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The investment case for folic acid fortification in developing countries
Author(s) -
Hoddinott John
Publication year - 2018
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/nyas.13527
Subject(s) - folic acid , fortification , investment (military) , business , argument (complex analysis) , economics , environmental health , medicine , chemistry , food science , politics , political science , law
There is compelling evidence that neural tube defects can be prevented through mandatory folic acid fortification. Why, then, is an investment case needed? At the core of the answer to this question is the notion that governments and individuals have limited resources for which there are many competing claims. An investment case compares the costs and benefits of folic acid fortification relative to alternative life‐saving investments and informs estimates of the financing required for implementation. Our best estimate is that the cost per death averted through mandatory folic acid fortification is $957 and the cost per disability‐adjusted life year is $14.90. Both compare favorably to recommended life‐saving interventions, such as the rotavirus vaccine and insecticide‐treated bed nets. Thus, there is a strong economic argument for mandatory folic acid fortification. Further improvements to these estimates will require better data on the costs of implementing fortification and on the costs of improving compliance where regulations are already in place.