into what we could expect if genetically modified crops were seriously instigated into unindustrialized countries. The first reason genetically engineered crops should be implemented into developing countries is because of their capacity to improve human health and nutrition and their ability to lessen the occurrence of malnutrition and micronutrient deficiencies. Reducing the prevalence of these massive public health problems is incredibly important due to the frequency and scale at which these problems occur. According to a report by the Department of Health Management and Policy at the University of North Texas Science Center, throughout the world, 3.5-5 billion people are iron-deficient, 180 million children are protein deficient, and 140-250 million people are vitamin A deficient. Furthermore, the World Health Organization (WHO) has estimated that thirty percent of the global population is inflicted with one or more forms of malnutrition and that forty-nine percent of the childhood deaths under age five in underdeveloped countries is a result of malnutrition (Campos-Bowers 1). Additionally, micronutrient deficiencies and malnutrition cause an increase in mortality, an increase in rates of illness, a depression of cognitive ability, a less productive work force, and a plethora of other issues. And if that were not bad enough, because of the adverse relationship between undernutrition and infection, people in underdeveloped countries actually require more

Carolyn Ahlers 3 nutritional components than which characterize the requirements of well-nourished populations (Bouis 192). Clearly, malnutrition and micronutrient deficiencies in developing countries are issues that need to be addressed. There are currently three main strategies that can be used to fight these malnutrition and micronutrient deficiencies. These include dietary intervention, supplementation, and biofortification (genetically modified crops). Dietary intervention is a strategy that encourages people to amend their eating behaviors and to eat healthier foods. However, this is simply not a viable option for those living in developing countries because of the fact that their main diet consists of staple crops. Staple crops, foods such as cassava, wheat, rice, and corn, contain insufficient concentrations of many essential vitamins and minerals, and more often than not, actually contain elements that inhibit nutrient absorption, such as phytales in grains that do not allow for zinc absorption (CamposBowers 2). In addition to the unavailability of crops with higher micronutrients, according to a study conducted by the International Food Policy Research Institute in Washington D.C., people in underdeveloped countries already spend nearly seventy percent of their income on food (compared to ten percent spent in developed countries) and therefore, simply do not have the means to buy healthier, more micronutrient-positive foods (Bouis 192). Consequently, micronutrient deficiency affects over two billion people worldwide (Graham 12). The second option to combat micronutrient deficiencies in developing countries is supplementation. This strategy entails providing essential micronutrients to people in third-world countries through the use of a vitamin pill or a micro-nutrient rich sprinkle. It is a strategy that has been applied for many decades, but unfortunately, has many problems

Carolyn Ahlers 4 associated with it (Campos-Bowers 1). First, although supplementation programs have shown some success in the past, they have never been able to completely eradicate micronutrient deficiencies largely due to their logistical issues. For example, supplementation programs are not economically sustainable; they require constant funding which regrettably can easily falter given the onset of political crises, wars, and economic downturns. Additionally, because of the infrastructural deficiencies commonly seen in developing countries, it is incredibly difficult to get these supplements to the places where they are most needed. For example, in India, the Nutritional Anemia Control Programme started in 1970 to curb iron deficiencies through the use of supplements, proved incredibly unsuccessful due to problems such as mismanagement, underfunding, logistical problems, and poor compliance. In fact, the coverage of these iron supplements only reached about thirty percent of pregnant women and about ten percent of adolescent girls (Beyer 479). This research showing that supplementation programs are not an effective strategy to fight micronutrient deficiencies was further supported by Peter Beyer at the Center for Applied Biosciences at the University of Freiburg, Germany, when he analyzed the impacts of vitamin A supplements in 103 priority countries and found that their coverage stagnated at fifty-eight percent. These reports show that supplementation programs by themselves simply will not produce the micronutrient increases that are necessary (479). This leads me to the third strategy that could be used to combat nutritional deficiencies in developing countries: biofortification, or in other words, genetically modified crops (Campos-Bowers 2). Biofortification encompasses three subfields that can be applied either independently or in combination with each other. These include lowering

Carolyn Ahlers 5 the amount of antinutrients in food staples, increasing the amounts of nutrients and compounds that promote bioavailability of minerals, and increasing the content of minerals and vitamins in staple plants (Bouis 194-195). This third strategy is viable due to the fact that unlike macronutrients, which comprise thirty percent of a tissues dry weight, micronutrients comprise less than .1 percent of a plants dry weight. This means that significant increases in micronutrient levels are feasible (DellaPenna 3). I will now elaborate on this third subfield in greater detail. One example of a plant that has been genetically modified to have increased levels of micronutrient levels and that has the potential to have huge health benefits for developing countries is Golden Rice. This genetically modified crop has been engineered to produce Bcarotene, which is a possible intervention for the massive public health crisis of vitamin A deficiency (VAD) (Qaim 555). VAD is a big problem for developing countries; 140 million pre-school children and seven million pregnant women worldwide are affected by it (Stein 1). Of these, according to the UN SCN Fifth Report on the World Nutrition Situation for Improved Development Outcomes produced by the United Nations Standing Committee on Nutrition, three million children die every year. In addition to causing high rates of mortality, VAD also causes a plethora of other issues including blindness and increased rates of infectious disease (Stein 1). Fortunately, Golden Rice has the potential to improve this situation. Because this technology was not yet available in the market, top researchers Stein, Sachdev, and Qaim, created a report for the International Association of Agricultural Economists Conference in which they created a methodology of comprehensive ex ante evaluation of Golden Rice, focusing on nutrition and health effects as well as on

Carolyn Ahlers 6 socioeconomic aspects. This research was performed in India because of the wide prevalence of VAD in this country; of the 140 million pre-school children worldwide suffering from VAD, thirty-five million live in India. In fact, 71,000 children under age six die and over 3,500 preschoolers go blind ever year due to VAD in India. Additionally, 2.6 million pregnant women and 1.6 million children suffer from blindness, and .8 million children die every year to measles as an offset of this disease (Stein 2). To compile their data, these researchers used a nationally representative dataset of 120,000 households and calculated vitamin A intakes before Golden Rice by using food consumption data and food composition tables and then calculated vitamin A levels with Golden Rice, assuming that the current share of rice consumed was replaced by Golden Rice. Then, by knowing individuals current VA intakes, their potential additional intake through GR, and their estimated average requirements, [they] determined the relative success of GR in closing the gap between intakes and requirements(Stein 3). These researchers found that the widespread consumption of Golden Rice would reduce the affliction of VAD by 59% and save thousands of lives. Additionally, they found that the most pronounced positive effects would be for the people at the lowest rung of the socioeconomic ladder as they usually suffer from higher rates of VAD than other higher-income groups (5). This research clearly showed that Golden Rice could have huge health benefits for developing countries. Another example of a genetically engineered crop that could have huge health benefits for developing countries is folate (vitamin B9) fortified grain. This genetically modified crop would require the transformation of two pathway genes from Arabidopsis thaliana which would lead to increased folate production and the reduction of problems associated with folate deficiency. Folate deficiency is a gigantic problem because it is linked

Carolyn Ahlers 7 to higher rates of spinal bifida, neural tube defects, cardiovascular diseases, anemia, and cancer. Additionally, it leads to impaired cognitive ability in adults (Beyer 480). According to the article Impact of Folic Acid Fortification of the US Food Supply on the Occurrence of Neural Tube Effects, required fortification of wheat flour with folic acid in the United States in 1998 was followed by significant reductions (nineteen percent) in neural tube defects (Honein 1). These same effects should be seen in underdeveloped countries, but unfortunately, folate-fortified crop development has not garnered the interest of donor agencies (Beyer 480). However, it is incredibly important that this crop receives support because a report entitled Incidence of Open Neural Tube Defects in Nova Scotia after Folic Acid Fortification found that the fortification of grain with folate would actually reduce the amount of neural tube defects by more than fifty percent. In addition, this report found that folate supplements actually had no effect on the incidence of neural tube defects so it is imperative that folate-fortified grain is implemented and not just supplements (Persad 1). As you can see, folate-fortified grain could have huge health benefits for developing countries, and therefore, more support of this genetically engineered crop is needed. Finally, in addition to Golden Rice and folate-fortified grain, the third genetically modified crop with potential health benefits that I want to elaborate on is iron-fortified rice. It is essential that this genetically modified crop is implemented into developing countries because of the prevalence of iron deficiency in third-world countries (Beyer 480); according to a report created by the World Health Organization entitled, Iron Deficiency Anemia: Assessment, Prevention, and Control: A Guide for Programme Managers upwards of one-third of the global population is inflicted with anemia, of which half is caused by iron deficiency. Additionally, approximately 800,000 people die yearly due

Carolyn Ahlers 8 to iron deficiency (Beyer 480). Because the staple crop of rice contains an endosperm that is a very poor source of iron, regions in which rice is the main food crop (usually developing countries) frequently suffer from iron deficiency. One crop that could potentially combat this deficiency is iron-fortified rice (Beyer 480). A study recently published on the impacts of iron-fortified rice on rural Bangladeshi women found that 50% increases in iron through biofortified rice would significantly reduce the rates of anemia among these women (Bouis 198). As you can see, iron-fortified rice could potentially have huge benefits for developing countries, so more support of this crop is required. As I have shown through the examples of Golden Rice, folate-fortified grain, and iron-fortified rice, genetically modified crops have the potential to have huge health benefits for developing countries. However, some people may argue that the implementation of these genetically modified plants into developing countries is not a good idea due to its potential negative health effects. This is certainly an issue that needs to be addressed. Before manipulating the micronutrient components of crops and feeding them to humans, careful consideration must be taken for the possibility of negative health outcomes. Fortunately, however, very recent epidemiological and clinical evidence has shown that for the minerals iron, calcium, selenium, and iodine, the upper safe levels of intake range from two to thirteen times the recommended dietary allowance (RDA) (RDA is actually misleading because it is not the level of minerals needed for optimal health, but rather the minimum level needed to avoid nutritional disorder. Therefore, this means that even higher levels of minerals would not be harmful.). Furthermore, the upper safe levels for folate and other vitamins are generally much higher than the upper safe ranges of

Carolyn Ahlers 9 minerals, which allows for a lot of room for manipulation. The one exception that needs to be noted is vitamin A, which can have negative health effects at five times the RDA. Fortuitously though, the Beta-carotene that is infused in Golden Rice has an upper safe level that is 100 times the RDA for vitamin A, which makes it very safe for humans (DellaPenna 3). As you can see, with good regulation, negative health effects can be substantially minimized or avoided entirely. Another reason why genetically modified crops should be seriously implemented into underdeveloped countries is because of their potential to enhance the economic systems of these regions. One example of a crop that has done just this is Bt cotton in India. This cotton, which is being used by five million farmers, has increased total household income by eight-two percent and, for the most vulnerable farmers, increased household income by 134 percent (Subramanian 302-303). Furthermore, this cotton has increased profits by eighty-nine percent and increased gross revenue by thirty-seven percent. Additionally, because of the lower number of crop losses associated with Bt cotton, average yields have increased by thirty to forty percent (Qaim 554). In fact, Matin Qaim at the Department of Agricultural Economics and Rural Development in Germany found that Bt cotton would place an additional 1.13 billion US dollars into the hands of small-hold farmers in India and place an additional 2.07 billion US dollars into the economies of these regions (555). The impact of Bt cotton would not only be for India though. The statistics I showed above correspond to India in which the increase in profit was 135 US dollars per hectare of land. Some countries would have profit gains very similar to India, and some countries would have profit gains even higher than India. For example, South Africa would have an

Carolyn Ahlers 10 increase of profit of 91 US dollars per hectare, and Australia would have an increase of 66 US dollars per hectare. Additionally, Mexico would have an increase in profit of 295 US dollars per hectare, and China would have the largest profit gain at 470 US dollars per hectare. While I will not list every country in which there is data for the increase in profit caused by Bt cotton, the important thing to note is that every single country would have significant profit increases if Bt cotton were fully implemented (Qaim 555). Clearly, genetically modified crops can lead to huge economical benefits. Some people may counter this point though by saying that genetically modified crops are too costly. However, the implementation of genetically engineered crops into undeveloped regions would actually be very cost effective and would cost much less than supplementation programs that are currently being used (Beyer 479). A report by the International Food Policy Research Institute found that biofortified varieties may reach undernourished people for a cost of only US $.02-.03 per person per year while the cost for commercial iron fortification would be a US $.12 per person per year and the cost for iron supplements would be over $3.00 per person per year (Bouis 198). This research was further supported by Peter Beyer at the Center for Applied Biosciences when he studied the costs of Golden Rice. He found that once these crops were developed, they would actually cost a fraction of the supplementation program costs. This is because these genetically modified crops are to be distributed throughout the traditional pathways of agriculture and are to be very sustainable. Once implemented, Golden Rice would have the same production costs of regular rice (Beyer 479). Researchers Stein, Sachdev, and Qaim found similar results; they found that each life saved would cost between $3.00 and $19.00 (Stein 5). This is incredibly cost effective, as the World Bank classifies anything under $200 as

Carolyn Ahlers 11 very cost effective (12). Clearly, cost should not be an issue in the implementation of genetically engineered crops. By elaborating on the potential health and economic benefits of Golden Rice, folatefortified grain, iron-fortified rice, and Bt cotton, I have shown that genetically modified crops can have potentially unparalleled impacts on developing countries. However, without more public support of these crops, they will never reach poor countries and their positive effects will not be seen. As the United Nations Security-General Ban Ki-Moon said when remarking on the Millennium Development Goals, In a world of great wealth and technological advances, no person anywhere should be left behind. The developed world has the technology and wealth to change the world. With the implementation of genetically modified crops in developing countries, real health and economic benefits can be seen, and finally, we can begin to assure that no person anywhere is left behind.

Carolyn Ahlers 12 Works Cited Beyer, Peter. "Golden Rice and Golden Crops for Human Nutrition." New BIOTECHNOLOGY 27.5: 478-81. Bouis, Howarth E., Bruce M. Chassy, and James O. Ochanda. "2. Genetically Modified Food Crops and their Contribution to Human Nutrition and Food Quality." Trends in Food Science & Technology 14.58 (2003): 191-209. Campos-Bowers, Monica, and Brian F. Wittenmyer. "Biofortification in China: Policy and Practice." Health Research Policy and Systems 5: 10-. DellaPenna, Dean. "Nutritional Genomics: Manipulating Plant Micronutrients to Improve Human Health." Science 285 (1999): 375. Graham, Robin David, Ross M. Welch, and International Food Policy Research Institute. Breeding for Staple Food Crops with High Micronutrient Density. Washington, D.C: International Food Policy Research Institute, 1996. Haddad, Lawrence James, Jay S. Ross, and United Nations System Standing Committee on Nutrition. 5th Report on the World Nutrition Situation : Nutrition for Improved Development Outcomes. Geneva: United Nations System Standing Committee on Nutrition (SCN), 2004. Honein, Margaret A., et al. "Vpliv Dodajanja Folne Kisline Zivilom v ZDA Na Pojavljanje Okvar Nevralne Cevi." JAMA [Slov (2001).

Carolyn Ahlers 13 Iron Deficiency Anaemia : Assessment, Prevention, and Control : A Guide for Programme Managers. Geneva: WHO, 2001. Persad, Vidia. Incidence of Open Neural Tube Defects in Nova Scotia After Folic Acid Fortification., 2002. Qaim, Matin. "Benefits of Genetically Modified Crops for the Poor: Household Income, Nutrition, and Health." New BIOTECHNOLOGY 27.5: 552-7. Stein, Alexander J., H. P. S. Sachdev, and Matin Qaim. "Potential Impact and CostEffectiveness of Golden Rice." Nature biotechnology 24.10: 1200. Subramanian, A., and M. Qaim. "The Impact of Bt Cotton on Poor Households in Rural India." Subramanian, A (2010). United Nations Security-General Ban Ki-moon's Statements. United Nations, 2012. Web. 16 Nov. 2013. <http://www.un.org/sg/statements/index.asp?nid=7125>.