Almost a decade after it was found that folic acid could prevent the development of neural tube defects such as spina bifida, three researchers have received the Kennedy Foundation international award for scientific achievement for the discovery.
The award was made to Professor Nicholas Wald of Barts Hospital, Professor Richard Smithells, emeritus professor of paediatrics at Leeds University, and Dr Andrew Czeizel of the Budapest National Institute of Hygiene for key studies that led to the eventual identification of the beneficial effects of folic acid.
The award came four years after the United States acted on the research and began to fortify flour with folic acid. The UK Department of Health last month launched a three month consultation before deciding whether to require manufacturers to add folic acid to flour in the same way.
For Professor Wald, however, the evidence for fortification has been overwhelming for some time. “There is now conclusive evidence that if women consume more folic acid there is a substantial reduction in the chances of having a baby with spina bifida,” he said. “Women need to take it before they become pregnant, so putting it in flour it is the most effective way of preventing this disorder in the population, and the Americans have been doing it since 1997.”
Most affected pregnancies are now picked up through screening, he said, and the real impact in Britain will be the avoidance of the discovery of an affected pregnancy leading to a termination. He said he is not expecting there to be opposition to fortification in the UK: “Nearly all groups that have expressed views have been very positive about it. It is mainly government that has been rather slow to act.
“The previous government was very reluctant to even consider fortification. It was felt that the approach to health care should be people taking control of their own lives, rather than a nanny state. Yet almost all public health involves governments or setting standards. Fortunately I think the current government is in favour.”
Figure.
Professor Nicholas Wald, who discovered the folic acid link