The Global Problem
Each year, about 200,000 children worldwide are born with folic acid-preventable spina bifida or anencephaly.
As of 2017, a total of 59 countries are preventing these birth defects through sustained mandatory folic acid fortification, but more than 100 countries do not currently have prevention programs. The main problem is that we know mandatory fortification of staple foods with folic acid will prevent almost all of these birth defects, but we are preventing only about 18% of them globally.
This is an important child health issue. The total number of cases of folic acid-preventable spina bifida and anencephaly is similar to that of polio before eradication programs, and 20 times higher than the thalidomide epidemic which also caused severe birth defects. The high count of afflicted babies and the severity of the conditions, in the face of an achievable solution, is why we focus on this problem.
The solution for prevention of spina bifida and anencephaly has been known for over 25 years, yet there has not been a well-planned, funded, and coordinated global program to eliminate these birth defects, as there has been for polio. A main limitation for prevention is that fortification is not seen as a priority in developing countries. The knowledge of its affordability and high cost-effectiveness is lacking among nutrition regulators and policymakers. Fortification is simple in concept, but it can be difficult to implement without coordinated efforts.
The report below which was published by the Center for Spina Bifida Prevention presents the global status of prevention: