#FFI20: Vijaya Kancherla
Assistant Professor in the Department of Epidemiology and Deputy Director of Center for Spina Bifida Prevention at Emory University Rollins School of Public Health
FFI: How did you become interested in nutrition?
Kancherla: I am trained in epidemiology; my specialization is in birth defects epidemiology. One of the things that I realized early on during my studies is that there is a gap in global birth defects research and prevention. Maternal nutrition has always stood out as one of the most common risk factors that we are able to fix globally and prevent many birth defects. If you want to aim for proven interventions to improve maternal and child health globally, improving nutrition plays a big role.
FFI: What inspired you to become involved with food fortification?
Kancherla: A lack of folic acid, which is vitamin B9, has been very well studied as an important contributor for neural tube birth defects, which are birth defects that affect the brain and spine of a developing fetus. Food fortification is a very effective way to [provide micronutrients] to reach everyone equitably; it overcomes some of the challenges of supplementation programs as it does not depend on accessibility, or women needing to make behavioral changes to remember and take a supplement pill every day.
FFI: How is your organization prioritizing fortification?
Kancherla: At the Center for Spina Bifida Prevention, we engage in science-based advocacy for birth defects prevention globally. One of our big projects has been understanding and modeling prevention of spina bifida and anencephaly through food fortification with folic acid, and we heavily rely on data from FFI. We work in close collaboration with FFI and publish papers every two years tracking countries that mandate folic acid fortification, and because of that, how many folic acid-preventable spina bifida and anencephaly cases have been averted globally. This work is published in the journal called Birth Defects Research. We won the best publication award from the Society for Birth Defects Research and Prevention for one of these papers. We use FFI data frequently in our birth defects prevention advocacy work.
FFI: What health outcomes do you expect fortification to improve globally?
Kancherla: There is an urgent need to improve nutrition among women of reproductive age in many countries. Fortification really helps in these situations. Many chronic diseases in the population are addressed by better nutrition, including nutritional anemias. Food fortification addresses hidden hunger. It is one of the best ways to improve maternal and child health, and to reach society’s vulnerable populations.
FFI: In your experience, what are the main components to a successful fortification program?
Kancherla: The biggest is political will. The government has to buy in, and they have to be fully on board. We have evidence to show that government mandated food fortification works better than leaving it as a voluntary policy. It’s also not just about having a policy on paper, fortification needs to be implemented well. Fortification must be sustainable, meaning it does not change when the government changes.
FFI: What can we do as a society to continue strengthening fortification efforts?
Kancherla: Education is very important. In my experience, when we work with countries where there is no fortification, we come in with data, and present our case. Mostly they agree and see the benefit. This type of education is important because there are currently over 100 countries that do not fortify [with folic acid]. We have to do a better job in having a fortification advocacy effort that is global. It has been 30 years since we gained the knowledge that folic acid prevents neural tube defects, but prevention is only reaching 25% of all preventable cases worldwide. We still see about 200,000 cases of spina bifida and anencephaly worldwide that can be averted. We have to do better to reach out to policymakers and public-private organizations to make this happen as soon as possible.
FFI: If you were not working in nutrition, what do you think you would be doing?
Kancherla: I also work on other factors that influence birth defects. Nutrition is a very big component of preventing neural tube defects. Some other factors that I am working on are environmental and maternal health-related factors that increase the risk of birth defects. I try to look at it in a comprehensive way, the causal associations for birth defects.
FFI: Is there anything else you would like to share?
Kancherla: I have worked hand-in-hand with FFI for the last 10 years at Emory University. I rely on FFI’s expertise and knowledge for fortification-related questions. Whenever I have a question, I open up the website or see the profile of whatever country I am interested in. FFI has very caring and multi-disciplinary group of people, and it has been one of most meaningful collaborations I have been a part of. Big thanks to FFI for maintaining an up-to-date knowledge base for researchers and policy makers as well as helping in global prevention of nutritional disorders and downstream effects such as birth defects.
This interview is part of the #FFI20 Champions campaign, a celebration of fortification heroes who have helped build a smarter, stronger, and healthier world by strengthening fortification programs over the past 20 years. To read interviews with other champions, visit the #FFI20 Champions campaign homepage.