Thalidomide: Understanding the Responsibilities of a Birth Defects Service

Abstract

In the late 1950s and early 1960s, the teratogenic drug thalidomide caused an epidemic of serious birth defects. Thalidomide embryopathy in its severest form produced limb reduction defects and other malformations, causing severe disability in survivors. This article uses the thalidomide incident as a case study to illustrate the health and social welfare responses that were put into place to address the needs of children born with disabilities and their families. These health and social service activities represent the core functions of a birth defects service. While thalidomide left its impact on industrialized countries, fifty years later, another teratogen, the Zika virus, threatened low- and middle-income countries. Congenital Zika virus syndrome, another disabling birth defect, is marked by severe microcephaly and intellectual disability in survivors. The article briefly compares the global health response to this teratogen five decades after the thalidomide episode, identifying that health systems of low- and middle-income countries still lack the preparedness to address severe birth defects caused by an unexpected teratogen.