During a recent discussion of humanitarian food aid at Georgetown University, where Hansch teaches, a student brought up ready-to-use therapeutic foods. Hansche happened to have a packet in his pocket. He pulled it out and served it up. UNICEF made international headlines this week by giving Britain's Prince William a taste of the peanut butter paste. At fund raisers for hunger initiatives, nonprofits routinely pass around packets for tasting.
"You can't beat a lesson like that," he said. "When you talk about measles immunizations you can't say, quick give me a shot so I can experience it."
Upping the standards
When it comes to addressing global hunger, though, ready-to-use therapeutic foods are just part of the solution. While Plumpy'Nut has been shown to help children teetering so close to death they would have otherwise required hospitalization, it isn't a long-term nutrition solution, said Chessa Lutter, senior advisor of food and nutrition for the Pan American Health Organization. Malnutrition comes in many forms, ranging from a vitamin deficiency to starvation. International aid organizations use a wide portfolio of products, many of which are fortified with vitamins and minerals, to address the various stages of hunger.
More than two billion people worldwide suffer from vitamin and mineral deficiencies, according to the World Health Organization — a condition that manifests itself in many ways, ranging from fatigue to stunted growth to blindness. By pumping an extra dosage of vitamins into foods like salt, bread and milk, the United States has successfully eliminated vitamin-deficiency-caused diseases like goiter, rickets, beriberi and pellagra. When it comes to foreign aid, though, the United States and other rich countries have been criticized for dumping surplus stocks of low-quality food on poor nations.
Medecins Sans Fontieres (Doctors Without Borders), one of the most vocal critics of U.S. food aid, has used the success of ready-to-use therapeutic products as ammunition to lobby for better fortified food products across the board. This year, inspired by the efficiency of ready-to-use therapeutic foods, the World Health Organization announced plans to tighten up the nutritional standards for all food aid for young children. The new guidelines will recommend increasing vitamin and mineral content, changing blending techniques and improving shelf life.
"It is a delicate issue that has a lot of implications for development agencies," said Dr. Francesco Branca, director of the World Health Organizations Department of Nutrition and Health Development. "Next year there will be a completely new generation of food available for emergencies and also for the longer term situations where food aid is necessary."
Historically, grain has made up the bulk of food aid. While grain provides lifesaving calories, without vegetables and fruits, people develop vitamin and mineral deficiencies, according to the World Hunger Education Service. To fill in the gaps, scientists developed fortified cereals to be used in humanitarian aid, like corn soy blend and wheat soy blend.
Compared to vitamin-packed foods like Plumpy'Nut, Medicins Sans Frontieres has called the soy blends "sub-standard."
Hansche dismissed this an "extreme" point of view, but, as a global nutritionist, he was candid about the shortcomings of food fortification in international aid.
"Is what we are doing adequate?" he said. "Absolutely not."
There are a number of barriers standing in the way of developing a Plumpy'Nut-style solution to other forms of malnutrition.
First off: cost.
"Food aid is still dominated by corn soy blend and wheat soy blend because they are cheap, but they aren't equivalent nutritionally to ready-to-use therapeutic foods," Lutter said. Fortified grains cost between three and five times as much as whole grains. Ready-to-use therapeutic foods, like Plumpy'Nut, cost even more.
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