A WHA Resolution: Folic Acid Fortification to Prevent Spina Bifida

16 May 2022


A healthy pregnancy starts with healthy nutritions. During the first 1,000 days of life, a healthy lifestyle including balanced nutrition is important to establishing a child’s future health.

One of the main goals of the International Federation for Spina Bifida and Hydrocephalus (IF) is to reduce the prevalence of neural tube defects and Hydrocephalus by primary prevention. This involves the following objectives:

  1. Improving national decision-makers’ access to knowledge about primary prevention of spina bifida and adult hydrocephalus
  2. Improving organisational capacity of IF members to work on primary prevention
  3. Improving processes  of multi-stakeholder networking
  4. Facilitating mutual learning among IF members
  5. Helping members and global partners to develop research-based advocacy strategies and supporting them in the implementation of their advocacy goals
  6. Supporting global prevention campaigns and communicating outcomes

Every January, the International Federation for Spina Bifida and Hydrocephalus works with its member organisations, partners and supporters to promote the World Folic Acid Awareness Week as part of the IF Global Prevention Initiative (IFGPI) as a prevention campaign to raise awareness about preventable Neural Tube Defects (NTDs) such as Spina Bifida and Hydrocephalus through folic acid supplements, staple foods fortified with folic acid or foods rich in folate, the natural form of folic acid.


Recognizing the 63rd World Health Assembly’s Resolution on Birth Defects that appealed to member states to prioritise prevention of birth defects, we are concerned by the high number of pregnancies affected by folic acid-preventable spina bifida and anencephaly globally.

World-wide at least 300,000 pregnancies are estimated to be affected with spina bifida and anencephaly annually, and 75% of them result in elective terminations, stillbirths, or under-five deaths. Those who survive have life-long paralysis and neurologic impairment; most require multiple surgeries, unavailable in low- and middle-income countries. Families face stigma and cannot afford the cost of care.

Folic acid fortification is the most effective public health strategy to prevent spina bifida and anencephaly equitably in the population. Fortified staple foods provide folic acid to women of reproductive age at a critical time in pregnancy, preventing spina bifida and anencephaly.

Mandatory food fortification with adequate folic acid has been implemented in 58 countries since the late 1990s. Folic acid fortification is safe, effective, and has high cost-benefit ratio. Yet, over 100 countries lack this intervention, adversely impacting the most vulnerable populations.

The International Federation for Spina Bifida and Hydrocephalus together with GAPSBiF and G4Alliance work together to promote WHA Resolution for Folic Acid Fortification for Spina Bifida.


  • Statement presented at the WHO Executive Board 150th Session – Pilar 3, Agenda Item 17: Maternal, Infant and young child nutrition. Click here.

  • WHA75 Side event

  • Joint Publication “Preventing birth defects, saving lives, and promoting health equity: an urgent call to action for universal mandatory food fortification with folic acid”. Click here.


  • Social media toolkit for WHA side event May 24, Geneva. Click here.
  • Infographic. Click¬†here.
  • IF Information Package on Global Prevention on Folic Acid. Click here.
  • Information about the WHA75. Click here.
  • IF Maternal Health and Prevention video. Click here.
  • Papers on folic acid fortification. Click here.
  • IF Policy Statement on Prevention of Neural Tube Defects and Mandatory Food Fortification (2005). Click here.
  • Smarter Futures ‚Äď An African way to Promote Food Fortification. Click here.
  • Advocacy Tool to Promote the Implementation of Folic Acid Intervention. Click here.
  • Food Fortification Global Progress. Click here.
  • World Health Organization. Guidelines on Food Fortification with Micronutrients (2006). Click here.
  • Essential Nutrition Actions: Improving Maternal, Newborn, Infant and Young Child Heath and Nutrition. Click here.
  • Global Fortification Data Exchange (GFDx). Click here.


  • The Global Alliance for Surgical, Obstetric, Trauma and Anaesthesia Care (G4 Alliance), Global Alliance for Prevention of Spina Bifida F (GAPSBiF), International Society for Pediatric Neurosurgery (ISPN), and World Federation of Neurosurgical Societies (WFNS).¬† Click here.
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