It might surprise you to find out that I’m asking a rhetorical question. While compiling the crowdmap, I found two rather promising innovations: Viread and Golden Rice. Viread is both an AIDs vaccine and an antiviral – while its use as an antiviral has been relatively uncontroversial, many activists have virulently questioned the clinical trials verifying its capacity as a vaccine. Golden Rice had a similarly transformative potential. The poor often have to rely on a single staple for their diet – rice, cassava, maize, bread– an unchanging, little supplemented carbohydrate that doesn’t provide the micronutrients constituting a healthy and well-rounded meal. Golden Rice helps mitigate the effects of a single-staple diet, by supplementing rice with Vitamin A. Enriching products with Vitamin A literally saves lives. The World Health Organization estimates that Vitamin A deficiency causes 3000 deaths and 500 000 cases of blindness per year world wide. However, food activists have attacked Golden Rice because it is a Genetically Modified (GM) food created using several Monsanto patents – their lobbying has limited its distribution within the EU and as a part of EU aid. So why is it that two impactful and effective innovations have dealt with so much opposition?
If we break down each innovation, case by case, more of the story falls together. Viread was tested by Gilead Sciences, a pretty profitable pharmaceutical company making most of its money from HIV antivirals. It ran a clinical trial in Cambodia, where the main trial participants were sex workers. It goes without saying that the relationship between Southern sex workers and an established Western biopharmaceutical company is unequal – one group consists of loosely-tied and socially marginalized people in a geographically marginalized area, while the other consists of a highly-organized and privileged group of people from a highly privileged geographic area. The relationship certainly deserves interrogation. And activists were certainly quick – too quick – to be be critical.
Following the start of the trials, activists from the Parisian organization ACT-UP facilitated the creation of the Asia-Pacific Network of sex workers. Both groups then engaged in high-impact publicity marketing at the 2005 World Aids Conference in Bangkok, Thailand. They sprayed Gilead’s booth with blood, stormed the stage when the biopharmaceutical presented, and threw strawberry jam at conference participants. A big splash and a few stains make for good publicity. But sometimes activists fail to see that the power dynamic characterizing their interactions with a marginalized population perfectly parallels that of a corporation. Activists are often a highly organized and agenda driven group, privileged individuals from a privileged country, interacting with a a loosely organized and very marginalized group. They only differ from corporations in terms of what drives their organization – one group has historically been motivated by good intentions, the other by profit.
Dr. Peter Singer and Dr. Abdullah Daar are two bioethicists examining the Gilead case – they realized that the company had in fact conformed to clinical trial best practices. Where activists charged that sex workers did not have informed consent of risk, they both had initial and continued access to counselling. Risk had been explained clearly. Where activists charged that sex workers had been discouraged to use condoms, that was simply not true – the clinical trial both provided condoms and encouraged their use. Some organizations argued that sex workers would feel like they didn’t need added protection while using Viread. I think this argument is a substantial underestimation of sex workers’ intelligence and capacity for risk analysis–as long as risk is clearly explained, someone working in the industry would have an adequate understanding of what they feel is an acceptable level of risk. Of course, if Gilead had failed to communicate risk or had discouraged condom use, that would be a different scenario entirely.
In this specific instance, Gilead ran an ethical trial. But activists seemingly attacked them without familiarizing themselves with the details of the Viread trials. They quickly drew comparisons to the Tuskegee experiment, where another marginalized population (African American men suffering from syphilis in the United States) were denied treatment as part of a scientific study testing the impact of penicillin on syphilis. And that was not the first or last time a pharmaceutical company had engaged in shady behavior, even if it was the most symbolic. Given their problematic history, is it any wonder that activists were quick to stereotype and demonize Viread?
This is not to say the trial was perfect. Activists pushed workers to demand better benefits and profit sharing as a result of their participation, arguing that sex workers were bearing the risk of trial participation, without having the ability to see the benefits. Given the scale of Viread’s profits, they really could afford to do better than a marginal payment. In their book The Grandest Challenge, Daar and Singer further argue that individual consent is a very Westernized concept – perhaps it is also important to engage in community wide consultation and gain wider societal approval. Co-creation of research expectations and ethics helps mitigate the power differences between the two groups. Whereas previously Gilead was only interacting with sex workers individually and imposing their ethics on the relationship, if wider Cambodian society had been consulted, the clinical trials may have also reflected its priorities.
And here’s the thing about the activists – their protests didn’t improve the nature of the trial. At the end of the day, they are not at risk for AIDs, so they can choose marketing tactics that impede the creation of good trial design rather than facilitating it. Their privilege impacts sex workers – to what extent do you really think they were involved in brainstorming marketing tactics? I really don’t think this was activists’ intention – given the extremely problematic history of big bad drug companies, is it really surprising that activist response was anything but immediate and sharply directed skepticism?
Golden Rice did not share all the ethical complications of Viread. It is a straightforward innovation. Vitamin A enriched rice helps make the staple food more nutritious, by including a necessary micronutrient. Micronutrient deficiency has been recognized to be generally problematic in the Global South – which is why innovations like Sprinkles micronutrient powder is so popular. So why is Golden Rice so controversial? Because it’s a Genetically Modified Organism partially owned by Monsanto, a corporation with a horrible history.
Doesn’t that seem straight out of some scary science fiction? I think the idea of GMs just strikes a lot of people as unnatural–while discussing it with a friend, he asked, “wouldn’t you be weirded out if your tomato had fish genes in it?” For me, the answer is unequivocally no. All living creatures share some genetic similarities. Guess what – humans and bananas share 50% of their genes already! So splicing genetic characteristics from one organism to another is not actually that strange. Moreover, humans have been involved with genetic selection since the beginning of farming – we would either eat or replant varieties of plants based on their nutritional value to us, perpetuating the spread of certain species. Such selection also alters nature, but we still enjoy its results without worry.
However, one issue with GM foods has been their use in environmentally harmful and exploitative ways, particularly by big biotech companies. Take Monsanto- the company achieved notoriety for creating a farming system requiring farmers to buy new seeds, insecticides, and fertilizer yearly. During periods where there are low crop yields for numerous years, farmers buying into the Monsanto system are unable to pay their debts, infamously resulting in farmer suicides in India. While this phenomenon cannot entirely and only be linked to Monsanto, the company undoubtedly played a role in exacerbating farmer poverty: it created and deployed inputs that could not be saved for future years, requiring farmers to buy them each season. If harvests were poor and farmers were unable to pay off their principle, their debt load would increase. And for a farmer who already makes very little profit, marginal revenue increases or decreases have a magnified impact. Farmers who had suffered multiple bad harvests followed by debt increase were driven to hopelessness – unable to even fathom a way of paying off debt, they committed suicide. That they felt that this was their only recourse underscores the severity of their situation. The depths of these farmers despair is profoundly saddening and has justifiably made Monsanto a target for criticism. But Monsanto’s notoriety should not extend to GM foods.
The main challenge posed by Monsanto and other large biotech companies is that they are encouraging the growth of monocropping. Farmers are encouraged to adopt their seeds, and often do for legitimate reasons (though in some cases, peasant farmers have lost their land when a landowner transitions to monocropping).However, over time the spread of one monocrop will reduce biodiversity. Many activists argue that once a critical mass of farmers only uses one type of rice, other varieties will be lost, and they will be reliant on that manufacturer’s brand. While that concern might be mitigated by seed banks, it is nevertheless important that farmers have access to a variety of different products. Moreover, the growth of monocrops kills off rice variety – once a critical mass of farmers uses one type of rice, other varieties may be lost. Biodiversity helps an organism population remain adaptable – while one strain might be resistant to a disease, others may be damaged by it. This is more than just sci-fi, Monsanto has a virtual seed monopoly. Farmers are essentially unable to buy a non-Monsanto option. And while Monsanto’s corporate behaviour has been particularly awful, it is a key actor in an industry that has instigated more than its share of controversy. It is also arguably emblematic of agribusiness – ask an anti GM activist about their concerns, and Monsanto will probably come up during the discussion.
Syngenta is an agribusiness company holding many of the patents for Golden Rice. While it was not directly involved in Golden Rice’s creation, many activist organizations market strategies are based on emphasizing the link between the GM and Multinational. It is one of Monsanto’s main competitors. These biotech companies form a small and arguably oligopolous cohort of 5 companies. Like Monsanto, Syngenta has some problematic products – pesticides with negative environmental impact, some of which may even be responsible for killing bee populations. So its not untainted by the sketchiness of agribusiness everywhere.
But it’s necessary to separate the product from the producer. Syngenta is working on a number of different strainsof nutrient enriched rice, each of which promises a way of resolving micronutrient deficiency in populations. Golden Rice has been repeatedly proven safe for consumption. It should be clarified – the product was not even developed by Syngenta – it was developed by Dr. Ingo Potrykus and Dr. Peter Beyer, in part using Syngenta patents. Its distribution is unrelated to Syngenta. In fact, the corporation’s only involvement was allowing Potrykus to use its patents for free. The product doesn’t appear poised to become a monocrop.
But at the same time, as George Santayana once said, “those who fail to learn from history are doomed to repeat it”. Agribusiness has done a lot to erode trust, which is one of the reasons why many Westerners are skeptical of its capacity and intention to create positive change. But not all GMs can be painted with the same brush.
It should also be remembered that the organic food movement is highly privileged. Just like those who oppose Viread, many of those opposing GMs are well-intentioned Westerners whose diets will be complete irrespective of whether they can access Golden Rice. They don’t suffer from Vitamin A deficiency induced night blindness. The majority do in fact have access to a well-balanced diet. Even though they aim to do good, why are they deciding whether communities have access to a potentially beneficial product?
I personally think both Viread and Golden Rice are innovations with the capacity to meaningfully improve the lives of marginalized people in the Global South. But, they are tainted by association – both Big Pharma and Big Agriculture have histories rife with human and environmental exploitation. This has generated in widespread Western cynicism, and attempts to block the spread of legitimate innovation to the Global South. At the same time, the fact that Western activists have such undue influence in this sector is a mark of their privilege.
But how do we move forward? I think a first step is for big industry to take social impact to heart. It is not enough to give social value lip service – people can and will find out if a company is engaging in sketchy behaviour. And socially conscious business is increasingly becoming good business – there are many people who will pay a premium to make sure the objects of their consumption were ethically produced. Activists do need to remain vigilant in this regard, however. It is easier to market social good than to actually engage in its creation. Also, social impact measurement is more than CSR, which can be tokenistic. Big industry needs to regain our trust. We need to hold it up to a high standard.
Activists also need to change. They need to meaningfully incorporate perspectives of the marginalized in their advocacy. Of course, if they hold all the information about Monsanto/Syngenta/Gilead Sciences and the costs/benefits of a particular product, they can and have lobbied the poor to advocate in line with their policy aims. This sucks. Good activism means first helping the community access unbiased information on interventions, and enabling them to express their perspective on what meets their needs. Though well intentioned, activists are also positioned to exercise their privilege unfairly.
What do you guys think? Would you trust a major corporation to innovate for the poor and underserved? How should communities be empowered? How can activists empower communities?
Also, if you have any innovations, corporate or non-corporate, perfect or problematic, please add them to my map:
Edit: Initial article said Dr. David Potrykus made Golden Rice. In fact, it was Dr. Ingo Potrykus and Dr. Peter Beyer.