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Biopolicy Journal
Pontificia Universidad Católica de Valparaíso
ISSN: 1363-2450
Vol. 3, Num. 1, 2000
Biopolicy, Volume 3 , Paper 2 (PY00002) November 24th 2000

Biopolicy, Volume 3 , Paper 2 (PY00002) November 24th 2000
Online Journal - URL: http://bioline.bdt.org.br/py

Establishing the Scope of a Multilateral System for Plant Genetic Resources for Food and Agriculture: Implications of Crop Exclusions

Cary Fowler, Ph.D. Agricultural University of Norway / IPGRI, P.O. Box 5001, N-1432 Aas, Norway cary.fowler@noragric.nlh.no

Code Number PY00002

Received October 19th, 2000
Accepted November 20th, 2000
Published November 24th, 2000

SUMMARY:

The Food and Agriculture Organisation (FAO) is currently hosting intergovernmental negotiations on plant genetic resources for food and agriculture. It expected that these negotiations will result in the creation of a Multilateral System with agreed rules for access and benefit-sharing for a specified group of crops. There are wide differences among governments about how many and which crops should be placed within this system. While much of the discussion has centered around the functioning of the Multilateral System, comparatively little has been said about what effect there might be on crops excluded from this system. This paper looks in particular at those crops of interest to the Consultative Group on International Agricultural Research (CGIAR) that are in danger of being excluded from the Multilateral System. The paper argues that exclusion of those crops is likely to result in reductions in access, conservation and plant breeding for developing countries with few offsetting benefits.

Key words: Food and Agriculture Organisation, FAO, International Undertaking, plant genetic resources, CGIAR, access, benefit sharing, Convention on Biological Diversity, CBD

INTRODUCTION

Following the coming into force of the Convention on Biological Diversity, the FAO began (in 1994) to host intergovernmental negotiations designed to bring its non-binding International Undertaking on Plant Genetic Resources into harmony with the Convention. The expectation and the goal was to produce a legally-binding agreement, one that might become a protocol to the Convention itself.

In Resolution 3 of the Nairobi Final Act of the Conference for the Adoption of the Agreed Text of the Convention on Biological Diversity (22 May 1992), delegates implicitly acknowledged that there were substantial differences between how access and benefit-sharing arrangements to genetic resources in general would be handled, and how agro-biodiversity specifically could and should be treated. In the former case, access would be granted by the country of origin on the basis of "prior informed consent" and "mutually agreed terms." This approach, however, was not as appropriate when applied to the intra-specific genetic diversity of agricultural species. Agricultural crops have been spreading about the globe for millennia. Countries of origin are difficult to identify with any precision, as distinctive properties of crops have arisen over vast amounts of territory, and time. Furthermore, much of this diversity has been collected (FAO 1998), making it difficult for any one country to benefit financially from being a supplier, simply because there will typically be multiple, potential suppliers.

Given the peculiar characteristics of agro-biodiversity noted above, delegates began to focus not so much on bilateral approaches as implied when individual countries of origin provide access based on negotiated terms, but on creation of a multilateral system for plant genetic resources for food and agriculture. This multilateral system, presumably, would obviate the need for determining countries of origin or negotiating terms of access on a case-by-case basis. Instead, facilitated access to genetic materials of an agreed list of crops would be given, and benefits would be shared (or provided) in a certain way by parties to the agreement.

From the beginning of the FAO negotiations in 1994, the centers and the genetic resource collections of the CGIAR have been a major consideration for delegates. Centers currently hold approximately 10% of the six million accessions in ex situ (typically, genebank) collections. The collections have a much greater importance than the 10% figure might indicate. A large, but unknown, number of the total accessions in storage are thought to be duplicates. The number of "unique" samples may be a third or less of the total. The CGIAR collections are much less plagued by the unintended duplication that characterizes other collections, mainly owning to the quality of the information and data associated with CGIAR collections. Moreover, CGIAR collections are disproportionately comprised of "landraces," highly diverse "farmers' varieties." Approximately 59% of the CGIAR materials are landraces, compared with only 12%, on average, for government genebanks, and 3% for private genebanks (FAO, 1998).

The CGIAR collections were assembled during a time when Plant Genetic Resources for Agriculture (PGRFA) were considered "the common heritage of humankind." There was an implicit, and sometimes explicit, guarantee that the collections would remain in the "public domain," cared for by the CGIAR, but available for all to use. In keeping with this history, the individual CGIAR centers signed identical agreements with FAO in 1994 "placing collections of plant germplasm under the auspices of FAO." These agreements formalized the status of the materials. The centers agreed:

...to hold the designated germplasm in trust for the benefit of the international community, in particular the developing countries in accordance with the International Undertaking on Plant Genetic Resources and the terms and conditions set out in this Agreement.

The agreements established the CGIAR collections as the only collections with a formal and recognized international character. And, they established the link between the CGIAR, these collections, and the FAO International Undertaking. Currently, some 514,000 accessions have been designated by centers under the terms of these agreements. These PGRFA collections are perhaps the most used in the world, not just because they contain much of the world's diversity of the most important crops, but because the CGIAR has invested tremendously in researching and documenting the materials, thus enhancing their value to plant breeders.

Current CGIAR management and access practices - in line with the 1994 agreements with FAO - depend on the genetic materials in these collections continuing to enjoy an international character; on the ability of the CGIAR to hold them "in trust for the benefit of the international community", and to make them available fully and freely to all.

The 160-member intergovernmental FAO Commission on Genetic Resources for Food and Agriculture has previously endorsed the agreements with CGIAR Centers. It might be assumed, therefore, that they would wish to see these materials included within the framework of the multilateral system that they are negotiating. Leaving them outside this emerging system would almost certainly undermine their international status, and create uncertainty about who actually had sovereignty and/or ownership over the materials, what the conditions of access and use might be, etc.

This brief paper concerns the plant genetic resources held "in trust" by the CGIAR, and the scope of the emerging multilateral system. Specifically, the paper addresses the possibility that not all of the genetic materials conserved by (or crops of interest to) the CGIAR will be included in the multilateral system established by the negotiations at FAO. The focus of the remainder of the paper will therefore be on crops that might be excluded from the system, on their importance to developing countries, and on the possible effects of placing them outside the multilateral system.

DEFINING THE SCOPE OF THE MULTILATERAL SYSTEM

The Chairman of the FAO Commission, Ambassador Fernando Gerbasi of Venezuela, called and chaired an important but "informal" meeting in Montreaux, Switzerland, in January, 1999, designed to break through the impasse that seemed to exist in the negotiations. Present were key delegates (as well as representatives of the CGIAR) attending in their personal capacity. Among other subjects, the meeting discussed the composition of the multilateral system, and the "chairman's elements" presented as the basis for negotiation referred to "a list of crops established on the criteria of food security and interdependence." After some debate countries accepted the criteria in principal. Wrangling has continued, however, about the precise content and length of the list, chiefly because of the implied trade-off between access and benefit-sharing provisions within the multilateral system1.

In August 2000, at the Third Inter-sessional Meeting of the Chairman's Contact Group of the FAO Commission on Genetic Resources for Food and Agriculture, regions submitted proposals for which crops should be considered within the scope of the proposed "multilateral system" under the revised International Undertaking on Plant Genetic Resources. As stated above, the aim of the FAO negotiations is to produce a legally-binding agreement, and thus lay down rules for the access, conservation, use, and benefit-sharing for plant genetic resources for food and agriculture (PGRFA).

While countries agreed that crops would be chosen on the basis of "food security," and the existence of "interdependence," neither term was defined, making it impossible to generate a list of crops based on an agreed formula. Large differences were evident among the lists proposed by the different regions. (See Table 1) Africa proposed a multilateral system comprised of 9 crops; Europe proposed a system of more than 250 crops. In general, lists proposed by Africa, Asia, and Latin America and the Caribbean, are more limited than those proposed by developed countries. (The Near East region did not present a list.) Only 5 crops are common to all proposals: rice, wheat, maize, sorghum, and potato.

An examination of the proposed lists yields few clues as to the precise criteria employed by regions in selecting crops. For example, Table 1 shows that apricot (with 2.7 million Mt. production in 1999) and pear (15.8 million Mt.) are included, while sweet potato (135.2 million Mt.) and groundnut (33.1 million Mt.) are excluded from the list proposed by Latin America and the Caribbean. Another list includes oats (24.8 million Mt.), but not soybean (154.3 million Mt.). A third list includes millet (26.4 million Mt., produced in 73 countries) but not banana (58.4 million Mt., produced in 123 countries), groundnut (produced in 108 countries), or soybean (produced in 82 countries), for example. It is difficult to discern how such combinations emerged if the only criteria applied were "food security" and "interdependence," however defined.

Centers of the Consultative Group on International Agricultural Research are currently engaged in genetic improvement work on a number of crops, in keeping with their declared mission to work towards food security and poverty alleviation. Of those crops, at least 5 are omitted from all developing country regional lists (faba bean, grass pea, pigeon pea, triticale, yam) and 7 (chickpea, cowpea, forages, groundnut, minor millets, soybean, sweet potato) are omitted from two of the three. In addition to these crops, CGIAR centers work to various degrees on a number of other crops omitted from these lists (agroforestry crops, Andean root and tuber crops, Bambara groundnut, coconut, date palm, quinoa, taro).

IMPORTANCE OF NON-LIST CROPS TO DEVELOPING COUNTRIES

"Food security" is a term that can relate to a situation at world, regional, national, district and/or household levels. Were one to consider which crops are important to food security at the level of each household (one extreme), the list would be considerably longer than if one were simply to consider those most important at the global level (the other extreme). In neither case would the constitution of the list be straightforward, however, as "food security" would still need to be precisely defined (whether in terms of total calories, protein, trace elements, etc.) and thresholds established that would serve to include and exclude crops, as appropriate. Clearly, this is not going to be done by diplomats in a political and highly-charged atmosphere and just as clearly, the decision of which crops to propose for inclusion will be and has been determined on the basis of political considerations.

Table 2 provides data on production (in metric tons) of each crop, and lists the five largest producers. Examining production figures is one of a number of ways in which the importance of these crops can be indicated or understood. In most cases, production in developing countries far exceeds that in developed countries. The one exception is soybean. Both developed and developing countries are significant producers of soybean, developed countries slightly more so.

African countries - and to a lesser degree, Asian countries - are the major producers of most of the crops highlighted in Table 2. Not surprisingly, African countries are the most highly dependent on these crops, when one considers the percentage of food energy supply provided (Table 3). Again, certain Asian countries are also prominent.

DIVERSITY'S MANY BIRTHPLACES AND HOMES

Table 2 also gives the primary "Center of Diversity" for each crop. In several cases, the "center" is considered to be an entire continent, and in at least one case (pigeon pea) there is some uncertainty about where the center is. In most cases, "secondary" centers also exist, though these are not listed in Table 2 2.

It should be noted that much of the diversity of these crops is now found in genebanks. This fact adds often-unappreciated complexity to the concept of "centers of diversity," that was developed in the days before modern genebanks were established and filled.

The largest collections for each crop are listed in Table 4. CGIAR centers have the largest ex situ collections of 5 of the 7 crops for which data is available, both in terms of numbers and even more so in terms of actual genetic diversity. Excluding the CGIAR Centers, it is interesting that virtually all of the largest ex situ collections for cowpea, faba bean, groundnut, sweet potato, and yam, are located outside the historic "Centers of Diversity."

When one considers both in situ and ex situ-held materials, it is clear that diversity is widely spread geographically and that genebanks have themselves become modern-day "centers of diversity." No single country or group of countries - indeed, no single continent - comes close to owning or controlling a significant share of the diversity of any of these crops. This point is important if one considers the practicalities of either trying to obtain access or provide that access under a bilateral system, which will exist if the crops are not included within the multilateral system. In the former case, those needing access may need to negotiate with numerous countries. In the latter situation, those wishing to extract benefits from granting access to their materials will find that they control only a small portion of the total diversity and that there may be many alternative sources of supply. Most of the transactions to acquire materials of these particular crops will probably be initiated by developing countries (the principal producers), while a combination of developing and developed countries would be potential suppliers.

The task of securing benefits faced by providing countries will be compounded by the need to determine not the centre of diversity, but the precise country of origin. As stated in the Convention on Biological Diversity, "the genetic resources being provided...are only those that are provided by Contracting Parties that are countries of origin of such resources..." (Article 15) Furthermore, under the Convention, the country where the accession is found may not be the legal "country of origin," because the Convention refers to the country of origin not of an accession or a variety, but of "distinctive properties."

One might conclude from the above that bilateral treatment of this group of crops is unlikely to generate substantial benefits. Most "buyers" of the genetic resources will be other developing countries (mainly African and Asian), many among the world's least developed. Suppliers will be numerous and dispersed. Ascertaining sovereignty and ownership will even be difficult. Bilateral treatment might, however, result in unexpected costs and in loss of existing benefits - topics briefly explored in the next section.

CONSERVATION AND DEVELOPMENT CONSTRAINTS FOR EXCLUDED CROPS

Under a bilateral regime, countries may be expected to bear increased responsibilities for conservation. And, of course, individual countries will be responsible for securing access to the genetic materials they need and for subsequent development of these resources. This will be most difficult for certain African nations. According to FAO (1998), "Of the 32 African countries with national plant breeding programmes, 16 do not have a national genebank." Thus, national capacity to conserve and keep on hand the genetic materials needed in crop breeding programmes is frequently absent. The CGIAR would certainly endeavour to continue to serve the needs of developing countries related to these crops. However, the CGIAR may be constrained in securing funding to provide "multilateral" conservation services for crops that are otherwise treated bilaterally and are not deemed to be sufficiently important to food security to be included within the multilateral system.

As the Multilateral System will presumably provide "facilitated access" to the genetic resources of crops, access to materials of crops outside the system is expected to be less-than-facilitated. Recent work (Fowler and Smale, 2000) has shown that developing countries, considered individually, are virtually always major net recipients of germplasm from the CGIAR. During the period 1970-1991/2, the ratio of samples provided to fifteen developing countries compared to samples received, was four to one. This was during a period of intense collecting, and the ratio - still indicative of major net flows to developing countries - demonstrates this. In 1992, a typical year indicative of the reduced collecting now taking place, the ratio (calculated on the basis of all developing countries) was sixty to one - sixty samples sent to developing countries for each sample received. This data reflects only transfers from genebanks. Were transfers of improved materials considered, the ratio would be much higher.

Ironically, restriction on access to CGIAR-held accessions of crops not in the Multilateral System may cut off one of the major sources of genetic resources available to developing countries, who, collectively, supplied most of the original materials.

No figures are available on the amount of multilateral or aid funding that is made available yearly for actual breeding work on these crops, either to national agricultural research systems (NARS) or to the CGIAR. However, such funding surely represents a substantial portion of total funding for "public" research on these crops in developing countries.

In a world divided into crops inside and outside the Multilateral System, the production of international public goods by CGIAR centers might seem "out of place" in crops that are not part of the international system. Given the fact that many of the plant breeders working in these crops are employed by the CGIAR, one might expect a significant decrease in total research for developing countries3. For example, the International Potato Center (CIP) employs approximately one-fifth of the sweet potato breeders working in developing countries (one-third if China is excluded). Most countries - including some of the largest producers - have no breeders at all. There are fewer than 20 working in 6-7 developing countries. The small number of breeders working on the crop are backstopped and serviced substantially by CIP. Indeed, CIP alone in the public sector, is doing population development, establishing core collections, analysing diversity through molecular markets, etc. for developing countries. Were this programme terminated, only the private sector (in this case, Monsanto) would be involved in utilizing such modern approaches to sweet potato improvement. Access by NARS to modern technologies and improved materials would decline precipitously.

The impact of CGIAR breeding work on crops considered in this paper may not be accurately measured just by considering the number of plant breeders alone. CGIAR breeders typically have ready access to a wide range of materials, an impressive infrastructure, and the assistance of colleagues in allied professions such as pathology, entomology, virology, nematology, agronomy, molecular genetics and socio-economics. This capacity underpins the work of CGIAR plant breeders, but also to some extent supports the work of breeders in developing country NARS.

In the case of sweet potatoes, cited above, even access to landraces would be rendered problematic by exclusion from the Multilateral System, and not just because of the necessity of negotiating access on a case-by-case basis with numerous governments. Sweet potatoes are subject to numerous diseases as well as certain biological constraints making their transfer either as seeds or as plants difficult and risky. Quarantine regulations typically exclude such transfers. Thus, materials are transferred as disease-free clones produced through tissue culture. The capacity to undertake this work is lacking in most developing countries. Thus, exclusion of sweet potatoes from the Multilateral System would not so much place individual countries in a position to provide access and reap benefits, as it would seriously restrict access and eliminate benefits, at least until countries established sophisticated biotechnology facilities for the crop.

The share of total developing country breeding activity undertaken by CGIAR scientists is arguably even higher for many of the other crops discussed in this paper. For example, there may be as few as three yam breeders in the developing world, two of whom work for the International Institute of Tropical Agriculture, a CGIAR center with headquarters in Nigeria.

Given the characteristics of "omitted" crops, there is little incentive for private plant breeding, thus one would not expect the private sector to fill the gap.

CONCLUSION

Negotiations are moving forward, slowly but steadily, at FAO. The question of the scope of the Multilateral System for plant genetic resources for food and agriculture is one of the major issues facing government delegates. It is likely to be debated and decided in the coming months.

There is a undeniable logic behind the proposition that the amount of access provided to genetic resources should be balanced by an appropriate amount of "benefit sharing." Centuries of botanical exploitation of developing countries (Crosby 1986), real and perceived, add emotional fuel to the argument. Nevertheless, the crops that on the brink of being excluded from the multilateral system being negotiated at FAO are predominantly ones of interest to developing countries and particularly to the poor in these countries. In any case, distribution of genetic resources of these crops (ex situ and in situ) is broad, explaining past failures and complicating any future effort to extract economic value from the provision of access.

Exclusion from the proposed multilateral system would eliminate whatever benefits are associated with this system (a matter still to be determined by negotiation), without necessarily replacing them with any benefits derived from the alternative bilateral arrangements. This paper points to the possibility of a significant loss of benefits, as well as to increased national responsibilities (and costs), if crops associated with the CGIAR are omitted from the multilateral system. In short, both access and benefits would likely be reduced. Conservation would be undermined, as it is dependent on both access and on the capacity of organizations such as the CGIAR to provide public goods and services for the international community.

As the goal of the FAO negotiations is to bring the International Undertaking into harmony with the Convention on Biological Diversity, an argument could be made that exclusion of such crops would not just be of questionable utility, it would, in practice, run counter to the goals of the Convention.

Table 1. Crops of Primary Interest to the CGIAR, Proposed for the Multilateral System, by Region*

CROP

AFRICA

ASIA

LATIN AMERICA & CARIBBEAN

NORTH AMERICA

EUROPE

Rice

+

+

+

+

+

Maize

+

+

+

+

+

Wheat

+

+

+

+

+

Barley

X

+

+

+

+

Pearl Millet

+

+

X

+

+

Finger Millet

+

+

X

+

+

Minor Millets

X

+

X

+

+

Sorghum

+

+

+

+

+

Groundnut

X

+

X

+

+

Cowpea

X

X

+

+

+

Beans (Phaseolus)

+

X

+

+

+

Lentil

X

+

+

+

+

Soybean

X

X

+

+

+

Potato

+

+

+

+

+

Sweet Potato

X

+

X

+

+

Yam

X

X

X

+

+

Cassava

+

X

+

+

+

Banana/Plantain

X

+

+

+

+

Faba Bean

X

X

X

+

+

Chickpea

X

+

X

+

+

Pigeon Pea

X

X

X

+

+

Pea

X

+

+

+

+

Rye

X

X

+

+

+

Triticale

X

X

X

?

+

Oats

X

+

+

+

+

Grass Pea (Lathyrus)

X

X

X

+

+

Forage Crops

X

(clover)

X

+

+

+ = proposed for inclusion
X = not proposed

* With the exception of the Africa Region list, this table does not include the complete list of crops proposed by the regions - only those of principal interest to the CGIAR.

Table 2. Major Crops Undergoing Active Genetic Improvement Efforts by the CGIAR, and Which Are Omitted from Two or More Regional Lists in the FAO International Undertaking Negotiations

Crop

Center of Diversity

Production (1999)

 

 

Developed Countries (Mt)

Developing Countries (Mt)

Number of Countries Producing

Top 5 Producers

Chickpea

Western Asia, probably in Caucasus region and/or Asia Minor

249,789

8,994,233

41

India, Pakistan, Turkey, Iran, Mexico

Cowpea

West Africa

52,100

3,224,884

27

Nigeria, Niger, Mali, Myanmar, Malawi

Faba Bean (broad beans)

Probably SW Asia

719,076

3,895,500

59

China, Egypt, Ethiopia, Morocco, Italy

Groundnut

S. America

2,035,545

31,037,110

108

China, India, Nigeria, USA, Sudan

Millets

Africa, N. China

1,635,937

24,714,095

73

India, China, Burkina Faso, Nigeria, Niger

Pigeon Pea

Probably Africa

Negligible

3,235,704

18

India, Myanmar, Malawi, Uganda, Tanzania

Soybean

China, E. Asia

77,465,121

76,857,994

82

USA, Brazil, Argentina, China, India

Sweet Potato

Mexico, C. America, S. America

1,679,960

133,514,521

109

China, Uganda, Indonesia, Viet Nam, Nigeria

Yam

Africa

202,100

36,737,389

54

Nigeria, Côte d'Ivoire, Ghana, Benin, Togo

 

Sources: A.C. Zeven and P.M. Zhukovsky, (1975) Dictionary of Cultivated Plants and Their Centres of Diversity. Wageningen: Centre for Agricultural Publishing and Documentation; Food and Agriculture Organization of the UN, (2000) FAOSTAT Database This listing of crops is not intended to be inclusive of all crops in which CGIAR centers are working.

Table 3. Food Energy Dependency on Crops Excluded from Two or More Regional Proposals

CROP

COUNTRY,
listed in order of percentage of dependence on the crop*

Chickpea

Data not available (DNA)

Cowpea

DNA

Faba Bean

DNA

Groundnut

Chad, Central African Rep., Burkina Faso, Senegal, Guinea

Millets

Niger, Burkina Faso, Mali, Senegal, Chad

Pigeon Pea

DNA

Soybean

US, Brazil, Tunisia, Israel, Dominican Rep.

Sweet Potato

Solomon Islands, Rwanda, Burundi, Papua New Guinea, Uganda

Yam

Benin, Côte d'Ivoire, Nigeria, Ghana, Central African Rep.

* Source: Contribution to the Estimation of Countries' Interdependence in the Area of Plant Genetic Resources, by Ximena Flores Palacios. (1998) Background Study Paper No. 7, Rev. 1. Rome: FAO Commission on Genetic Resources for Food and Agriculture

Table 4. Major Ex Situ Collections of Crops Omitted from Two or More Lists

CROP

Top 5 Ex Situ Collections (in ranked order by numbers of accessions)*

Chickpea

ICRISAT, ICARDA, Pakistan, US, Iran

Cowpea

IITA, Philippines, US, AVRDC, India

Faba Bean

ICARDA, Germany, Italy, Spain, Russia

Groundnut

US, India, ICRISAT, China, Argentina

Soybean

China, US, AVRDC, Brazil, Ukraine

Sweet Potato

CIP, Japan, US, Peru, Philippines

Yam

IITA, Côte d'Ivoire, India, Philippines, Sri Lanka

* Source: The State of the World's Plant Genetic Resources for Food and Agriculture. Rome: FAO. (1998) Note: Data for some crops under development by CGIAR centers is not available from FAO (e.g., Millets, pea, pigeon pea, and forages) CGIAR Centers are italicized.

FOOTNOTES

1 This debate is understandable, but it assumes among other things that substantial benefits for agrobiodiversity can be secured outside a multilateral system, i.e, through bilateral arrangements. The problematic nature of this strategy was one of the main factors leading to the convening of the FAO negotiations and the consideration of a multilateral approach. Little evidence exists to support the notion that there is a strong market for PGRFA.

2 The existence of secondary centers is indicative of a further complication of the use of the concept of "country of origin" and of handling of access and benefit-sharing arrangements bilaterally.

3 The author is grateful to staff at the International Potato Center, The International Institute of Tropical Agriculture and the International Crop Research Institute for the Semi-Arid Tropics for informally providing estimates of numbers of "full-time equivalent" breeders working on specific crops in developing countries.

REFERENCES

Crosby, A. (1986) Ecological Imperialism: The Biological Expansion of Europe, 900-1900. Cambridge: Cambridge University Press.

FAO (1998). The State of the World's Plant Genetic Resources for Food and Agriculture. Rome: Food and Agriculture Organization of the United Nations.

Fowler, C. and M. Smale (2000) Germplasm Flows: An Analysis of the Transfer of Plant Genetic Resources Between Developing Countries and the CGIAR. Rome: Global Forum on Agricultural Research / FAO.

 

Copyright remains with the author

Published by Biostrategy Associates, UK

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