Vitamin A deficiency and golden rice--a literature review

Purpose: To present one possible framework by which to appraise the potential for golden rice to prevent vitamin A deficiency (VAD)/xerophthalmia. Design: Literature review. Method: Twenty-nine articles were read and the term 'issue' was used for factors that the authors of the articles or secondary sources identified as being either causative or protective of VAD/xerophthalmia. The term 'issue' was not used exclusively to indicate that the factor caused VAD/xerophthalmia. Setting: VAD and xerophthalmia in developing countries. Main Outcome Measure: The number of issues identified and the frequency with which they occurred. Results: Twenty issues were identified with varying degrees of frequency. Socio-economic/environmental, parasitic infestation and dark green leafy vegetables were the issues mentioned most frequently. Each issue was addressed in relation to golden rice. It is difficult to ascertain whether the frequency with which an issue was raised is relative to how important it is in relation to the other issues. It is interesting to note that socio-economic/environmental factors are regarded as the fundamental causes of VAD/xerophthalmia and in this review it was one of the most frequently occurring issues in the 29 articles. Conclusions: It appears that the elimination of VAD/xerophthalmia in developing countries is not likely in the foreseeable future, even with the introduction of golden rice. This genetically modified rice does little more than add another supplement to the market. The World Health Organization and the United Nations International Children's Emergency Fund have failed to eliminate VAD/xerophthalmia through the use of supplements, fortification and dietary modification. So of interest is the rationale behind spending public money to develop rice which has been genetically modified with pro-vitamin A when other supplements have failed. It is the socio-economic/environmental issues which impact on whether a population has VAD/xerophthalmia and these are not being addressed.