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The investment case for folic acid fortification in developing countries
1Division of Nutritional Sciences and Charles H. Dyson School of Applied Economics and Management, Cornell University, Ithaca, New York.
Annals of the New York Academy of Sciences
|January 25, 2018
Summary
Mandatory folic acid fortification is a cost-effective strategy to prevent neural tube defects. The investment case demonstrates favorable cost-per-death averted compared to other life-saving interventions.
Area of Science:
- Public Health
- Nutritional Science
- Health Economics
Background:
- Neural tube defects (NTDs) are preventable through folic acid fortification.
- Limited resources necessitate evaluating public health interventions based on cost-effectiveness.
- An investment case provides economic justification for public health initiatives.
Purpose of the Study:
- To establish an investment case for mandatory folic acid fortification.
- To compare the cost-effectiveness of folic acid fortification with other life-saving interventions.
- To inform financing estimates for implementing folic acid fortification programs.
Main Methods:
- Cost-benefit analysis of mandatory folic acid fortification.
- Comparison of cost per death averted and cost per disability-adjusted life year (DALY) with other public health interventions.
- Estimation of implementation and compliance costs.
Main Results:
- The estimated cost per death averted by folic acid fortification is $957.
- The estimated cost per DALY averted is $14.90.
- These costs compare favorably to interventions like rotavirus vaccines and insecticide-treated bed nets.
Conclusions:
- There is a strong economic argument supporting mandatory folic acid fortification.
- Further research is needed to refine cost estimates for implementation and compliance.
- Folic acid fortification represents a high-value public health investment.
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