G20 neurologists want mandatory folic supplements for women to check spinal defects at birth

PTI

Kolkata, November 29

The Neuroscience20 or N20 Summit held along with the G20 meeting of global leaders at Bali earlier this month wants member countries to mandatorily fortify staple food like cereals or salt with folic acid to reduce prevalence and deaths from Spina Bifida-F, a spinal birth defect.

The neurologists grouping from the G20 countries was set up as part of an initiative by US President Barrack Obama nearly a decade back to give inputs to world leaders from the grouping on the cost of neurological, spine and mental disorders, as neurological diseases are believed to significantly impact the world economy due to their chronic and life-threatening nature.

While the N20 deliberated on a number of neurological issues, it also focused on prevention of Spina Bifida as it is believed to be responsible for raising health care costs in large swathes of the world including India.

“Eight countries including the UK and the US have already ordered mandatory fortification of staples with folic acid. The UK did it last year itself while the US took similar steps several decades back...We now want the remaining 12 including India, China and Indonesia to implement this WHO recommendation,” Dr Sandip Chatterjee, president of the Indian Society of Paediatric Neurosurgery, told PTI on Tuesday.

Chatterjee was part of the N20 grouping drawn from top neurologists, neuro-surgeons and neuro-psychiatrists from the G20 countries which met at Bali earlier this month.

Studies indicate that up to 80 per cent of Spina Bifida cases could be prevented if women of childbearing age are given folic acid supplements at the WHO recommended dosages.

Chatterjee, also a professor of neurosurgery and director of a city-based hospital, said he had made a presentation on the subject at the N20 Summit and pointed out that studies showed that the supplementing of folic acid “significantly reduced the number of children with this spinal condition in countries which have gone in for this simple move”.

Roughly between six to 10 out of a thousand children are born in India with a condition called Spina Bifida, a birth defect that occurs when the spine and spinal cord don't form properly, requiring life-long treatment and often a series of surgeries.

“They need neurosurgery at birth, suffer from deformities of the spine. They also develop kidney problems and even have water accumulation in their brain. The spending per child with these conditions can be up to Rs 50 lakh,” pointed out Chatterjee.

Studies have found that Spina Bifida-F can be prevented in most cases if mothers had folic acid supplements before they conceived.

“The problem is folic acid level in women in this part of the world is sub-normal. Women are currently being given folic acid supplements after their pregnancy is confirmed that is after six weeks of actually becoming pregnant, by which time the child's spine is already formed,” he lamented.

“We want to raise awareness about this and get India, the current chair of the G20, to implement this life-saving move. Adding folic acid in the same way as iodine is added to salt is a low-cost way of handling a major medical challenge for the globe,” the neurosurgeon said.

Doctors now rubbish earlier fears that folic acid doses could mask anaemia caused by Vitamin B12 deficiency as uncalled for. Studies have also proven that fears that the supplement could lead to cancer are baseless. Instead, surveys show that the intervention by the US authorities to make folic acid in staple food mandatory since 1998 has been accompanied by reduced incidence of colorectal cancer.

“We would like this to be taken up next year by the remaining 12 countries while India is the chair of the G20 movement,” Chatterjee said. 

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