Stakeholders from the health and nutrition sectors, government, academe, legislative bodies, and non-government organizations gathered together on June 28, 2016 during a science legislative forum on folic acid. Conducted by the National Academy of Science and Technology (NAST), the forum had local and international experts as speakers and reactors on the role of folic acid fortification and supplementation in reducing neural tube defects (NTDs).
NTDs are the second most common group of serious birth defects that may result in immediate infant death, deformity or disability. Studies have shown that folic acid reduce effectively the risk of NTDs and measures have been taken to increase awareness and consumption of folic acid. However, its full potential has not been realized in most countries, including the Philippines.
The forum aimed to review the following: global and Philippine burden of NTDs; burden of folic acid deficiency and insufficiency in the Philippines; evidence for, impacts of, and safety of increasing folic acid intake; experiences in folic acid intake increase globally and in the Philippines. It also oriented the various stakeholders on the proposed legislations on folic acid supplementation and fortification and the role of government agencies, academe, and the private sector.
Three of the forum speakers were from UP Manila. UP Manila Chancellor Carmencita Padilla, NAST Academician, member of NAST’s Health Sciences Division and forum focal person, noted that women of reproductive age need to take folic acid not only for good health but also to save babies from NTDs. She said that women planning to get pregnant should take the vitamin at the pre-conception stage or during the early months of pregnancy.
Philippine General Hospital (PGH) Director Dr. Gerardo Legaspi talked on the surgical management of patients with NTDs while PGH Pediatric Neurology Head Dr. Marissa Lukban discussed the burden of NTDs in the Philippines. According to the data presented by Dr. Lukban, the occurrence of NTDs in the Philippines General Hospital is 23 per 10,000 live births; there is no available national data. She emphasized that cases are underreported at the Institute of Human Genetics Birth Defects Registry and the discrepancy among the regions, primarily because of varied reporting by the hospitals. Both speakers noted that surgical procedures and life-long co-morbidities of disabling NTDs were costly. They stated that long-term management of NTD patients may require frequent hospitalization and affect the family’s productivity.
Meanwhile, Dr. Robert John Berry, Medical Epidemiologist at the Prevention Research Branch of the National Center on Birth Defects and Developmental Disabilities, US Center for Disease Control, discussed folate deficiency and the role of folic acid in NTDs reduction as supported by studies. He explained that aside from deficiency, folate insufficiency is a new category of folate status that requires same attention since both pose a risk for NTDs.
Dr. Helena Pachon, Senior Nutrition Scientist of the Food Fortification Initiative, and Ms. Maria Lourdes Vega of the National Nutrition Council Nutrition Policy and Planning Division, discussed food fortification efforts and experiences in the Philippines. The former emphasized key messages on folic acid fortification of staples, such as its benefits in reducing NTDs and greater effectivity compared to supplementation. She also stated that the Philippines is one of five countries mandating wheat flour fortification but unfortunately, the existing fortification law does not include folic acid. Vega, on the other hand, expressed the openness of the local flour industry to mandatory folic acid fortification.
The last talk by Chancellor Padilla was on the highlights of the proposed legislation on folic acid. She noted that the proposed bill presents a comprehensive approach to folic acid awareness promotion and increasing folic acid consumption through fortification and supplementation.
Among the highlights of the proposed bill are: to ensure that every woman of reproductive age has access to food and food products containing folate and folic acid and folic acid supplements to reduce the risk of miscarriage and having babies with neural tube and other birth defects; to ensure that there is adequate supply of folic acid-fortified food and food products and folic acid tablets at an affordable price; to ensure that there is sufficient and correct information on the role of folate and folic acid for women of reproductive age and their children; to ensure the creation of a sustained inter-agency collaboration for the aggressive implementation and monitoring of this Act; and to foster collaborative undertakings in continuous research on folic acid food fortification and supplementation.
Dr. Padilla is the author of the Newborn Screening Act (RA 9288) approved in 2004 and the Rare Disease Act of the Philippines (RA 10747) approved early this year. Ms. Maria Lourdes Sanchez, Secretary of the House of Representatives Committee on Health cited a previous bill on folic acid authored by Cong. Rufus Rodriguez during the 14th Congress that passed the 3rd and final reading in 2008 but which was not acted upon in the Senate. Other folic acid bills in the succeeding Congresses also did not prosper. Sanchez stated that the previous approval in final reading of the folic acid education bill may help in the approval of a new bill in the House Committee, along with its inclusion in the DOH legislative agenda.
The forum’s synthesis was done and presented by UP Manila Vice Chancellor for Research and National Institutes of Health Executive Director Dr. Eva Cutiongco-Dela Paz. With reports from the NAST website and press release
