Abstrait

Ready to use therapeutic foods with <50% protein from dairy.

Peter Akomo, Steve Collins

Severe Acute Malnutrition affects an estimated 14.4 million children globally yet only less than 25% of them are reached with treatment. Ready to Use Therapeutic Food (RUTF) which is used as the main treatment remains expensive and limits coverage. The World Health Organization (WHO) currently stipulates that at least 50% of protein in RUTF must come from dairy. However, given the high cost of dairy, recent research has focused on developing cheaper alternative formulations by excluding or reducing dairy content. The WHO recently set a criterion for reviews looking at three broad aspects of alternative formulations of RUTF with reduced or no dairy and as a basis to inform an update of the stipulation on dairy content. While two of the reviews were not conducted, the single one completed was on efficacy and, sadly, was done using a wrong methodology that pooled dissimilar formulations in a meta-analysis. Surprisingly, the WHO used the findings from this only and spurious review to wrongfully refuse to approve a cheaper and efficacious amino acid-enhanced plant-based RUTF formulation that would allow a further one million children with SAM to access treatment annually within existing budgets. This decision by the WHO keeps the status quo for an indefinite period against clear evidence of the benefits of this plant-based formulation, and needs to be urgently reviewed in accordance with standard scientific methods to ensure innovation is not unduly blocked.