Egan et al.1 congratulated for their recent analysis of the decline of folic acid fortification of food staples in Ireland. Their examination confirms that it is unwise to rely on manufacturers to voluntarily include this additive. The public health truism that self-regulation is no regulation here is obvious. Given that Ireland has one of the highest rates of neural tube defect (NTD) affected pregnancies in the world which, alarmingly continues to rise, means that the time for inaction is over.