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098. Development of a Neurosurgeon led Global Alliance for Science Based Advocacy for Folic Acid Fortification: the evolution and objectives of GAPSBF

Authors: Jeffrey P. Blount, MD, FAAP, FAANS

Introduction:
Spina Bifida and anencephaly (SBA) remain profound sources of morbidity and mortality worldwide. Children with SBA require lifelong care, consume vast resources, and have high levels of disability and suffering. Class I medical evidence has existed for three decades that folic acid fortification (FAF) of food is a safe and effective in markedly reducing SBA. Yet, only about 23% of the global burden is currently prevented despite decades of work by dedicated stake holders. Neurosurgeons hold a unique vantage point due to provision of lifelong care for SBA and hold respected positions in society. An alliance was developed by a group of neurosurgeons to facilitate vigorous use of science-based advocacy. Accomplishments, milestones, and objectives are reviewed in this presentation.Methods: Over 15 months an informal group of neurosurgeons and epidemiologists formed an alliance dedicated to development of neurosurgical advocacy for FAF. The founding principle was to develop skills and knowledge to empower other neurosurgeons to become “boots-on-the-ground” in affected countries with best available science-based advocacy to work toward meaningful fortification policies. Epidemiologists, fortification experts and a widening circle of neurosurgeons were recruited.
Results:
The following objectives and milestones were developed and are completed or in progress: a.) summary manuscript marking 30-year anniversary of MRC trial that provided Class I evidence for FAF b.) ISPN resolution supporting FAF c.) introduction of FAF resolution at 2022 World Health Assembly d.) development of direct support networks to locations with focal epidemics of SBA; e.) development of global alliance of neurosurgeons dedicated to FAF. Great progress has been attained and will be summarized.
Conclusion:
FAF is a public health triumph of the twentieth century yet only a small fraction of potential has been realized. The Global Alliance for Prevention of Spina Bifida (GAPSBF) strives to use science-based advocacy to attain elimination of SBA.