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Academy of Medical Sciences

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UNICEF - Ukraine Office

(June 13, 2001, Kyiv, Ukraine)

(Report reviewed and approved by Prof. Y. Kundiev)


The participants were greeted by the organizers of the event Prof. Y. Kundiev, M.D., Vice-President of the Academy of Medical Sciences of Ukraine; Prof. S. Berezhnov, M.D., Deputy Chief Sanitary Physician of the Ministry of Public Health of Ukraine; Prof. W. Wertelecki, M.D., Director of the Ukrainian-American Birth Defects Program, Secretary Treasurer of the World Alliance of Organizations for the Prevention of Birth Defects and Professor and Chairman of Medical Genetics, University of South Alabama; Ms. O. Radzievska, Main Specialist for USAID regarding public health programs.

From left to right: Prof Yu. Kundiyev, Prof. S. Berezhnov, Ms. O. Radziyevska, Prof. W. Wertelecki
The Conference Presidium (click)

The key-speakers were:

  1. Professor Y. Kundiev, M.D. - "Preventive Medicine in Ukraine: from Scientific Research to Implementation".
  2. In his speech, Dr. Kundiev stressed the importance of preventive medicine that determines and evaluates various health risk factors. The European Department of the World Health Organization created an initial plan concerning food products safety surveillance for 2000-2005. Preventive measures, including food safety, should include identification of groups of risk factors, risk evaluation, management and control, statistical data analysis.

  1. Professor W. Wertelecki, M.D. (USA) - "Birth Defects in Ukraine: Present Condition".

  2. Professor W. Wertelecki (click)

    The speaker announced that it is everyone's responsibility to prevent those birth defects that are possible to prevent. Children and their health care are neglected in Ukraine and should be above and beyond politics. The Ukrainian-American Birth Defects Program is fully implemented in two oblasts and is being expanded to five others. The main strategies are birth defects surveillance, health care for children with birth defects, promotion of birth defects prevention among medical specialists and population. This requires the involvement of most medical specialists. The fundamental strategy  is to charge neonatologists to find, report and initiate comprehensive care of children with birth defects. The second strategy is to charge medical geneticists with the coordination of long term complex medical needs of affected children. Finally, the Ukrainian Alliance for the Prevention of Birth Defects, which includes families, professors and community leaders must help parents of children with birth defects to adjust and find assistance from the health system, social service, educational and other organizations. In the final analysis, how a society deals with their children, particularly those who are disabled by faults not of their own making, is a measure of its civilization.

    Birth defects in general terms were defined, and also a definition of spina bifida was given. Dr. Wertelecki stressed the importance of the Internet access in the implementation of the Program's goals. The same goals were pursued by the Ukrainian Alliance for the Prevention of Birth Defects, the first national model of the World Alliance.

  3. Professor G. Oakley, M.D. (USA) - "Folic Acid Revolution".
  4. Prof. G.Oakley reporting about Folic Acid Fortification Program in USA
    Prof. G.Oakley, M.D.  (click)

    The discovery that folic acid could dramatically prevent neural tube defects, cardiovascular diseases associated with arteriosclerosis, as well as colon cancer, has become a real revolution in medicine. Furthermore, research proves that Alzheimer disease risks are also decreasing thanks to folic acid. It is sometimes very difficult, however, to persuade people to take a multivitamin every day. Ukraine is a grain basket of Europe. Therefore, a classical approach to birth defects prevention in Ukraine would be fortification of flour and grain products with folic acid.

    Fortification program achievements in the USA and China were described. A special United Nations General Assembly session in September 2001 will be discussing the issue of children's health care. A special World Health Organization commission is going to present materials on folic acid and prevention of neural tube defects. The elimination of these defects is planned for 2005.

    When answering the participants' questions, Dr. Oakley evaluated different levels of grain products fortification.

  5. Professor O. Wolowyna (USA) - "Information Systems and Health Care Reform".

  6. Dr. Oleh Wolowyna (click)

    The speaker stressed that health care and prevention programs or health systems information in general heavily depends on the ability to acquire and understand facts. Different approaches to information systems and the Internet implementation in health care reform were characterized. Information systems should offer information that is

    • accurate,
    • complete,
    • accessible,
    • high quality,
    • and flexible in terms of user needs adjustment.

    Dr. Wolowyna demonstrated a new system of medical statistics analysis that was created using "Dynamic HyperCubes" program.

(Click to enlarge and for legends)
ROUND TABLE (summary views):

Professor I. Barylyak, M.D., Professor Y. Kundiev, M.D., H. Mikulska, M.D. (Deputy Head of the Public Health Administration of Volyn oblast), L. Firsov (the Head of the Project "Zdorovia Horian", Ukrainain Alliance member), M. Aleksanian (UNICEF representative for Ukraine, Belarus, and Moldova): offered comments regarding flour fortification with folic acid.

Professor O. Timchenko, M.D., Professor O. Sulima, M.D., Professor V. Kordyum, M.D.: offered comments regarding the need for all women of reproductive age to consume the appropriate amount of folic acid daily during pre-conception period. It was also stated that there was a need for Ministry of Public Health regulations regarding this issue.

Mr. M. Kompanets (President of the Ukrainian Grain Association), Mr. M. Hnasyuk (Volyn Bakery #2 Director), Ms. L. Zarytska (leading technological engineer of Rivne Bakery #36): stated that flour producers were ready to start folic acid fortification literally today. There is experience and equipment in place since vitamin fortification of bread and grain products was implemented in the USSR. We also have some equipment. The government's approval and corresponding orders and regulations are needed.

Dr. Mikael Aleksanyan (UNICEF Representative in Ukraine) underscored the great importance to introduce micronutrient fortification policies in Ukraine. Dr. Aleksanyan stressed that flower fortification with iron is part of public health policies for at least 50 years. Regarding iodine and folic acid , Dr. Aleksanyan stated that iodine fortification of salt and flower with folic acid should be treated as matters of priority by the Ukrainians authorities.

In conclusion, Professor Y. Kundiev, M.D. suggested that a working group at the Ministry of Public Health and the Ukrainian Academy of Medical Sciences be created. This group would consist of 5-7 experts who would study complete available data on the experience of the USA and other countries regarding folic acid fortification.

The purpose is to create:

The bread, presented by Volyn Bakery Director, could be fortified with folic acid
The bread, presented by Volyn Bakery Director,
could be fortified with folic acid (click)

After the conference and the round table discussion, a press conference was held. Journalists asked questions about folic acid role in the prevention of neural tube defects, and also possibilities of folic acid food fortification implementation.

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IBIS:International Birth Defects Information Systems

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21/January/2002 dc