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Primary prevention of spina bifida is most effectively achieved through the mandatory addition of Folic Acid to staple foods, so called mandatory food fortification with Folic Acid. Mandatory fortification would mean that Folic Acid reaches all women of childbearing age before they become pregnant, providing the most efficient protection against neural tube defects for nearly every child.

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Smarter Futures is a public-private-civic partnership that supports similar partnerships of flour millers, governments, vitamin and mineral suppliers, international organizations, and academic institutions to make fortification of wheat flour a reality in Africa. The aim of Smarter Futures is to improve health in Africa through the enrichment of wheat and maize flour with essential vitamins and minerals.