No quick-fix solution: Don't use packaged food to fight malnutrition, says govt -Rema Nagarajan

-The Times of India

NEW DELHI: The Women and Child Development ministry has written to all states and union territories that there isn't enough evidence to support the use of Ready-to-Use-Therapeutic foods (RUTF) for the management of severe acute malnutrition (SAM). This is a blow to the multi-crore complex of international NGOs who push packaged food as a strategy to address severe malnutrition and companies that produce them.

The WCD letter pointed to the concern that "use of RUTF may replace nutritional best practices and family foods that children should normally be eating". It said this could impact negatively on continued breastfeeding in children older than six months and undermine the importance of providing nutritional counseling.

The letter referred to the health ministry's February 2009 letter that categorically stated that the use of RUTF for management of malnutrition is not an accepted policy of the government and that its instructions in this respect should be "strictly complied with".

Recently, responding to public health activists and paediatricians protesting against the promotion of commercially produced RUTF for treating SAM, the health ministry had stated that it was only "temporarily helpful for nutritional rehabilitation" and not of benefit to "a common household in developing appropriate food habits for children as against home augmented food". The health ministry added that based on these findings of the SAM alliance constituted by the government, which includes the department of biotechnology and Indian Council of Medical Research (ICMR), it had concluded that what was required was a "comprehensive family centric approach involving care-givers instead of a food centric approach".

Published studies set in India repeatedly showed that RUTF, which showed remarkable results in treating children with SAM in Africa, has proved much less effective in trials here. This had prompted paediatricians and nutritionists to write a letter to the prime minister cautioning against "quick fixes" of buying commercial products instead of focusing on sustainable measures such as care support for mothers, clean drinking water and food security.

International organisations pushing RUTF as a strategy include UNICEF and the Global Alliance for Improved Nutrition (GAIN), whose donors include governments of countries such as the US, the UK, Canada, Netherlands and France and the Bill and Melinda Gates Foundations. GAIN also has alliances with multinational food companies. These international organisations have funded several pilot projects and persuaded state governments to use pre-packaged, fortified energy-dense pastes to fight SAM.

In May, Maharashtra floated a Rs 100 crore scheme to feed children a pre-packed nutritious paste thrice a day for 72 days. A private firm was to supply these packages bypassing the 1.08 lakh anganwadis in the state.

Recently, Tata Steel supplied cartons of RUTF for distribution in West Singhbum district, in a joint mission with the Jharkhand State Nutrition Mission and UNICEF. The WCD department of Odisha too had decided to use RUTF. The Adani Foundation has been distributing RUTF in several states. RUTF is being distributed in several districts in Madhya Pradesh, Gujarat and Rajasthan too. Several private firms, big and small, manufacture these nutritional pastes and have bagged contracts worth crores.

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The Times of India, 12 September, 2017,

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