Folic acid-preventable spina bifida and anencephaly are pandemic, affecting 225,000 children a year. These birth defects are as preventable as polio. As we near the eradication of polio, it is time to make the commitment to global prevention of all folic acid-preventable spina bifida and anencephaly (FA-P SBA) by 2010. Folic acid fortification of centrally processed foods, such as wheat and corn flour, could immediately prevent all of these birth defects for much of the world's population. These fortification programs will also help adults by increasing serum folate concentration, eradicating folate deficiency anemia, providing human genome stability and reducing homocysteine serum concentration, which will probably prevent heart attacks and strokes, and may prevent colon cancer and Alzheimer's disease. Where there is no centrally processed and distributed food to fortify, intense efforts must be made to increase consumption of synthetic folic acid through vitamin supplements. Geneticists can play a major role in preventing FA-P SBA by helping to create the political will in each country to implement fortification and supplement programs to eliminate disease caused by the current pandemic of folate deficiency.