Global Health Programs: Global Initiative to Eliminate Folic Acid-preventable Neural Tube Defects

Objective

The Centers for Disease Control and Prevention (CDC) provides the scientific and programmatic expertise to build upon and strengthen global neural tube defect surveillance systems, and expand the reach of global folic acid fortification.

Program Description

Expansion of global folic acid fortification efforts can have a significant impact on infant mortality and childhood morbidity worldwide. CDC’s National Center on Birth Defects and Developmental Disabilities (NCBDDD) has developed the Global Initiative to Eliminate Folic Acid-Preventable Neural Tube Defects (GIENTD) to significantly reduce infant mortality and childhood morbidity resulting from the more than 300,000 neural tube defect-affected births worldwide each year, contribute to the achievement of United Nations Millennium Development Goal 4, and help to meet the Global Health Initiative Child Health Goal. The initiative aims  to expand the number of developing countries with mandatory folic acid fortification of high penetrance staples and provide sustainable support of long-term interventions to eliminate folic acid-preventable neural tube defects worldwide. Key components of the initiative are to provide needed technical expertise for surveillance of neural tube defects, monitor fortification efforts and improve laboratory capacity.

The GIENTD strategic objectives are to:

1. Work with WHO and others to establish a global policy to support and advance country-level fortification efforts
2. Strengthen and expand global folic acid fortification and other intervention efforts, and fill scientific and technical gaps by engaging in strategic partnerships
3. Strengthen the public health capacity for blood folate and neural tube defect surveillance, epidemiology and laboratory capacity globally, including determining biomarkers for optimal blood folate concentrations for neural tube defect prevention

Public Health Impact

• Globally there are more than 300,000 babies born with neural tube defects each year. Expanding the reach of global folic acid fortification in developed and developing countries can lead to the prevention of 150,000-210,000 neural tube defects per year.
• Many countries currently do not have the surveillance systems that can accurately monitor prevalence of neural tube defects and other observable birth defects. Through this initiative, CDC can provide needed technical expertise for surveillance of neural tube defects, monitoring of fortification efforts and improvement of laboratory capacity.

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