The Importance of Medical Student Advocacy in Global Neurosurgery: The Example of Folate Fortification

Abstract

Folic acid, also known as Vitamin B9, is a water soluble vitamin used by pregnant women to reduce the risk of spina bifida and anencephaly (SBA) in their children.1 Neurosurgeons are experts in diagnosing, assessing, and surgically treating NTDs. Pediatric neurosurgeons recognize that their role spans beyond these aspects, to include advocacy for children with neurosurgical conditions.2 Neurosurgeons are well positioned to engage in advocacy related to pediatric neurosurgery, given their expertise in the field, the importance of primary prevention, and substantial social and professional networks that allow them to collaborate with individuals in other fields and take leadership roles.3,4
 
 Despite clear evidence demonstrating the effectiveness of increasing folic acid intake in women of childbearing age, the formulation and adoption of effective policy has been challenging. Currently, only 23% of all folate-preventable cases of spina bifida and anencephaly are being prevented.5Although mandatory food fortification with folic acid is associated with markedly reduced birth prevalence of SBA, hospitalization rates, and deaths after discharge, only 56 countries have instituted mandatory folate fortification.3,5 The efficacy of folate supplementation is variable, dependent on patient knowledge and adherence.3 Greater well-coordinated advocacy efforts are necessary to facilitate the implementation of effective folate policy.