UNICEF goes local with RUTF products in war against malnutrition

Gone are the days when the supply of humanitarian nutrition products relied on just a handful of western companies. UNICEF is pushing its supply of Ready to Use Therapeutic Food (RUTF) into a more competitive future driven by local suppliers ready to help their own region. 

UNICEF is the world’s main buyer of RUTF products, procuring about 80% of the global supply of the emergency products used as a quick fix treatment for those suffering from severe acute malnutrition.

Yet for years the UN’s children charity has been importing these solutions, mainly from companies like France’s Nutriset and Norway's Compact. 

Now it’s looking to use its key buyer status to change this, and in 2013 it set itself the goal of sourcing 50% from suppliers located in programme countries by 2016.

It’s a target already exceeded, with 56% of the RUTF procured in 2016 coming from suppliers in malnutrition programme countries, up from 38% in 2015.  

Next year it is set to continue or even top this trend. 

The creation and expansion of these suppliers marks a major change for the RUTF industry, and a major opportunity to bring prosperity to programme countries.

“Basically the overall arching goal is that we want to enable countries to look after their own children,” Alison Fleet, nutrition technical specialist within UNICEF’s supply division, told us.

She said the benefits for the economy, empowerment and closer engagement with programmes and governments as well as responsiveness to humanitarian crisis were clear.

“When we have a supplier that’s based in the country then engagement with the government is a lot more streamlined and this is very important for the sustainability aspect because the government can then incorporate the product within their programme guidelines.”

RUTF: A brief history

RUTF products come in pre-measured dosed sachet packets, which are easy for children to eat without assistance. They contain peanut paste, milk, vegetable oil, sugar and vitamins and minerals. 

Recovery rates thanks to the product have been seen to be as high as 90%

The story of RUTF products is a relatively recent one. 

Chad conducted its first trials using the peanut nutrition mixes in 1997, with charity Concern Worldwide following suit in Ethiopia in 2000. 

But it wasn't until 2002 that UNICEF procured its first 57 metric tonne shipment from the world’s only supplier at the time, French firm Nutriset.

About 14 years later and UNICEF is set to procure 69,000 MT from 23 different suppliers in 2017.

Competition up, prices down

Increased volumes and supplier diversity have seen prices of the products fall dramatically.

In eight years prices per carton have dropped by 23%, from $57 (€54.41) in 2008 to $44 (€41.97) in 2016.

UNICEF's suppliers now include:

-Compact AS in Norway

-Compact Pvt in India

-Diva Nutritional Products in South Africa 

-GC Rieber Compact South Africa

-Edesia in the US

-Hilina in Ethiopia

-InnoFaso in Burkina Faso

-Insta Products in Kenya

-Ismail Industries in Pakistan

-Kaira District Cooperative in India

-Mana Nutritive Aid Products in the US

-Meds & Food for Kids in Haiti

-Nuflower Foods and Nutrition in India

-Nutriset in France

-NutriVita Foods in India

-Project Peanut Butter in Ghana

-Malawi and Sierra Leone

-Samil Industry in Sudan

-Société JB in Madagascar

-Société de Transformation Alimentaire in Niger

-Tabatchnick Fine Foods in US

-Valid Nutrition in Malawi

However, Joan Howe, communication specialist for UNICEF’s supply division, said conversations around price had to be “very nuanced”.

Local suppliers remain about 12-14% more expensive than established international suppliers normally producing on a bigger scale.

There remains some significant hurdles in bringing this cost down, since local production requires the importation of most packaging materials and ingredients from international suppliers.

These materials and ingredients are subject to import duties because ‘humanitarian item’ exemptions are often only awarded to finished products.

Attracting affordable investment capital for expansion would also be key catalyst for change, but often local producers face high interest rates on capital loans and long cash conversion cycles. 

Yet Fleet warned against too much of a focus on price.

“It’s a very, very important aspect of our competitive bidding, that we get the best price for the product. At the same time we want to make sure that the quality is maintained.” 

Sourcing quality

Indeed the quality of the products’ main ingredient, peanuts, continues to be a safety concern.

One RUTF newbie, Kenyan firm Insta Products (EPZ), told us it couldn't yet use African peanuts in its production because of potential carcinogenic aflatoxins.

Meanwhile US chocolate giant Hershey, which has been active in the field with charity Project Peanut Butter, has made significant investments to change this.

Last year it committed to using 100% local peanuts for its Ghana school feeding programme, which aimed to reach 50,000 school children by 2016 with its free RUTF product Vivi.

Part of this meant training 7,500 peanut farmers on agricultural practices and roasting to ensure a safe, reliable supply for the programme.

Branching out 

But what responsibility does UNICEF take for the newly-created companies once it no longer needs its regional supply?

Fleet said UNICEF was in close contact with other NGOs and organisations like the World Food Programme, and it could be that the companies pass on to production of other similar products like ready-to-use supplementary food (RUSF), which contains more milk and is used to treat more moderate acute malnutrition.

However she added: “The thing is we never promise them that we will give them business for life.”

Howe echoed this, adding the companies could go on to procure their own contracts for RUTF products.

The unfortunate truth remains that there will probably always be a need for these emergency nutrition products. 

"It doesn't necessarily mean that when we stop supplying the problem disappears," she said. 

In 2016 most of UNICEF's RUTF products went to programmes in Nigeria (4,236 MT), Yemen (2,693 MT), Sudan (2,287 MT), South Sudan (2,036 MT) and Ethiopia (1,946 MT).

Beyond the 15%

Indeed despite the increasing volumes procured by UNICEF, it estimates its supply only covers 15% of the global caseload of severe acute malnutrition.

As a result it is currently working on its FOND (Food Online Nutrition Database) project, which looks to find alternative RUTF recipes based on substitute or locally-sourced ingredients.

It hopes this will lead to greater coverage of malnutrition needs in regions where the current RUTF is not well accepted.

“Countries in Africa are satisfied with the peanut-based formulation, however, their expectation is that the product will become more cost effective and that the procurement will also lead to local economic benefits, such as job creation,” UNICEF told us.

“However, in Asia, the peanut-based formulation is not as popular and country specific formulations will be needed to overcome the barriers to coverage. UNICEF’s strategy for RUTF will most likely extend the target of locally procured RUTF in the next five years, along with other strategic initiatives that will enhance access to treatment of severe acute malnutrition.”