The Importance of Folic Acid: Anifa’s Story

Anifa is an 18-month-old girl who was born with spina bifida, a serious birth defect of the spine. Like most children with spina bifida, Anifa is paralyzed and has no bowel or bladder control. She lives with her family in a village in Nigeria where there is no primary health center to help her. As a result, Anifa could not have surgery to close the opening in her spine until she was nine months old. During this time, her spinal cord was exposed and without protection. In the United States, the first surgery for a baby born with spina bifida usually takes place within the first 24 hours of life to avoid complications or death. But Anifa had no choice but to wait.

Anifa will likely face lifelong medical challenges associated with spina bifida, and the financial and emotional impacts her family will endure are overwhelming. In the United States, children born with spina bifida often live long and productive lives, even though they face many challenges. In many other countries, however, the outlook for children like Anifa is not as positive.

Worldwide, more than 300,000 babies are born every year with neural tube defects, which include spina bifida and anencephaly, a birth defect of the brain. Neural tube defects are a significant cause of death and lifelong disability, and many are preventable. Since fortification of flour with folic acid was implemented in 1998, the United States has seen a significant decline in neural tube defect rates. However, rates remain very high in other countries throughout the world.

Building on the success of folic acid fortification in the United States, CDC’s National Center on Birth Defects and Developmental Disabilities developed Birth Defects COUNT, a global initiative to significantly reduce death and lifelong disability resulting from neural tube defects. The initiative aims to increase folic acid intake among women of reproductive age to prevent neural tube defects. These efforts can help prevent approximately 150,000-210,000 neural tube defects globally each year.

Birth Defects COUNT is a critical step toward reducing the challenges faced by children like Anifa.