Treatment of malnutrition has commercial dimensions

(Published )

C Shivakumar

Chennai:

The ready to use therapeutic food supplied to eight states, bypassing central and state governments, by the Unicef had commercial dimensions.

Many non-governmental organisations and experts question Unicef’s urgency to import a particular brand of ready to use therapeutic food into India, when such food can be locally produced.

“Why is Unicef forgoing all the norms to supply ready to use therapeutic food in India. With $60 per sachet, it is not possible for a poor child to avail of a sachet of plumpynut. Obviously, it has commercial dimensions,” says a source.

The UN body “has included the product on its own in the Draft Child Development and nutrition work plan,” says Ministry of Women and Child Development (MWCD).

The world body also tried to bend the rules and even lied to the government of supplying ready to use therapeutic food to two states but in reality supplied it to eight states.

“While furnishing information in response to the provisional starred question in Lok Sabha vide its letter dated February 11, 2009, Unicef mentioned names of only two states. Whereas it now appears that procurement/supply of ready to use therapeutic food has been made for eight states,” says MWCD.

 “We have taken up with the issue with Ministry of External affairs. The Unicef has intimated the ministry of restoring $880,000 funds of equivalent value of the ready to use therapeutic food supplies to GOI-UNICEF India Country Programme 2008-2012.  The government and media should be vigilant,” Joint Secretary of MWCD Dr Shreeranjan said.

“The GOI-UNICEF India Country Programme 2008-2012 never mentioned supplies of ready to use therapeutic food or emergency food.  In our governmental programmes, we don’t encourage ready to use therapeutic food. But at the same time, if it is done privately then ministry of health has to decide on the issue,” he said.

But shouldn’t Unicef be held accountable for lying and giving false information. “Now the world body is portraying as the government of India has wronged them but the fact is that they wanted to promote the market of French firm Nutriset, which sells its food under the brand Plumpynut, by sending it  into public programmes.

 Unicef, which buys three quarters of the world's supply, bought 10,000 tonnes of ready to use food sachets in 2008, more than triple the volume bought in 2007. Medecins Sans Frontieres and the former US president's Clinton Foundation are major buyers too, sources said.

With the rocketing global demand for ready-to-use-foods being unable to be met by Nutriset, many firms have started paying royalty to the French firm and setting up plants globally.

In India, Norwegian manufacturer Compact for Life, began manufacturing in India recently and plans are on to expand it to countries where Nutriset has not patented Plumpynut. 

“Products like Plumpynut are effective in specific circumstances, to treat severe acute malnutrition.

However, interventions of this kind, involving branded and patented products, also tend to be linked with a dangerous invasion of corporate interests in food policy and nutrition programmes,” warns Indian Right to Food Campaign.

The business of nutrition for poor

In the year 1999, Andre Briend, a French paediatric nutritionist, developed a ready to use product ‘Plumpynut’ . The product is based on peanut butter for use in treatment of severe malnutrition.

Few trials were conducted in African countries to prove it’s’ efficacy. These trials, though having many limitations in the design of the studies, were used effectively to push the product into international guidelines as a treatment option to treat severe malnutrition, first in indoor facility and later on in home based care.

This was done despite the fact that for any public health decision of such a proportion, there should have been many Randomized Controlled Trials based on which there should have been a Meta analysis/ systematic review.

One of the studies, which was quoted maximum while building a case for the product was supported by the Nestle foundation and the manufacturer of the product, Nutriset. Andre Briend, who was a part of the research team for this study, was given a consultancy by Nutriset during the conduct of this study.

Interestingly, Andre Briend, was part of the research team for other trials in Africa also. Briend was later affiliated with the Department of Child and Adolescent Health and Development, World Health Organization, Geneva; becoming part of important policy decisions on the treatment of “severe acute malnutrition” which suggested among other things, ready to use therapeutic food as “the” intervention to combat malnutrition.