Ethiopia's First Plumpy'nut Factory Opens

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Until American companies "get on it and become competitive," he said, major manufacturing of the revolutionary food will remain minimal.

(Thanks to "spooky06" for the tip!)

Article by Indrias Getachew, UNICEF

UNICEF correspondent Sabine Dolan reports on Ann M. Veneman's inauguration of Ethiopia's first Plumpy'nut therapeutic food factory.

ADDIS ABABA, Ethiopia — UNICEF Executive Director Ann M. Veneman inaugurated Ethiopia's first Plumpy'nut therapeutic food factory in Addis Ababa on February 20. The inauguration marks a joint venture between UNICEF, U.S. Fund for UNICEF board member Amy Robbins and the Hilina Enriched Foods Processing center.

Plumpy'nut is a high-protein and high-energy peanut-based paste used for the treatment of severely malnourished children. An estimated one and a half million children in Ethiopia are severely malnourished. At full capacity, Hilina Enriched Foods will produce up to 12 tons of the paste.

"Today as we open the doors of the fourth, and largest, factory in Africa that will produce Plumpy'nut, we are taking a step in the right direction in addressing the issue of malnutrition," said Veneman.

Generous solution

In 2005, Amy Robbins donated $1.3 million to UNICEF to allow the purchase and import of 267 tons of Plumpy'nut to Ethiopia. Formulated by French scientist Andre Briend in 1999, Plumpy'nut has been used to save children's lives in major emergency situations in Darfur, Niger and Malawi.

Plumpy'nut requires no preparation or special supervision so an untrained adult such as a parent can deliver it to a malnourished child at home, allowing governments to reduce the amount of money spent on therapeutic feeding stations. The paste has a two-year shelf life when unopened and stays fresh even after opening.

Though Plumpy'nut is relatively inexpensive and easy to transport, Robbins discovered that huge costs were incurred from its importation and that limited capacity at the French plant made it difficult to ensure timely food supplies from Europe.

To solve the problem, she donated $340,000 towards investment in the needed equipment to manufacture Plumpy'nut within Ethiopia.

Yesterday she visited a mother in South Omo, Ethiopia whose 10-month old baby was struggling with malnutrition but gaining weight by eating Plumpy'nut. "It was impressive because you see your investments, your partnerships are really tangible in the happy, healthy children and that expands to happy mothers and entire communities," said Robbins.

"I am a mother. I have four sons who are living in New York City and I am very disturbed by the fact that my sons have everything and there are so many children in the world who have nothing. And so I thought there was an opportunity to take the business expertise that I gained in New York and bring it here to Ethiopia."

Increased recovery rates

Malnutrition contributes to more than half of all child deaths in Ethiopia. The country's 2005 Demographic and Health Survey shows that 47 percent of Ethiopia's children are stunted, 38 percent underweight and 11 percent wasted.

"Recovery rates for severely under-nourished children have been as high as 90 to 95 percent by using Plumpy'nut as a therapeutic intervention," said Veneman. "Therapeutic foods are also helping AIDS patients who need adequate nutrition to absorb life-prolonging ARV treatment."

The under five mortality rate in Ethiopia has declined to 123 out of every 1,000 live births from peak levels in 1990 when one in every five children died before the age of five.

"Ethiopia has seen improvements in addressing malnutrition yet widespread hunger continues to exact an enormous cost in terms of human suffering and lost potential," said Veneman.

February 23, 2007

I had never heard of Plumpy'nut, but is sounds amazing. Why isn't it better known and better utilized? An article from ABC News may hold the answer:

Peanut Paste Saves Starving African Children
A Peanut-Based Food Paste Has Revolutionized the Treatment of Malnutrition in Africa
By KATE KLONICK

Oct. 1, 2006 — - It seems underwhelming in its plastic silver package, but Plumpy'nut, the peanut-based therapeutic food paste, is more than enough for hundreds of thousands of malnourished children.

Plumpy'nut, generically known as ready to use therapeutic food, or RUTF, is the invention of André Briend, a French pediatric nutritionist currently working with the World Health Organization.

For years, powdered milk laden with vitamins had been a solution to malnutrition. But preparing the milk required hygienic environments and refrigeration, which usually necessitated inpatient treatment, and was costly and time consuming.

Teaming with Michael Golden, an Irish nutritionist, Briend, who then worked for Action Against Hunger, sought to create a take-home, spoil-proof, preparation-free food to treat malnutrition.. In 1999, Plumpy'nut, a thick, edible, pastelike substance containing peanuts, vegetable oil, milk powder, vitamins and minerals, was created.

Each packet -- roughly the size of a cereal bar -- contains 500 calories of perfectly proportioned proteins, fats and carbohydrates. Two packets a day for two weeks are enough to nourish and rehabilitate a starving child.

Plumpy'nut Goes to Africa

Though the product was created almost seven years ago, it became widely used only in 2005 when the relief group Doctors Without Borders introduced it in Africa.

"It went a bit slowly," said Milton Tectonidis, a Doctors Without Borders special nutritionist. "They first came up with the product as an alternative to milk, tested it on inpatients, ran a number of trials ... and found the results were excellent."

By 2003, the group started giving Plumpy'nut to outpatients, said Tectonidis. "We worked with other NGOs [nongovernmental organizations] to test it out. In each case, it treated 1,000 or 2,000 patients, and we took inspiration from them. When we came out with it in 2005, we treated 60,000 in four months."

Since then, several hundred thousand malnourished children have been rehabilitated with Plumpy'nut, which is handed out in weeklong supplies -- a total of 14 packets -- to the mothers of starving children.

Perhaps more important than the number of children who've been helped by the peanut paste are the resources it has freed up in a resource-scarce environment.

"If you calculate the cost with all the staff and the water and the electric and the hygienic processing and construction," said Tectonidis, "it comes out as much more to treat inpatient than out-patient."

Instead, precious medical attention and relief resources can be devoted to the critically ill or those wounded in war.

Problems With Peanuts: Allergies in Africa

While widespread distribution of a peanut-based product like Plumpy'nut could pose a danger to allergy-prone children in the United States, that is not a concern on the African continent.

"Food allergy seems far less common in poor countries than in rich countries," said Briend. "This well-known observation has been explained by different factors, but apparently, crowding and repeated exposure to infections seem to play a role."

The dearth of allergies and asthma in developing nations, and the rapid growth of these ailments in industrialized countries (registered peanut allergies in the United States doubled from 1997-2002), is largely attributed to the hygiene hypothesis, a topic addressed in an April 2002 article in Science magazine called "Allergy, Parasites and the Hygiene Hypothesis."

"The lack of intense infections in industrialized countries, owing to improved hygiene, vaccination and use of antibiotics, may alter the immune system such that it responds inappropriately to innocuous substances," explained the article.

"After several years of using this product," said Briend, "and feeding several hundreds of thousands of severely malnourished patients with it, I never heard of a place where it was a real issue."

Buying the Basics

Recently, another product was developed. EZ Paste, generically known as BP-100, is similar to Plumpy'nut but does not contain peanuts. It does not have a commercial manufacturer.

As of 2006, only one company, the French-based Nutriset, was manufacturing Plumpy'nut and its individual ingredients for self-assembly.

"There should be hundreds of them," said Tectonidis, making products like Plumpy'nut.

But until American companies "get on it and become competitive," he said, major manufacturing of the revolutionary food will remain minimal.

Plumpy'nut costs roughly 25 cents per packet to manufacture, making a two-week supply (the amount usually needed to make a significant difference in malnutrition) costs roughly $7.

But by using peanut and milk surpluses in countries like the United States, where farmers are often paid to destroy their surplus crops, Tectonidis hopes to be able to buy the ingredients for RUTF wholesale, which would cut manufacturing costs in half.

"There could be a program where they get the raw materials for free and distribute it to the people all over the world," he said. "As long as they agree to sell the product without charging for the raw materials, we could get the product down to 10 or 12 cents a package."

The United Nations World Food Program could help such a collaboration, which Tectonidis said is urgently needed. "Young children in poor countries are dropping like flies due to acute malnutrition," he said.

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