‘Plumpynut’ features in malnutrition fight


NEW YORK — The World Health Organization estimates that 20 million children worldwide suffer from severe acute malnutrition right now. This untenable condition leads to a child dying every five seconds in regions such as the Sahel, the Horn of Africa and South Asia, known as the world’s “malnutrition hot spots.” Yet, some recent developments have the potential of eliminating the enormous threat to survival that malnutrition poses to children.

Malnutrition has a severe effect on children’s health since it weakens resistance to germs that cause pneumonia, malaria, diarrhea, measles and AIDS, which together are responsible for half of deaths of children under 5. Those children that survive acute malnutrition suffer from stunted growth and developmental delays that will affect them the rest of their lives. Inadequate diets mainly affect young children, since they have very specific nutritional needs.

Recently UNICEF and organizations such as Medecins Sans Frontieres (MSF), also known as Doctors Without Borders, have been promoting the use of a highly nutritious, ready-to-use food specifically designed for young children. RUF has already achieved significant success in fighting malnutrition. In 2006, MSF treated more than 150,000 children in 99 program sites in 22 countries.

RUF, also called “Plumpynut,” is the result of the work of a French researcher from the Institut de Recherche pour le Developpement in Paris and the French company Nutriset. Together they have developed a dense spread of milk, proteins, vegetable fat, peanuts and sugar enriched with vitamins and minerals. Because milk is already an ingredient the spread doesn’t need to be diluted, thus eliminating potential contamination from the dilution process and making it more “user friendly.”

Most importantly RUF has the advantages of being easily transported, safely stored even in tropical climates and easily distributed since it comes protectively wrapped in individual portions.

RUF is so effective because malnutrition results not only from too little food but also from the lack of essential nutrients in the food that is available. As Dr. Christophe Fournier, the president of MSF’s International Council has declared, “It is not about how much food children get, it is what is in the food that counts.”

Until the development of RUF, international food aid relied heavily on fortified blended foods. According to MSF, those blended foods have limitations that make their use less effective than RUF. Among other shortcomings they are less dense in calories and nutrients needed by children and make it more difficult for children to absorb critically needed nutrients.

Since 2000, RUF has been successfully used by MSF in Congo, Ethiopia, Burundi, Angola, Sudan, Niger and Afghanistan. But according to MSF, although RUF has proved to be extremely effective in fighting malnutrition, estimates are that only an estimated 600,000 out of the 20 million children suffering from severe acute malnutrition will have had access to RUF in 2007.

It would seem callous and unethical not to speed up the expansion of RUF programs so that they reach all 20 million of the world’s starving children. Estimates are that accomplishing this would cost approximately $1 billion.

While it may be tempting to think that this new and effective food will solve the public health crisis associated with children’s malnutrition, RUF alone is not enough. An effective, sustainable solution to childhood malnutrition requires an approach that empowers communities (particularly women) in promoting health and fostering independence among vulnerable populations.

It should include vigorous programs of nutrition education and income-generating activities and literacy classes for women that include nutritional themes. Malnutrition, a major scourge of children in the developing world, can be conquered.

Cesar Chelala is an international public health consultant and author of “Children’s health in the Americas,” a publication of the Pan American Health Organization.