It will be clear by now that Golden Rice adoption in a country requires the engagement of several functions of Government, many of whom may not be used to working together. These include agriculture, health, nutrition, medical, women and child welfare, communications, budget and strategic planning. There may be others, including subgroupings within the main functions.
For example, within ‘Agriculture’ are represented the national rice seed-breeding institutes already mentioned, and extension services to assist farmers and growers. Additionally, there are Government rice seed multiplication and distribution systems. In some countries, these functions are performed solely by Government-funded units, in others the Government contracts with the private sector to provide part or all of the required service.
Cooperation in planning and running public meetings may be appropriate, for example, between agricultural extension services, and local government health and nutritional education specialists, with all specialists benefiting by working with communications specialists.
In some of these functions, government routinely benefits from the assistance of NGOs, and/or the private sector, to help Government deliver its service to the people, and there is no reason for change within an overall strategy chosen for Golden Rice adoption.
There are also roles for different levels of government: village, region, city and national. It would be extremely helpful, in each country and at each level of government and in each necessary function, for interested individuals to announce their interest, reach out to other functions and individuals in the same and the other functions, at the same level of government, whom they may not previously know, and bring people together to discuss how to coordinate their activities for the common purpose: improved health and welfare through Golden Rice adoption.
It would be useful for each appropriate level of government, for the relevant group to elect a leader through discussion. And then to invite participation from all other functions needed for efficient and timely decision-making and management of resources needed or controlled by the group to facilitate adoption of Golden Rice.
The relevant leaders from each level of government then need to establish linkages with the corresponding leaders of groups in the other levels of government.
From these responsible self-help initiatives, a national coordinating system should develop to allocate, prioritise and direct the use of relevant resources to improved health and welfare through Golden Rice adoption.
In theory, one seed grain of rice can result in 20,000 tonnes of rice in a few years if all the seed produced is replanted after harvesting each crop cycle. Rice has a tremendous capacity for multiplication. But practically, Golden Rice seed cannot be made available to all farmers in a country at the same time. Seed multiplication output and dissemination have to be prioritised.
The most rational way to address this is to identify the regions within the country where the need and/or demand for Golden Rice is highest, and supply seed to those areas first. This could be related to where the incidence of vitamin A deficiency is highest, which in turn could be related to the areas where childhood blindness is most prevalent, and/or where child or maternal mortality remains stubbornly high, or where, for any reason existing interventions, such as vitamin A capsules, cannot be reliably and routinely delivered.
Conversely, Golden Rice communication and support services to growers and consumers may be the most difficult to manage in very remote areas. The Golden Rice seed multiplication and distribution system will be able to advise on what production can be expected in what time scale. It will be necessary to integrate need with practicality in determining which areas in a country should be the first recipients of Golden Rice seed for farmers to grow. Locally discussed and informed decisions will be the best way to decide on priorities.
The Golden Rice nutritional trait has been introduced into locally adapted and preferred rice varieties (and such work will continue). These Golden Rice varieties grow the same as the equivalent white rice variety. Before farmers will grow Golden Rice, they will need to know that they will be able to sell it and that their profitability will not be adversely affected compared to growing white rice. The rice breeders need to communicate these facts to local growers. ‘Field days’ may need to be organised with the involvement of locally influential growers and perhaps agricultural extension services: ‘seeing is believing’. Other communication methods may be required, all of course in local language.
For consumers to want to buy and consume Golden Rice, they will need initial encouragement. They need to be reassured that there can be no adverse effects of consuming Golden Rice as a source of vitamin A, which is essential for maintenance of healthy sight and a healthy immune system to combat disease. They need to understand that the only possible effect of consumption is beneficial and that independent local scientists (as well as foreign scientists and clinicians) have reviewed all the relevant data and found Golden Rice to be safe to humans and the environment. They need to understand that each Golden Rice grain is uniformly labelled with its colour, which is different from spoiled rice and rice which fraudsters may have coloured in imitation of Golden Rice. This uniform colour of Golden Rice, which shows that it contains beta-carotene, is the only difference from the same white rice variety. The taste is the same as the white rice variety, and of course consumers will need to become used to eating it regularly, for it to be effective. They need to understand that there is no charge for the nutritional trait and that the inventor’s donation is without any financial benefit to those involved with the development or distribution of Golden Rice. The nutritional trait has been developed as a ‘public good’, with the assistance of their Government, and others in other countries.
It is necessary to understand how to reach consumers, and tailor the approach to local circumstance, for effective communication. In some places, it may be via radio, it could be via text message, or TV, or newspapers or other social media. Who do consumers trust? Perhaps it is the local health workers? Perhaps a popular health programme, perhaps celebrity sports, film or TV personalities?
Focus groups probably need to be run to establish which would be the most effective, and the most cost-effective, communication messages and channels. Maybe the local business school can provide training in how to organise these, and record the results to influence strategy. When systems have been tried, results should be measured, and learning applied to future iterations of the systems so that they become more and more efficient at message delivery.
The aim is, at a low per capita cost, to establish demand for Golden Rice from consumers as encouragement to farmers to grow and harvest it. After such demand has been created, after a few cycles it will then continue without continuous social marketing.
Of course, grower interest and consumer demand have to be developed together, which is more challenging than introducing a new rice variety which only benefits the grower. The grower needs to understand that s/he can assist in, indeed is essential to, the well-being of the people who eat the crop.
For initial crops of Golden Rice, perhaps Government, local or central, needs to guarantee to purchase the crop, to start the cycle of availability and consumption. Whereas in rural setting this will probably not be needed for many crop cycles, there are other settings where government purchase and distribution programmes for Golden Rice may usefully continue.
Vitamin A deficiency occurs not only in the countryside, but also in urban centres where the population has no opportunity to grow their own Golden Rice: for these locations, an ongoing Government-managed supply system will probably be beneficial. In some countries, there is a well-established midday meal service in schools. Mandatory inclusion, and supply of Golden Rice as part of the midday meal would do a lot to combat vitamin A deficiency in the most vulnerable group to vitamin A deficiency: children. Where such a service does not currently exist, perhaps it could be created and Golden Rice routinely served. Alternatively, perhaps each child could be provided with a bag of polished Golden Rice to take home for preparation and consumption, on a regular basis, and receive instruction on the expected benefits in school to share with parents.
Again, local experience and commitment will determine the most appropriate way forward. And again, measurement of progress from the first beginning, for example, of the different delivery systems for the nutritional message will allow refinement and improvement in processes to make them more and more effective in the later targeted adoption areas. The same measurement systems will also allow determination of when external support can be reduced without adverse impact, so that available resources can be focussed elsewhere.
Measurement of effectiveness
It is well established that a source of vitamin A is beneficial to health, with no side effects. The human body converts the coloured beta-carotene in Golden Rice to vitamin A. Beta-carotene surplus to the bodies requirement is excreted without conversion to vitamin A.
Mothers have sufficient vitamin A when the circulating vitamin in their blood protects the mothers sight and ensures a robust immune response to infections. When mother’s vitamin A status is sufficient, it is expected that this will benefit any developing foetus through the placental blood supply, and any breastfed child through the mother’s milk.
It is important to measure the effectiveness of Golden Rice adoption. Initially, this will need to be by proxy measurements. Dietary records are useful. Dietary recall 24 h after consumption is a validated method for nutritional record keeping. General health records of a population are also useful contributory data to understanding.
Measurement of the impact of Golden Rice consumption on vitamin A status of large groups of people requires sophisticated science involving randomized controlled trials (‘RCTs’) and is carefully controlled by national, and international, regulations. Such research is carefully planned, and costly, and is for specialised and independent clinical researchers to take the lead on. It is to be encouraged.
Measuring epidemiological impacts of new vitamin A deficiency interventions, that is—in this case—measuring changes in health outcomes as a result of Golden Rice consumption, also requires careful experimental design and experimental conduct. Such research also involves RCTs, within established rules for conducting such research. It also requires more time than vitamin A status research, to understand and measure population health effects. Again, such appropriately qualified independent research is to be encouraged.
All results should be published in appropriate formats, in reputable peer-reviewed scientific journals, not least so that each country’s results can benefit from experience in other countries.