In each country, the Center will develop and support a program of country-level science-based advocacy by identifying and supporting in-country champions and facilitators. These advocates will include physicians, parents of affected babies and children, and other influencers who will build the necessary social and political support for mandating, successfully implementing and evaluating the effectiveness of folic acid fortification. Leadership for this approach will be provided by the Center in collaboration with other interested partners. The goal is to obtain a government mandate for folic acid fortification of a centrally processed food.
Once we achieve the political will in a country, we will support the national government and industry with an implementation team to follow through on the necessary steps to institutionalize and evaluate the fortification program. We have recently identified high-priority countries where mandatory fortification has the greatest opportunity to prevent folic acid-preventable spina bifida and anencephaly. Technical support will be provided to strengthen the design, implementation, and monitoring of mandatory cereal grain fortification processes by millers. Our partner, the Food Fortification Initiative, will provide leadership for this approach.
Training will be provided to the country or regional coordinator on fortification and project management techniques. We will integrate these prevention programs into the existing government and milling systems to make prevention sustainable.
The Center will develop a biomarker surveillance program (based upon serum and red blood cell folate concentrations) and assist governments in using biomarker surveys to assess the success of required fortification programs. These surveys can also be used to demonstrate the need for mandatory fortification where there may be resistance.