A University of Georgia researcher is leading an international effort to reduce neural tube defects, such as spina bifida, in developing countries that is backed by a $734,437 grant from the Bill and Melinda Gates Foundation to the hosting organization, Nutrition International.
Lynn Bailey, a noted expert in folate research and head of the department of foods and nutrition within the UGA College of Family and Consumer Sciences, is chair of an expert advisory group assembled last year by Nutrition International to develop a “roadmap for action” for preventing NTDs.
The group is charged with building global capacity for folate testing laboratories in low and middle-income countries along with effective folic acid fortification programs and NTD-surveillance systems to document the effectiveness of these approaches to prevent NTDs. The term of the initial phase of funding is 18 months.
Bailey was chosen to lead the group due to a lifetime of work in the research of folate, an essential B vitamin required for DNA synthesis and normal growth and development.
Maternal folate deficiency within the first month of pregnancy is a major cause of NTDs, with a global estimate of around 260,000 affected pregnancies annually.
It’s predicted that developing countries are most likely to have lower folate status and thus be at much higher risk of NTDs. These impoverished countries also present the most challenges in assessing folate status, implementing folic acid intervention programs and establishing birth defect surveillance programs.
The majority of NTDs can be prevented with folic acid interventions including mandatory fortification of the food supply and in some cases targeted folic acid supplementation.
“There’s never been a global coordinated effort to eradicate NTDs,” Bailey said. “We’re not going to prevent neural tube defects in a few years, but our collaborative efforts will make significant progress by setting up global regional labs to assess folate status, establishing and implementing folic acid intervention programs and assessing the effectiveness of these programs by monitoring the impact on NTD-affected pregnancies.”
One of the initial tasks of the expert advisory group is to conduct a landscape analysis to prioritize countries where intervention is most desperately needed.
Many impoverished regions lack the resources to establish the required infrastructure to fortify foods.
In areas where fortification has been implemented, the number of children born with NTDs has dropped significantly. Chile, for example, reported a 40 percent reduction within two years of implementing folic acid fortification.
While some funding will be directed toward establishing regional labs to assess folate status and conduct blood analysis, another key component of the project includes engaging global partners, governments and advocates in efforts to not only implement folic acid fortification but also to build capacity to sustain these programs.
“It really saves the country money if they invest in folic acid fortification because to care for an infant or a child with an NTD if they do survive beyond infancy is exorbitantly expensive,” Bailey said.
The project is the result of a technical consultation also chaired by Bailey and hosted by Nutrition International that began in 2016 and includes global partners like the Centers for Disease Control and Prevention and the World Health Organization.
The group of experts produced a series of peer-reviewed journal publications recently published in a special edition of the Annals of the New York Academy of Sciences focused on three areas: folate status assessment in women of reproductive age; NTD burden and surveillance; and interventions for NTD prevention.
Bailey, who was part of the U.S. Food and Drug Administration committee that recommended folic acid fortification to the U.S. government in the mid-1990s to prevent NTDs, served as lead author or co-author on three of these recently published papers.
“The exciting thing about this opportunity is it brings together individuals who have boots on the ground in developing countries and really understand what’s workable in a low-resource environment where the NTD risk is very high,” Bailey said.
The special edition, “Folate status in women and neural tube defect risk reduction,” can be viewed at the following link: https://nyaspubs.onlinelibrary.wiley.com/toc/17496632/1414/1
For more information on Nutrition International, visit https://www.nutritionintl.org
