Approximately only 15 percent of global cases of spina bifida and anencephaly that are preventable through folic acid fortification are actually being prevented according to a study led by epidemiologists and nutrition scientists from the Departments of Epidemiology and Global Health at Emory’s Rollins School of Public Health and the Food Fortification Initiative.

Published in the July edition of Birth Defects Research Part A Clinical and Molecular Teratology, the study emphasizes the preventable morbidity and mortality caused by the lack of cost-effective, easily implementable, and proven strategy of government-required folic acid fortification of food (also termed mandatory fortification). The researchers measured the current status of folic acid-preventable spina bifida and anencephaly (FAP SBA) worldwide. This was particularly significant as it was the 25th anniversary of the Medical Research Council study that proved unequivocally that folic acid prevents a majority of spina bifida and anencephaly.

According to study results, in the year 2015, there were about 35,500 fewer births with spina bifida and anencephaly, a commendable prevention achieved in 58 countries through mandatory folic acid fortification of wheat and maize flour. However, this also points to the urgency of preventing about 233,000 other FAP SBA cases that are still occurring in the remaining countries without effective folic acid interventions, say the authors. Most of Europe, Africa, and Asia is not implementing mandatory fortification with folic acid. Researchers believe that the implementation of mandatory fortification with folic acid offers governments a rapid way to prevent FAP SBA-associated disability and mortality, and to help countries achieve their health-related Sustainable Development Goalsrelated to reduction in infant and under-five mortality.

"No baby in the world should develop preventable birth defects such as FAP SBA and congenital rubella syndrome, because we have a known preventable strategy to aid against these conditions," says Dr. Godfrey P. Oakley Jr., MD, a pediatrician and the director of the Center for Spina Bifida Prevention at Emory’s Rollins School of Public Health. "Ignoring a preventable strategy for preventing serious birth defects can be compared to having a vaccine for Zika virus and not using it."