Parables on Genetic Engineering
Beyond Outreach, to Engagement
Mosquitoes
In 2012 staff members on Oxitec’s research team for genetically modified mosquitoes were attending a town hall meeting in the Florida Keys. Oxitec’s mosquitoes are all males, they don’t bite, and are genetically modified with a kill switch gene. All of their offspring will die in the larval stage, never reaching maturity, never biting and, most importantly, never infecting people with diseases such as dengue, malaria, or zika.
The staff members must have felt pretty confident going into this town hall meeting. They had already run trials with these mosquitoes on Grand Cayman. And after all, it was the Florida Keys Mosquito Control District (FKMCD) that had reached out to *them* in order to help halt the spread of zika and dengue. The FDA had also decided to assess the field trial at a lower risk category, allowing Oxitec to conduct their own risk assessment qualitatively, due to the already demonstrated safety of the technology. Beyond all of this, the staff members had already been conducting “community engagement.” They had spoken with the county commission, the Key West City Commission, written articles in the local newspapers, and been on the radio talking about the field trial every week. Therefore, I suspect they were quite surprised when the town hall meeting began and every single attendant bar one was there to oppose the trial.
The trial had been scheduled for 2016 but local opposition forced it to cancel. The company did try again, and was able to conduct the field trial in 2021. But why did they fail to conduct the first planned trial? Oxitec had seemingly done everything right. They went through all the proper legal channels, they even went above and beyond to “engage” with the community. So what happened? Why was there so much public opposition?
Meanwhile, that same July in Juazeiro, Brazil, Margareth Capurro was listening to the sounds of cheers from local residents at the opening of a production facility for those same mosquitoes. Oxitec was also conducting a trial in Brazil, and Dr. Capurro, a biologist at the University of Sao Paulo, was leading the trial.
When she and her team were trying to get approval for the release of mosquitoes in Juazeiro, Brazil didn’t have a well established regulatory system for genetically modified insects. Unlike her counterparts in the United States, Dr. Capurro couldn’t rely on national regulatory approval to move ahead. While Oxitec had gotten permission to proceed, local support was going to be key to a sustained effort, and establishing a more regular legal pathway for future tests.
So Dr. Capurro got to work. She and her team did much the same work as the team in the Keys did: they went on TV and radio, wrote newspaper articles, and met with local officials. But this wasn’t the key part of their engagement. In fact, this work could hardly be called engagement at all, as the communication was only one way. So Dr. Capurro and her team went a step further. They went house to house talking with residents and listening to their concerns one on one. They also went to schools where they would speak to parents, children, and local educators about the mosquito trial. More than that, since the trial needed mosquito traps widely and evenly distributed across the test area, hundreds of residents hosted these traps, giving them an opportunity to participate in the trial itself and to engage in a continual dialogue with the scientists running it.
Cows
It turns out mosquitoes aren’t the only things people don’t like being genetically modified. Things were going well for Robert Schenkel in 1984. He headed American Cyanamid’s research into recombinant bovine growth hormone, or rBGH. American Cyanamid was one of four companies that had developed a way to synthesize the hormone that cows used to stimulate milk production. They had conducted tests on milk produced using cows treated with the hormone, and the FDA had concluded that it was safe for human consumption. Now they had moved on to test herds, so the FDA could assess the safety of the cows, and so they could tell farmers exactly how much to expect their yields to increase. Everything was by the books, and the system was working as intended.
But it didn’t take long for that good outlook to come crashing down. In 1986 activists petitioned the FDA to conduct an environmental impact statement for rBGH on the grounds that it would, “damage the environment, cause unnecessary suffering to cows, and wreak havoc on the dairy community.” Each of these claims was based off of the projected systemic effects from the increase in production, rather than the effects of the hormone itself.
Environmentalists were concerned about the downstream effects of the genetic changes and the environmental effects of increased production. Animal rights activists had seen that the dairy industry had just been paid by the federal government to slaughter millions of cows due to overproduction of milk, and predicted that similar cruelties would become more commonplace if milk production was increased by the predicted 20% when there was already a milk surplus. Dairy farmers were concerned that an increase in production would favor farms that could afford to treat all their cows, causing a contraction in the industry of a predicted 25%-30%, most of which would be small farms. The FDA was equipped to test for safety, but not these other socio-economic risks.
It was at this point that activist and political entrepreneur Andy Rifkin got involved. Wherever there was opposition to big biotech companies, Rifkin would soon follow. He was an opponent to all things genetic engineering and saw rBGH as his most important battle yet. Latching on to existing opposition, Rifken fanned the flames and soon, even the FDA’s assurances of safety were under question. The issue became so inflammatory, that congress asked the National Institute of Health (NIH) to conduct an independent study of the possible health effects of rBGH.
But the problem was not one that could not be solved with mere facts of scientific consensus. Grocery stores like Kroger had sworn off rBGH treated cows from any of their dairy products. Maine and Vermont signed rBGH labeling laws. Neither the studies for the FDA, nor the independent review of the NIH, or any assurances by experts really, were working to convince people to accept rBGH!
In the end, the companies making rBGH and the large milk producers outlasted the opposition movement. Rifken did what political entrepreneurs do, and moved on to the next big issue. Opposition died down. Most milk producers began using rBGH, with a small market remaining for those whose concern over genetic modification did not wane. But it took 10 years. In the end, no one really won. All the social consequences opponents were worried about still came to pass, and yet the rollout of the new technology was still delayed by a decade.
Parables
What do these stories tell us about how experts and government officials should relate to the public? Why did they succeed in Brazil and fail in the United States? Why was the outcome of rBGH so unsatisfactory?
I don’t mean to oversimplify the issues here. In the case of Oxitec, there was a clear difference in stakes and resources. Citizens in Juazeiro were at substantially higher risk from dengue and zika than residents of the Florida Keys. Thus it makes sense that they would consequently be more willing to accept potential risks from the genetically engineered mosquitoes. Floridians also had more resources to be able to research and oppose Oxitec in response to those risks. In the case of rBGH, it is also clear that political entrepreneurs and fanatics like Rifkin can exacerbate a contentious situation if they find doing so is in their interests. But these factors are only part of the story.
The other part is about how experts and bureaucrats approach citizens. There is an important difference between outreach and engagement. In Florida, Oxitec conducted outreach, but not engagement. The flow of information was one way. No one got to air their grievances. There was no compromise with the concerns of the locals. No regular citizens were involved in the process. Not until the only choice they had was to either accept Oxitec’s trial as it was presented to them or reject it outright. So we shouldn’t be surprised that they rejected it.
We can see this contrast clearly in the case of Oxitec’s mosquitoes because of how successful the same trials were, at the same time in Brazil. While it isn’t clear Oxitec actually had to make any compromises with locals there, their relationship with locals was certainly different. In contrast with Florida, Oxitec scientists in Brazil approached residents in a two way dialogue before the trials were fixed. Locals got to directly express their concerns to the scientists. They weren’t just told what was going on. And they were even involved in the test, with some locals helping to gather mosquito samples on their properties. Even this simple move from mere outreach to actual, two-way engagement seemed to make a big difference in Oxitec’s success.
In the case of rBGH there was a clear gap between the concerns regulators like the FDA were designed to address, and the issues that detractors actually cared about. So it stands to reason that we should not expect FDA approval to assuage those concerns. They were not initially about safety, but about values and ways of life. Therefore outreach in the form of scientific fact was useless. What would have nipped opposition in the bud was, again, engagement: a two way dialogue complete with compromise and real say in the development and use of the new technology.
I see the confusion between outreach and engagement hinder policies far too often. When Albuquerque officials try to convince local business owners of the benefits of ART, it falls on deaf ears because it should have been a dialogue and should have happened earlier in the process. America has neither new nuclear power plants, nor has decomissioned its existing plants, now aging beyond their intended life because both sides expect that public outreach disseminating the “facts” will force their opponents into logical submission. And the U.S. military is not going to get out of its recruitment crisis by convincing people to join via outreach without actually trying to address the legitimate concerns over the treatment of veterans and the moral opposition to U.S. military actions.
None of these issues are solely the result of using outreach when the right tool is engagement. Just like the stories of genetic engineering mishaps. But, also like those stories, missing the distinction between the two can only serve to make things worse.
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