Are innovative ready to use therapeutic foods more effective, accessible and cost-efficient than conventional formulations? A review

Abstract

Ready to Use Therapeutic Foods (RUTFs) are used in international food assistance strategies as a safe and effective way of treating children suffering from severe acute malnutrition (SAM). Though the peanut-based formulation has a proven track record in terms of efficacy in treating SAM around the world, the conventional formulation is not without challenges. Concerns regarding cost, the availability of local ingredients, the presence of aflatoxin, shifting global supply patterns, and dietary appropriateness of the peanut-based RUTF have encouraged researchers to experiment with other lipid sources in formulations. This shift requires not only changes to RUTF formulations, but also changes to supply chain activities. The goal of this review is to first, provide an update on the efficacy of recently trialed non-peanut RUTF formulations in treating SAM in infants and children and second, to review recent UN agency led interventions into local/regional RUTF supply chains and programmatic capacity. Based on published documents (2017–2019), this review flags three significant issues requiring further attention from the international food assistance community: the need for follow-up studies of children treated for SAM with RUTFs in programmatic countries, a regional customization of Community-Based Management of Acute Malnutrition (CMAM) protocols to maximize cost effectiveness and programmatic coverage, and an increase in the number of studies focusing on the acceptability of non-peanut RUTF formulations by the infants and children in low and medium income countries.