NINETEENTH CONGRESS OF THE 
REPUBLIC OF THE PHILIPPINES 
First Regular Session
)
SENATE
551
Senate
of ti)c «^ra-ftar^
72 JUL 13 P S 219
RECEIVE© BY.
S. No.
Introduced by Senator PIA S. CAYETANO
AN ACT
ESTABLISHING AN INTEGRATED UTILIZATION aND PROMOTION OF FOLIC 
ACID FOOD FORTIFICATION AND SUPPLEMENTATION
EXPLANATORY NOTE
Maternal health has been closely linked to newborn survival. The desire to have 
children and raise them well empowers many women and families to plan for their 
pregnancies. Women who want to prepare for their pregnancy must give due 
importance to their health and well-being, especially when it comes to proper nutrition, 
as this will also affect their children.
In the Philippines, congenital anomalies are in the top ten (10) causes of infant 
and child mortality for the past six decades.1 Some of these defects, such as neural 
tube defects (NTDs), happen in the first month of pregnancy—often before a woman 
even knows that she is pregnant. NTDs are birth defeats of the brain, spine and cord.
Globally, an estimated 260,000 pregnancies are affected by NTDs, with 75% of 
live births resulting in mortality before the age of five. They are associated with
1 Alcausin, M.M.L, Sur, A.L.D., Tumulak, 
& Padilla, CD. (Sep 5, 2017). AB122. Occurrence of
birth defects at the Philippine General Hospital, 2013-2014: a prospective study. Retrieved July 5,
2022, from httDs://www.ncbi.nlm.nih.qov/pmc/artides/PMC5641757/.


increased fetal and infant mortality, morbidity, lifelong disability, and high economic 
costs.2
Folic acid is a micronutrient belonging to the B complex group of vitamins. This 
micronutrient can be found in fruits, vegetables, legumes, and dairy products; and its 
deficiency can be brought about by low intake of the food group mentioned above, 
malabsorption and intestinal parasite infec'dons, and genetic disorders of folic acid 
metabolism. The consumption of folic acid before and during early pregnancy makes 
NTDs preventable, with the U.S. Public Health Service recommending 0.4mg daily. Its 
supplementation should start five to six (5-6) months before conception but many 
pregnancies happen unplanned, especially among teenagers and young adults.3
Folic acid deficiency increases the risk of pregnant women to have a miscarriage 
or give birth to a child with congenital anomalies or birth defects.4 In the Philippines, 
the scale and impact of folic acid deficiency is still difficult to quantify due to insufficient 
data. To meet the dietary reouirements of folic acid, it is recommended to consume 
food that includes green leafy vegetables (spinach, kangkong, asparagus), fruits 
(melon, oranges, banana, avocado) and legumes, beef liver, and lean beef. 
Consuming a multivitamin of 0.4mg of folic acid daily also guarantees a woman of 
receiving the amount needed for a healthy pregnancy.5
First filed in the 17th Congress by the undersigned at the House of 
Representatives, this proposed measure aims to provide a comprehensive approach 
to address the causes of folic acid deficiency and its association to miscarriages and 
congenital anomalies. By fortifying food products with folic acid and ensuring its 
adequate intake among women of reproductive age, congenital anomalies can be
2 Ostrea, Jr., E.M. (Mar 30, 2022). Prevention of Fetal Neural Tube Defect with Folic Acid 
Supplementation. Retrieved July 5, 2022, from
https://actamedicaphilippina.upm.edu.ph/index.Dhp/acta/article/view/5539.
3 Ibid.
4 Office on Women's Health, (n.d.). Folic acid. Retrieved July 5, 2022, from 
https://www.womenshealth.aov/a-z-topics/folic-acid.
5 Food and Nutrition Research Institute, (n.d.). Folic Acid Prevents Birth Defects. Retrieved July 5, 
2022, from https://www.fnri.dost.qov.ph/index.php/publications/writers-pool-corner/59-babies-and- 
children/96-fQlic-acid-prevents-birth-defects.


prevented. Thus, this bill aims to implement policies and programs to promote and 
increase the supply, access, consumption, and utilization of an adequate quantity, 
quality, and a variety of food with folic acid for different population groups, which shall 
also include food-based strategies, nutrition counseling, public health and food safety 
measures.
For these reasons, the passage of this bill is urged.
J?.
PIA S. CAYETONO/liS.


NINETEENTH CONGRESS OF THE 
REPUBLIC OF THE PHILIPPINES 
First Regular Session
)
SENATE
S. No. 551
ffigi senate
of tl)f i^rfretard
72 JUL13 P5 *19
RHCElViD 8V:
Introduced by Senator PIA S. CAYETANO
AN ACT
ESTABLISHING AN INTEGRATED UTILIZATION AND PROMOTION OF FOLIC 
ACID FOOD FORTIFICATION AND SUPPLEMENTATION
Be it enacted by the Senate and the House or Representatives of the Philippines in 
Congress assembled:
1 
ARTICLE I
2 
GENERAL PROVISIONS
3 
Section 1. Short Title. -- This Act shall be known as the 'FoUc Acid Act".
4 
Sec. 2. Declaration of Policy. - It is the policy of the State to equally protect
5 
the life of the mother and the lives of the unborn from conception, promote the right
6 
to health of the people, and instill health consciousness among them. In pursuit of
7 
these policies, the State recognizes the need to adopt and support a comprehensive
8 
approach that addresses the causes of folic acid deficiency and its association to
9 
miscarriage and congenital anomalies. Programs, projects, and activities to promote
10 
and increase the supply, access, consumption, and utilization of an adequate quantity,
11 
quality, and a variety of food for different population groups shall be enacted to
12 
strengthen policies that were formulated and irr plemented which includes food-based
13 
strategies, nutrition education, public healtii, and food safety measures, and
14 
supplementation. The State also recognizes that an effective public education program
15 
is vital in preventing the ill-effects of folic acid deficiency among pregnant women,
16 
such as miscarriages and congenital anomalies.


1 
Sec. 3. Objectives. — The objectives of this Act are:
2 
a) To support the achievement of the Sustainable Development Goals (SDGs),
3 
particularly on SDG 3 (Good Health and Well-being), for adequate nutrition
4 
and attainment of healthy life for all and at all ages;
5 
b) To ensure that every woman of reproductive age has access to food and
6 
food products containing folate and folic acid and folic acid supplements to
7 
reduce the risk of miscarriage and having babies with neural tube defects
8 
and other birth defects;
9 
c) To ensure that there is adequate supply of folic acid-fortified food and food
10 
products and folic acid tablets at an affordable price;
11 
d) To ensure that there is sufficient and correct information on the role of
12 
folate and folic acid for women of reproductive age and their children;
13 
e) To ensure the creation of a sustained inter-agency collaboration for the
14 
aggressive implementation and monitoring of this Act; and
15 
f) To foster collaborative undertakings in continuous research on folic acid
16 
food fortification and supplementation.
17 
ARTICLE H
18 
DEFINITION OF TERMS
19 
Sec. 4. Definition of Terms. — For the purpose of this Act, the following terms
20 
shall be defined as follows:
21 
a) Birth Defect refers to a physical or biochemical abnormality present at birth,
22 
which may be inherited or is a result of environmental influence, while the baby
23 
is developing in the mother's womb/
24 
b) Folic Acid refers to a micronutrient belonging to the B complex group of
25 
vitamins, available in its endogenous (as folate) and synthetic forms;
26 
c) Fortification refers to t.ie practice of deliberate!/ increasing the content of an
27 
essential micronutrient in food, so as to improve the nutritional quality of the
28 
food supply and provide a public health benefit with minimal risk to health;
29 
d) Neural Tube Defects refer to birth defects of the brain and spinal cord which
30 
occur in the first montii of pregnancy;
31 
e) Reproductive Age refers to the age from first menstruation period of a
32 
woman up to the age of cessation of menstruation; and


1 
f) Supplementation refers to the provision of relatively large doses of
2 
micronutrients, usually in the form of pills, capsules, or syrups.
3 
ARTICLE III
4 
INTEGFIATED UTILIZA’^ION AND PROr^ OTION OF FOLIC ACID FOOD
5 
FORTIFICATION AND SUPPLEMENTATION
6 
Sec. 5. Awareness and Promotion. - Medical and allied professionals in the
7 
healthcare delivery system shall integrate in their practice, reproductive health,
8 
existing burden of miscarriages and birth defects, folic acid intake and deficiency, as
9 
well as the nature and benefits of dietary diversifications, fortification, and
10 
supplementation. The Department of Education (DepEd) and the Commission on
11 
Higher Education (CHED) shall incorporate the above-mentioned information in their
12 
curriculum.
13 
The Department of Health (DOH), in coordination with the Philippine
14 
Information Agency (PIA), shall disseminate information and produce other awareness
15 
and promotional programs deemed appropriate under this Act through print,
16 
broadcast, and social media, the use of mobile and computer applications, among
17 
others.
18 
Sec. 6. Dietary Diversification. - The Food and Nutrition Research Institute
19 
(FNRI), in collaboration with the National Nutrition Council (NNC), shall design
20 
functional food and promote nutrition practices through nutrition education.
21 
Sec. 7. Food Fortification. - Fortification of food and food products with folic
22 
acid shall adopt and strengthen Republic Act No. 3976 or the Philippine Food
23 
Fortification Act of 2000, which mandates the fortification of certain food and food
24 
products with vitamin A and iron. The type of fortification and the fortificant of choice
25 
shall be the responsibility of the Food and Drug Administration (FDA), Within three (3)
26 
years after the enactment of this Act, all food groups identified by the NNC as
27 
commonly consumed and should be consumed by women of reproductive age shall
28 
be fortified with folic acid, in addition to the other micronutrients added to these food
29 
groups.
30 
Sec. 8. Foiic Acid Supplementation. — AH programs implemented pursuant to
31 
this Act shall adopt and strengthen the DOH Administrative Order 2010-0010 or the
32 
Revised Policy on Micronutrient Supplementation, and shall ensure that: 1) there is


1 
adequate supply of folic acid tablets; 2) the production, packaging, and distribution of
2 
folic acid tablets meet quality standards; and 3) it is affordable and can be easily
3 
accessed by every Filipino.
4 
The DOH shall ensure that folic acid supplements are part of the routine
5 
services in all barangay and municipal health centers. Women of reproductive age
6 
shall be required to take folic acid tablets daily. Supplements shall also be given in
7 
evacuation centers during emergencies, disasters, and calamities. The DOH shall
8 
ensure that adequate information regarding the prescriptions, administration, and
9 
delivery of supplements, as well as safety of ingestioii, are provided to ail barangay
10 
health workers and women of reproductive age.
11 
Sec. 9. Research Development and Extension. — Research development and
12 
extension undertakings on folic acid shall be incorporated in the National Unified
13 
Health Research Agenda of +:he Philippine Najonal Health Research System. The
14 
National Institutes of Health and all regional health research and development
15 
consortia are required to take part in these undertakings.
16 
ARTICLE IV
17 
IMPLEMENTATION
18 
Sec. 10. Lead Agency. - The DOH shall be the Lead Agency in implementing
19 
this Act. For the purposes of achieving the objectives of this Act, the DOH shall:
20 
1) 
Establish a National Coalition on Folic Acid Provision and Utilization;
21 
2) 
Develop the implementing rules and regulations for the immediate
22 
implementation of a comprehensive program on folic acid within one
23 
hundred eighty (180) days from the enactment of this Act;
24 
3) Identify a regional agency that will oversee the implementation of the Act
25 
in every region in the country; and
26 
4) Coordinate with government and non-government organizations for the
27 
implementation of this Act.
28 
Sec. 11. National Coalition on Foiic Acid. - A National Coalition on Folic Acid
29 
Provision and Utilization shall be established under the DOH to provide policy
30 
directions and to oversee the overall implementation of actions, programs, and
31 
projects related thereto. The National Coalition shall assist in the conceptualization,
32 
planning, and implementation of the various programs and projects, primarily on


1 
health policy, research development, and extension, awareness and promotion,
2 
monitoring and review, regional operations, and support.
3 
The National Coalition shall be composed of government and private sectors,
4 
academe, hospitals and other health centers, research institutes, and other non-
5 
medical societies.
6 
Sec. 12. Quality Assurance. — A quality assurance system will be established in
7 
accordance with DOH guidelines for food fortification, as well as guidelines set by the
8 
World Health Organization (WHO) on food fortification and micronutrient
9 
supplementation.
10 
Sec. 13. Monitoring. - The DOH is given the overall responsibility for the
11 
monitoring program and reporting progress. Other agencies may contribute to
12 
elements of the monitoring program as deemed appropriate by the DOH.
13 
Sec. 14. Review. — A periodic review shall be done by the DOH, in coordination
14 
with the National Coalition on Folic Acid Provision and Utilization, at least once every
15 
five (5) years. Outcome data from the National Nutrition Survey and other nutrition
16 
surveillance systems shall be used in conducting such review.
17 
Sec. 15. Database. — All DOH regional offices shall maintain a database of all
18 
patients receiving folic acid interventions and those who refuse to take folic acid
19 
supplements. The data shall be submitted to the DOH Central Office on an annual
20 
basis to establish a national registry pursuant to this Act. Outcome data from said
21 
registry shall form the basis for future programs and projects deemed necessary by
22 
the national government to be incorporated and implemented in this Act.
23 
Sec. 16. Financing and Other Resources. - The Department of Trade and
24 
Industry, Department of Science and Technology, Livelihood Corporation, and
25 
government banks are hereby required to assist and support affected manufacturers
26 
in upgrading their technologies by facilitating soft loans and financial assistance for
27 
the procurement of necessary technologies and machines in compliance with the
28 
provisions of this Act. The Department of the Interior and Local Government shall
29 
mobilize and establish financing programs to support folic acid interventions. Provision
30 
for folic acid supplements and analytical and biochemical laboratory testing for folic
31 
acid levels shall be incorporated in benefit package of the Philippine Health Insurance
32 
Corporation.


1 
Sec. 17. Establishment and Accreditation of FoUc Acid Laboratory Services. -
2 
The DOH shall ensure that free-standing and hospital-based laboratories are offering
3 
affordable and accurate analytical and biochemical folic acid tests. These laboratories
4 
must be strategically located to be easily accessible to the public.
5 
Sec. 18. Non-Compliance with FoUc Acid Fortification. — The following shall be
6 
considered non-compliance with the fortification process:
7 
a) If the food fortification levels do not comply with the DOH requirements and
8 
WHO guidelines, except when the deviation from the fortification levels is
9 
justified and is properly declared in the labeling; or
10 
b) If the process of fortification does not conform with the DOH and other
11 
government standards.
12 
Sec. 19. Incentives and Disincentives. — All women who have taken folic acid
13 
tablets before, during, and after conception up to delivery shall be given appropriate
14 
incentives as identified by the National Coalition on Folic Acid.
15 
Any woman who refuses to take supplements on the grounds of religious and
16 
cultural beliefs and for other reasons not specified, must acknowledge in writing her
17 
understanding of the risks to her and to her unborn child. A copy of this refusal shall
18 
be indicated in the surveillance registry.
19 
ARTICLE V
20 
FINAL PROVISIONS
21 
Sec. 20. International Commitments. - Nothing in this Act is intended to violate
22 
provisions of treaties and international agenda to which the Philippines is a party.
23 
Sec. 21. Implementing Rules and Regulations. - Within one hundred eighty
24 
(180) days from effectivity of this Act, the DOH shall issue the implementing rules and
25 
regulations to this Act.
26 
Sec. 22. Repealing Clause. — All general and special laws, decrees, executive
27 
orders, proclamations and administrative regulations, or any parts thereof, which are
28 
inconsistent with this Act are hereby repealed or modified accordingly.
29 
Sec. 23. Separability. -If, for any reason or reasons, any part of provisions of
30 
this Act shall be declared or held to be unconstitutional or invalid, other provision or
31 
provisions hereof which are not affected thereby shall continue to be in full force and
32 
effect.


1 
Sec. 24. Effectivity. - This Act shall take effect fifteen (15) days after its
2 
publication in at least two (2) newspapers of general circulation.
Approved,