Médecins Sans Frontières (MSF) calls for increased and expanded use of nutrient dense ready-to-use food (RUF) to reduce the 5 million annual deaths worldwide related to malnutrition in children under five. Current food aid — which focuses on fighting hunger, not treating malnutrition — is not doing enough to address the needs of young children most at risk, MSF warned.

“It’s not only about how much food children get, it’s what’s in the food that counts,” said Dr. Christophe Fournier, President of the MSF International Council. “Without the right amounts of vitamins and essential nutrients in their diet, young kids become vulnerable to disease that they would normally be able to fight off easily. Calls for increased food aid have ignored the special needs of young children who are at the greatest risk of dying.”

RUF, which come in individually-wrapped rations, contain all the necessary nutrients, vitamins, and minerals that a young child needs. This dense therapeutic food which has milk powder, sugars and vegetable fats can be produced and stored locally and transported easily, even in hot climates. It allows a child to recover from being malnourished and catch up on lost growth. Being easy-to-use, mothers — not doctors and nurses — are the main caregivers, meaning far more children at risk can be reached.

“In Somalia we are giving acutely malnourished kids packets of ready-to-use food and we see them gain weight and begin thriving within a couple of weeks,” said Dr. Gustavo Fernandez, MSF Head of Mission in Somalia. “RUFs are practical to use in places like Somalia where security is very bad. General food distribution is also needed, but it is not going to be very effective to treat kids under three years old.”

Severe acute malnutrition in early childhood is common in large areas of the Horn of Africa, the Sahel, and South Asia — the world’s “malnutrition hotspots.” The World Health Organisation (WHO) estimates that there are 20 million young children suffering from severe acute malnutrition at any given moment and MSF estimates that only three percent of these will receive RUF in 2007.

Therapeutic RUF for only malnourished children, as current WHO, World Food Programme, and UNICEF guidelines recommend, is too restrictive. Given its nutritional benefits, RUF has the potential to address malnutrition at earlier stages and is far more effective than fortified blended flour, which is normally distributed. MSF is piloting a programme using a modified RUF as a supplement to prevent children from becoming acutely malnourished.

“Instead of waiting for kids to get gravely ill we decided to act earlier,” said Dr. Susan Sheperd, MSF Medical Coordinator, Maradi, Niger. “We are piloting a programme that gives RUF to all children under three in at risk communities so that they get the nutrients that are missing in their normal diet.”

Through this early treatment or prevention approach in Niger, MSF is providing mothers with small containers of RUF as a supplement to their normal diet. Early results from this ongoing project, which is reaching more than 62,000 children, indicate that RUF is significantly more effective than the traditional approach of supplying fortified flours and cooking oil to mothers of young children.

MSF is calling for donors and UN agencies to urgently speed up the introduction and expand the use of RUF. This is going to take a new allocation of funds to cover the cost of