12 January 2026
Neural tube defects (NTDs), including spina bifida and anencephaly, are among the most common and severe congenital anomalies, yet many cases are preventable through adequate folate intake before and during early pregnancy. This peer-reviewed article, published in Frontiers in Public Health (2025), examines the impact of mandatory staple food fortification with folic acid in the Eastern Mediterranean Region (EMR) and forms part of a collaboration between IF and the WHO Regional Office for the Eastern Mediterranean (WHO EMRO).
Through a situational analysis of national policies and available epidemiological data, the study shows that countries with mandatory fortification programmes, such as Oman and Morocco, have achieved notable reductions in NTD prevalence, in line with extensive global evidence. Worldwide, many countries have demonstrated that mandatory folic acid fortification is a safe, cost-effective, and equitable public health intervention to prevent NTDs.
However, the article also highlights persistent challenges in the EMR, including uneven policy implementation, limited surveillance systems, and data gaps, which restrict accurate assessment and hinder broader progress. Several countries in the region still rely on voluntary fortification or lack comprehensive prevention strategies altogether.
With this publication, IF aims to facilitate further dialogue and policy engagement on mandatory folic acid fortification, building on global best practices. The article contributes to ongoing international discussions, such as those highlighted during World Folic Acid Awareness Week, and calls for strengthened monitoring systems, multisectoral collaboration, and political commitment to prevent avoidable birth defects and improve maternal and child health outcomes worldwide.
It’s inspiring to see how regions can learn from each other’s experiences. Many thanks to all colleagues and partners who contributed to this work!
