Their View: Focusing on defects will improve global health
Over the past 25 years, the March of Dimes has achieved admirable success in helping to reduce U.S. birth defects. Prevention and treatment have cut deaths caused by defects almost in half. Now, the organization is looking to broaden its mission. In a recently announced five-year study, it found that across the world, nearly 8 million children with serious birth defects are born each year. Of these, 3.3 million die by age 5.
Because of reporting challenges, the data compiled in the Global Report on Birth Defects are somewhat imprecise. But they generally show that the worst rates of birth defects are in poor and middle-income countries.
Genetic flaws cause a number of common defects, ranging from spina bifida and sickle-cell anemia to Down syndrome. Others result from poor prenatal care, including inadequate nutrition. Cultural practices also are implicated: In some societies, chiefly in the Mideast and Africa, intermarriage among relatives is the cause of deformities.
Experience has shown that these problems can be dramatically reduced, often at very little expense. Global health organizations should use the March of Dimes study as a rallying point and work toward improvements.
The report offers a range of good recommendations. Improved health care for pregnant women would reap huge benefits, and could be achieved with modest investments. A few years ago, for instance, Chile instituted a program to fortify flour with folic acid; neural-tube defects in that country fell by 40 percent.
Strengthening family planning and education about birth defects also would help. Surveys in Johannesburg found that many people did not know what Down syndrome was, or that its risk increased with the mother's age.
Targeting birth defects is one relatively easy way to improve global health. The March of Dimes estimates that some 70 percent of all birth defects can be prevented, or their disabling effects mitigated. The organization deserves praise for opening this important discussion.
-The Providence Journal