Jeffrey Blount, M.D., director of the Division of Pediatric Neurosurgery, UAB and Children's of Alabama.An international health organization is calling for universal mandatory folic acid fortification of staple foods to help prevent spina bifida and anencephaly. The Global Alliance for Prevention of Spina Bifida-F, co-founded by Jeffrey Blount, M.D., a pediatric neurosurgeon at the University of Alabama at Birmingham, is an international alliance of clinicians, researchers and advocates aiming to advance the prevention of spina bifida and anencephaly. GAPSBi-F is urging the World Health Assembly, currently meeting in Geneva, Switzerland to pass a resolution supporting global folic acid fortification.
Spina bifida and anencephaly are two severe and often fatal birth defects. These neurological conditions impact over 320,000 pregnancies every year worldwide. Overall, 56 countries, including the United States, fortify foods with folic acid but more than 100 countries do not.
“This resolution is an essential step toward overcoming the stalled progress on prevention of spina bifida, one of the most disabling of birth defects,” said Blount, director of the Division of Pediatric Neurosurgery in the Department of Neurosurgery at the Heersink School of Medicine. “A WHA resolution aimed at food fortification with folic acid, also known as vitamin B9, will give a needed push for countries to fortify. Nearly sixty countries globally have already done so, and there is no reason not to implement this intervention in all countries.”
GAPSBi-F published an article on May 23, 2022 in Lancet Global Health calling for universal mandatory folic acid fortification, coming more than 30 years after publication of a landmark trial by the British Medical Research Council that showed folic acid could prevent the majority of cases of spina bifida and anencephaly. The GAPSBi-F Lancet Global Health article is co-authored by Blount, Anastasia Smith, M.P.H., doctoral student in the UAB School of Public Health and Kathrin Zimmerman M.D., a recent graduate of the Heersink School of Medicine, along with other experts in epidemiology, advocacy and nutrition science.
Blount, who is also the chief of pediatric neurosurgery at Children’s of Alabama, says the timing of folic acid intake is critical to prevent spina bifida. Although vitamin B9 is often given in the form of prenatal vitamins, this timing is too late to prevent this birth defects as the spinal cord is formed during the first month of pregnancy.
Food fortification with folic acid, however, is a timely and underutilized solution. The article by GAPSBi-F highlights the benefits of mandatory fortification as the most proven, safe, effective, sustainable and cost-saving prevention strategy. Despite 30 years of incontrovertible scientific evidence, according to the Global Fortification Data Exchange more than 100 countries do not require fortification with folic acid. Currently, the world is only preventing a quarter of all preventable cases of spina bifida.
“With the WHO prioritization of sustainable development goals, food fortification with folic acid will bring the world closer to the targets on reducing child mortality and achieving health equity,” Blount said. “This is a smart and high-yield global health initiative.”
“This is one of many important initiatives in the UAB Comprehensive Spina Bifida Program,” Blount said. “Both our pediatric and adult clinics are some of the busiest and most accomplished clinics nationally in impacting policy and treatment for patients with spina bifida. Other accomplished national leaders in the Comprehensive Spina Bifida Program include Drs. David Joseph, Michael Conklin, Brandon Rocque, Tracy Wilson, Danielle Powell and Betsy Hopson MHSA.”