This review explores the importance of including the WHO-recommended formulation of weekly iron and folic acid supplementation in the Model Essential Medicines List (MEML). This inclusion is key because it would help countries prioritize this formulation in their national supply management and procurement plans for medicines. The WHO’s guidelines on WIFAS acknowledge its effectiveness in reducing anemia but did not previously have enough evidence to confirm its role in reducing neural tube defects (NTDs).
To address this gap, a comprehensive 3-arm randomized double-blind placebo-controlled trial was conducted with 331 women aged 18-45. The study investigated the effectiveness of supplements containing 60 mg of iron as ferrous fumarate with varying doses of folic acid (0 mg, 0.4 mg, or 2.8 mg), taken once weekly for 16 weeks followed by a 4-week washout period. This research aims to provide the necessary evidence to potentially include this formulation in the MEML. If the results demonstrate that weekly folic acid supplementation effectively reduces the risk of NTDs, it could lead to a revision of the WHO guidelines. The inclusion of WIFAS in the MEML for both anemia reduction and NTD prevention could significantly enhance global efforts to combat these health issues.
Roche, M. L., Samson, K. L. I., Green, T. J., Karakochuk, C. D., & Martinez, H. (2021). Perspective: Weekly Iron and Folic Acid Supplementation (WIFAS): A Critical Review and Rationale for Inclusion in the Essential Medicines List to Accelerate Anemia and Neural Tube Defects Reduction. Advances in Nutrition, 12(2), 334–343.