Global fortification of foods with folic acid to prevent birth defects proposal goes before World Health Assembly

Savanah Kirchner
UAB pediatric neurosurgeon Jeffrey Blount co-founded the group who presented the resolution on fortification of folic acid in staple foods to the WHO.

1203946424711471.kbK3ZKlCtE1TQoWdmTIr height640Jeffrey Blount, M.D.A resolution to enhance fortification in staple foods with folic acid, also known as vitamin B9, passed the World Health Organization Executive Board without objection at the organization’s 152nd session this week. The proposal is now slated for discussion and full vote at the WHO World Health Assembly meeting in Switzerland in May.

The resolution was spearheaded by the Global Alliance for the Prevention of Spina Bifida, a global coalition co-founded by Jeffrey Blount, M.D., professor in the Department of Neurosurgery at the University of Alabama at Birmingham Marnix E. Heersink School of Medicine. The resolution was sponsored by the Colombian Ministry of Health, led by GAPSBiF member and Colombian neurosurgeon Kemel A. Ghotme, M.D., Ph.D.

Folic acid has long been known to reduce the risk of neural tube defects. In the United States, mandatory fortification of enriched cereal grain products with folic acid was authorized in 1996 and fully implemented in 1998. Regulations for mandatory fortification of wheat flour with folic acid are currently in place in 60 countries, although in many cases these regulations have not been implemented.

“The goal of GAPSBiF has been to use science-based efforts to advocate, support and implement policy changes to decrease the incidence of pregnancies affected by preventable neural tube defects,” said Blount, who is the director of the UAB Division of Pediatric Neurosurgery housed in Children’s of Alabama. “Thirty years of minimal progress and now we have the promise for a resolution that calls upon and sets a standard for fortification that will save hundreds of thousands of children from getting spina bifida. This means real potential for decreasing global spina bifida.” 

Foods that are fortified with folic acid include enriched breads, flours, pastas, rice and cornmeal, along with fortified corn masa flour used to make corn tortillas and tamales. Folic acid is found in some fortified breakfast cereals and some dietary supplements.  

GAPSBiF members worked to garner support from other WHO member nations, as well as non-government agencies, including the Global Alliance for Improved Nutrition and the Micronutrient Forum and International Federation for Spina Bifida and Hydrocephalus. This would be the first-ever WHO resolution fostered by the neurosurgical community, and potentially a successful example of science-based advocacy and diplomacy.   

Since its inception in 2019, GAPSBiF has grown exponentially, with members now including public health professionals, physicians, civil advocates from around the world, and leaders from the G4 Global Alliance for Surgical, Obstetric, Trauma and Anesthesia Care and leaders from the WHA.         

The WHO Executive Board is composed of 34 technically qualified members elected for three-year terms. The main functions of the board are to implement the decisions and policies of the World Health Assembly, and to advise and generally facilitate its work.