EIGHTEENTH CONGRESS OF THE 
)
REPUBLIC OF THE PHIUPPINES 
)
First Regular Session 
)
S E N A T E  
s. No. 
^ 9 3
rr if liir c'Trftnrf
V 
IIJL-8 P3 26
Introduced by Senator PIA S. CAYETANO
AN ACT
ESTABLISHING AN INTEGRATED UTILIZATIO N  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. Many, however, do not have the knowledge and access to 
reproductive health services.
Public health data show that congenital anomalies rank among the top 20 
causes of death across the life span and are already the third leading cause of death 
in the infancy period. Some of these defects, like that of the neural tube defects, 
happen in the first month of pregnancy—often before a woman even knows that she 
is pregnant. Neural tube defects are birth defects of the brain, spine and cord.
In the Philippines, 17% of all intended pregnancies end up in miscarriage. 
Further, more than half of all pregnancies are unplanned.
Empirical studies have shown that folic acid deficiency increases the risk of 
pregnant women to have an early miscarriage or give birth to a child with congenital 
anomalies or birth defects. A prevalence study of folic acid deficiency among 
pregnant women showed that more than half (51.7% ) had deficiency. Moreover, the


scale and impact o f folic acid deficiency in the Philippines is still difficult to quantify 
due to insufficient data. However, folic acid deficiency makes a substantial 
contribution to the national and global burden of miscarriage, neural tube defects, 
intrauterine growth retardation and pre-term births. 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 infections, and genetic disorders of folic acid metabolism. 
Unfortunately, the mean one-day intake of Filipinos, women of reproductive age 
(including pregnant and lactating mothers), is low in vegetables (10.7% ), fruits 
(7.3% ), legumes (0.55% ), and dairy products (3.8% ), based on the 2008 National 
Nutrition Survey. Intervention studies claim that folic acid intake can lower the risk 
of miscarriages and neural tube defects by 20% and 70%, respectively.
These 
premises, 
therefore, 
warrants a 
comprehensive 
approach 
that 
addresses the causes of folic acid deficiency and its association to miscarriages and 
congenital anomalies. Fortification of food products with folic acid has been 
considered to be the most effective method of ensuring adequate intake o f folic acid 
in women of reproductive age. Periconceptional folic acid supplementation also has a 
strong 
protective 
effect 
against 
congenital 
anomalies. 
Actions, 
policies, 
and programmes to promote and increase the supply, access, consumption, and 
utilization of an adequate quantity, quality, and a variety of food for all population 
groups shall be enacted and supported, which further includes food-based 
strategies, nutrition counseling, public health and food safety measures.
For these reasons, the passage of this bill is urged.
rjb i
»IA i. CAY/TANO


EIGHTEENTH CONGRESS OF THE 
)
REPUBLIC OF THE PHILIPPINES 
)
First Regular Session 
)
of I'lC 
r - r l  i Q
S E N A T E
293
S. No.
’19 JUL-8 P3:26
RECEIVLD
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 o f Representatives o f the Philippines in 
Congress assembled:
1 
ARTICLE I
2 
GENERAL PROVISIONS
3
4 
Section 1. Short Title. -  This Act shall be known as the "FoUc Acid Act".
5 
Sec. 2. Declaration o f Policy. -  It is the policy of the State to equally protect
6 
the life of the mother and the lives of the unborn from conception, promote the right
7 
to health of the people, and instill health consciousness among them. In pursuit of
8 
these policies, the State recognizes the need to adopt and support a comprehensive
9 
approach that addresses the causes of folic acid deficiency and its association to
10 
miscarriage and congenital anomalies. Actions, policies, and programmes to promote
11 
and increase the supply, access, consumption, and utilization of an adequate
12 
quantity, quality, and a variety of food for all population groups shall be enacted to
13 
strengthen other policies that were formulated and implemented which includes
14 
food-based strategies, nutrition education, public health, and food safety measures,
15 
and supplementation. The State also recognizes that an effective public education
16 
program is vital in preventing the ill-effects of folic acid deficiency among pregnant
17 
women, such as miscarriages and congenital anomalies.


1 
Sec. 3. Objectives. -  The objectives of this Act are:
2 
a) To support the achievement of global goals for adequate nutrition and
3 
attainment of healthy life for all and at all ages;
4 
b) To ensure that every woman of reproductive age has access to food and
5 
food products containing folate and folic acid and folic acid supplements to
6 
reduce the risk of miscarriage and having babies with neural tube defects
7 
and other birth defects;
8 
c) To ensure that there is adequate supply of folic acid-fortified food and
9 
food products and folic acid tablets at an affordable price;
10 
d) To ensure that there is sufficient and correct information on the role of
11 
folate and folic acid for women of reproductive age and their children;
12 
e) To ensure the creation of a sustained inter-agency collaboration for the
13 
aggressive implementation and monitoring of this Act; and
14 
f) To foster collaborative undertakings in continuous research on folic acid
15 
food fortification and supplementation.
16
17 
ARTICLE I I
18 
DEFINITION OF TERMS
19
20 
Sec. 4. Definition o f Terms. -  For the purpose of this Act, the following terms
21 
shall be defined as follows:
22 
a) Birth Defect refers to a physical or biochemical abnormality present at birth,
23 
which may be inherited or is a result of environmental influence, while the
24 
baby is developing in the mother's womb/
25 
b) Foiic Acid refers to a micronutrient belonging to the B complex group of
26 
vitamins, available in its endogenous (as folate) and synthetic forms;
27 
c) Fortification refers to the practice of deliberately increasing the content of an
28 
essential micronutrient in food, so as to improve the nutritional quality of the
29 
food supply and provide a public health benefit with minimal risk to health;
30 
d) Neurai Tube Defects refer to birth defects of the brain and spinal cord which
31 
occur in the first month of pregnancy;


2
3
4
5
6
7
8 
9
10
11
12
13
14
15
16
17
18
19
20 
21 
22
23
24
25
26
27
28
29
30
31
1
e) 
Reproductive Age refers to the age from first menstruation period of a 
woman up to the age of cessation of menstruation; and
f) 
Supplementation refers to the provision of relatively large doses of 
micronutrients, usually in the form of pills, capsules, or syrups.
ARTICLE I I I
INTEGRATED UTILIZATION AND PROMOTION OF FOLIC ACID FOOD 
FORTIFICATION AND SUPPLEMENTATION
Sec. 5. Awareness and Promotion. -  Medical and allied professionals in the 
healthcare delivery system shall integrate in their practice, reproductive health, 
existing burden of miscarriages and birth defects, folic acid intake and deficiency, as 
well as the nature and benefits of dietary diversifications, fortification, and 
supplementation. The Department of Education (DepEd) and the Commission on 
Higher Education (CHED) shall incorporate the above-mentioned information in their 
curriculum.
The Department of Health (DOH), in coordination with the Philippine 
Information Agency (PIA), shall disseminate information and produce other 
awareness and promotional programs deemed appropriate under this Act through 
print, broadcast, and social media, and the use of mobile and computer applications, 
among others.
Sec. 6. Dietary Diversification. -  The Food and Nutrition Research Institute 
(FNRI), in collaboration with the National Nutrition Council (NNC), shall design 
functional food and promote nutrition practices through nutrition education.
Sec. 7. Food Fortification. -  Fortification of food and food products with folic 
acid shall adopt and strengthen Republic Act No. 8976 or the Philippine Food 
Fortification Act of 2000, which mandates the fortification of certain food and food 
products with vitamin A and iron. The type of fortification and the fortificant of 
choice shall be the responsibility of the Food and Drug Administration (FDA). Within 
three (3) years after the enactment of this Act, all food groups identified by the NNC 
as commonly consumed and should be consumed by women of reproductive age


1 
shall be fortified with folic acid, in addition to the other micronutrients added to
2 
these food groups.
3 
Sec. 8. FoUc Acid Supplementation. -  All programs implemented pursuant to
4 
this Act shall adopt and strengthen the DOH Administrative Order 2010-0010 or the
5 
Revised Policy on Micronutrient Supplementation, and shall ensure that: 1) there is
6 
adequate supply of folic acid tablets; 2) the production, packaging, and distribution
7 
of folic acid tablets meet quality standards; and 3) it is affordable and can be easily
8 
accessed by every Filipino.
9 
The DOH shall ensure that folic acid supplements are part of the routine
10 
services in all barangay and municipal health centers. Women of reproductive age
11 
shall be required to take folic acid tablets daily. Supplements shall also be given in
12 
evacuation centers during emergencies, disasters, and calamities. The DOH shall
13 
ensure that adequate information regarding the prescriptions, administration, and
14 
delivery of supplements, as well as safety of ingestion, are provided to all barangay
15 
health workers and women of reproductive age.
16 
Sec. 9. Research Development and Extension. -  Research development and
17 
extension undertakings on folic acid shall be incorporated in the National Unified
18 
Health Research Agenda of the Philippine National Health Research System. The
19 
National Institutes of Health and all regional health research and development
20 
consortia are required to take part in these undertakings.
21
22 
ARTICLE IV
23 
IMPLEMENTATION
24
25 
Sec. 10. Lead Agency. -  The DOH shall be the Lead Agency in implementing
26 
this Act. For the purposes of achieving the objectives of this Act, the DOH shall:
27 
1) 
Establish a National Coalition on Folic Acid Provision and Utilization;
28 
2) 
Develop the implementing rules and regulations for the immediate
29 
implementation of a comprehensive program on folic acid within one
30 
hundred eighty (180) days from the enactment of this Act;
31 
3) 
Identify a regional agency that will oversee the implementation of the
32 
Act in every region in the country; and


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


1 
in upgrading their technologies by facilitating soft loans and financial assistance for
2 
the procurement of necessary technologies and machines in compliance with the
3 
provisions of this Act. The Department of the Interior and Local Government shall
4 
mobilize and establish financing programs to support folic acid interventions.
5 
Provision for folic acid supplements and analytical and biochemical laboratory testing
6 
for folic acid levels shall be incorporated in benefit package of the Philippine Health
7 
Insurance Corporation.
8 
Sec. 17. Establishment and Accreditation o f FoUc Acid Laboratory Services. -
9 
The DOH shall ensure that free-standing and hospital-based laboratories are offering
10 
affordable and accurate analytical and biochemical folic acid tests. These
11 
laboratories must be strategically located to be easily accessible to the public.
12 
Sec. 18. Non-Compliance with FoHc Acid Fortification. -  The following shall be
13 
considered non-compliance with the fortification process;
14 
a) If the food fortification levels do not comply with the DOH requirements
15 
and WHO guidelines, except when the deviation from the fortification
16 
levels are justified and are properly declared in the labeling; or
17 
b) If the process of fortification does not conform with the DOH and other
18 
government standards.
19 
Sec. 19. Incentives and Disincentives. -  All women who have taken folic acid
20 
tablets before, during, and after conception up to delivery shall be given appropriate
21 
incentives as identified by the National Coalition on Folic Acid.
22 
Any woman who refuses to take supplements on the grounds of religious and
23 
cultural beliefs and for other reasons not specified, must acknowledge In writing her
24 
understanding of the risks to her and to her unborn child. A copy of this refusal shall
25 
be indicated in the surveillance registry.
26
27 
ARTICLE V
28 
FINAL PROVISIONS
29
30 
Sec. 20. International Commitments. -  Nothing in this Act is intended to
31 
violate provisions of Treaties and International Agenda to which the Philippines is a
32 
party.


1 
Sec. 21. Implementing Rules and Regulations. -  Within one hundred eighty
2 
(180) days from effectivity of this Act, the DOH shall issue the implementing rules
3 
and regulations to this Act.
4 
Sec. 22. Repealing Clause. -  All general and special laws, decrees, executive
5 
orders, proclamations and administrative regulations, or any parts thereof, which are
6 
inconsistent with this Act are hereby repealed or modified accordingly.
7 
Sec. 23. Separability. -  If, for any reason or reasons, any part of provisions of
8 
this Act shall be declared or held to be unconstitutional or invalid, other provision or
9 
provisions hereof which are not affected thereby shall continue to be in full force and
10 
effect.
11 
Sec. 24. Effectivity. -  This Act shall take effect fifteen (15) days after its
12 
publication in at least two (2) newspap>ers of general circulation.
Approved,