[The neonatal screening programs in Spain.Science, research and public health, keys to their quality and effectiveness.]

There is broad consensus on the health benefits that neonatal screening has provided in Spain, since Professor Mayor Zaragoza began his research project for the early detection of phenylketonuria and other aminoacidopathies in 1968, to date. In these decades there has been a great evolution and development of Neonatal Screening Programs (NSP) in Spain. This paper presents the effect on the development of the NSPs of the decentralization of Public Health responsibilities in the Autonomous Communities, creating differences among them by atomizing the decisions on the expansion of the diseases to be screened. The availability of effective detection and treatment methods was the justification, often unique, for the inclusion of new diseases in an NSP. On rare occasions, neonatal screening was assumed as a public health program that should offer guarantees of effectiveness, from information for informed consent to the correct treatment and follow-up of detected cases. This situation of enormous inequality in access to neonatal screening has changed with the introduction of appropriate legislation to guaranty the correct development of NSP within the National Health System. Forums coordinated by the Ministry of Health with the participation of those responsible for public health from the Autonomous Communities and scientific societies have been fundamental. An example of the convergence of research and science for the benefit of a basic Public Health program.