‘An already bad drug resistance situation will become a lot worse’

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Dr (Lt Col) GPI Singh, Director Principal, Adesh Institute of Medical Sciences and Research explains to  Samrat Chakrabarti some of the public health issues related to the introduction of Bt Brinjal in our food chain

Does India have the medical infrastructure to deal with any chronic health conditions that may arise out of GM food crops like Bt Brinjal in the long term?

No one in the world has the facilities. We have facilities to pick up acute effects. sub-chronic effects. But chronic effects that show themselves after many years like say cancer or reproductive defects that show up after a one or two generations, we can’t pick those up. We can only go by the precautionary principle. If there is a real fear of unintended harmful consequences, then we must take all steps to see that these don’t come to pass. The United Nations Commission on Environment and Development treaty also known popularly as the Rio Declaration of 1992, enshrines several principles that should inform our approach to technology. The precautionary principle, according to this treaty says, whenever there is a suspicion or doubt or fear of irreversible damage to the environment or human health, the lack of scientific certainty will Not be used as a reason by the member states to postpone effective preventive action. You can’t say then, where is the evidence. You don’t wait for someone to die of cancer to say that this is bad and causes cancer.

Acute effects are easy to establish. You feed someone poison and he immediately turns ill. That’s an acute effect. The dose-response relationships can also be established in the case of acute effects. Give less and there is less allergy. Give more and there is more allergy. These dose-response relationships are not easily established in the case of chronic biological effects. This is our worry as doctors. India is a signatory to the Rio Declaration but we are ignoring it. There is enough scientific literature to show that smoking causes lung cancer. How long did it take to establish this? Thirty-forty years? You want the same thing to happen with GM crops?

There are concerns about Bt brinjal possibly leading to antibiotic resistance. Do you share these concerns as a public health professional?

That is one of our biggest public health fears from this. Antibiotic resistant markers are used in the present technology to ascertain whether the plant cell has received the transgene or not. You shoot the new genes using a gene gun, like a spray into millions of cells. The insertion is quite arbitrary. There is no way of telling which gene have imbibed the transgene and which has not. The goal is to identify those plant cells that have received the gene and then replicate, clone and make them into a new plant. How do you do that? In this case they mix the transgene along with an antibiotic resistant marker gene so that the plant cell that receives the transgene also receives the marker which makes it resistant to an antibiotic. Once the genetic transfer process is done, the culture plate of cells are immersed in an antibiotic and the cells that don’t die are the ones that have received the anti-biotic resistant marker gene and the Bt gene (transgene). Those cells will then be tissue-cultured and cloned and made into a new seed. What you then get is a new species of plant called GMO — genetically modified organism or as we call it God Move Over. We’ve taken over. Because of this process, the new plant cells that are cloned and tissue-cultured into the new plant that we will be eating, because of the marker used, is also antibiotic resistant. The most common antibiotics being used are Kanamycin, streptomycin, neomycin and ampicillin. These are all broad spectrum antibiotics. Doctors, when they know what is specifically wrong with you and which specific infection you have will use a narrow spectrum antibiotic. If I am still not able to tackle the infection and make it go away, I use a broader spectrum antibiotic. Broad spectrum antibiotics like Kanamycin are essential in dealing with conditions where the doctor is not sure what is causing the infection. Kanamycin is used in the case of drug resistant tuberculosis. It’s our second line of defence against drug-resistant tuberculosis. You probably know as a journalist that tuberculosis is a huge problem not just in India but all over the world, including the US. It’s a nightmare. When someone’s immune system is compromised by HIV, the first infection to take over and kill is tuberculosis. Tuberculosis can no longer be treated with single antibiotic. We use a cocktail of drugs. What we have now emerging is Multi Drug Resistant tuberculosis. It has become resistant now even to the cocktail. Now the world is also beginning to struggle with XDR tuberculosis — extreme drug resistant tuberculosis. This kind is resistant to even the third line of drugs.

We have a huge government-run programme in India called Revised National Tuberculosis Control Program (RNTCP) where billions of rupees and a significant portion of the health budget, is being spent because tuberculosis is a killer. Not only is the cost in terms of lost lives, but in drop in productivity. A nation that has tuberculosis is a nation that is sick. RNTCP is already struggling with MDR and XDR tuberculosis. And now you are introducing Kanamycin resistant plant into the environment. If this Kanamycin resistance transfers to your gut bacteria where millions of bacteria essential to our survival reside and is regularly let out of the body through faeces then there is a real chance that other harmful bacteria will pick up the drug resistance. And I don’t think we are particularly proud of our sanitation in this country. An already bad drug resistance situation will become a lot worse. But this is only half the story. The introduction of a novel gene like this can give rise to exotic, novel diseases that we cannot even begin to second guess. I am totally with Dr Bhargava when he says that it will be the biggest public health disaster of the 21st century if GM food crops are introduced into the environment.

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