Systemic gaps in newborn screening for birth defects in LMICs demand integrated health, policy, and equity reforms
Original framing: “[Correspondence] Newborn screening for birth defects in LMICs cannot wait” — The Lancet
Robust epidemiological data indicate that birth defects now account for up to 15 % of under‑5 mortality in several LMIC regions, yet surveillance is limited by inadequate laboratory capacity and inconsistent case definitions. Advances in point‑of‑care genetic testing provide feasible options if coupled with quality assurance frameworks.
Birth‑defect mortality in LMICs is not merely a technical gap but a symptom of historic under‑investment, fragmented financing, and exclusion of local knowledge.
By weaving indigenous surveillance practices, regional laboratory cooperation, and universal health‑coverage policies, the proposed pathways address both the supply chain and the sociocultural determinants of care. Historical precedents from East Asian universal screening illustrate how centralized mandates can be adapted to decentralized, community‑driven models. Empowering marginalised voices and employing trickster insights prevent the illusion of a quick fix, ensuring that interventions remain accountable and culturally resonant. Ultimately, coordinated action across ministries, donors, and grassroots actors can transform newborn screening from an optional add‑on into a cornerstone of child survival equity.