Plumpy'nut

Plumpy'Nut is a peanut-based paste in a plastic wrapper for treatment of severe acute malnutrition manufactured by Nutriset, a French company.[2][3] Removing the need for hospitalization, the 92-gram (3¼ oz) packets of this paste can be administered at home and allow larger numbers to be treated.[2]

Plumpy'Nut
Plumpy'Nut, a ready-to-use therapeutic food (RUTF)
Nutritional value per 92 g[1]
Energy2,100 kJ (500 kcal)
45 g
30.3 g
12.8 g
Other constituentsQuantity
Ingredientspeanut paste, vegetable oil,
powdered milk, powdered sugar,
vitamins, minerals
†Percentages are roughly approximated using US recommendations for adults.
Source: Nutriset, France

Plumpy'Nut may be referred to in scientific literature as a Ready-to-Use Therapeutic Food (RUTF) alongside other RUTFs such as BP100.[4]

Nutriset has been criticized by Médecins Sans Frontières for enforcing its Plumpy'nut patents.[5]

Use

Plumpy’Nut is used as a treatment for emergency malnutrition cases. It supports rapid weight gain derived from broad nutrient intake which can alleviate a starving child from impending illness or death.[6] The product is easy for children to eat because it dispenses readily from a durable, tear-open package. The fortified peanut butter-like paste contains fats, dietary fiber, carbohydrates, proteins (as essential macronutrients), vitamins and minerals (as essential micronutrients). Peanut butter itself is a rich source of vitamin E (45% of the Daily Value, DV, in a 100 gram amount) and B vitamins (particularly niacin at 67% DV).[7]

Plumpy'Nut has a two-year shelf-life and requires no water, preparation, or refrigeration.[2] Its ease of use has made mass treatment of malnutrition in famine situations more efficient than in the past.[3][8] Severe acute malnutrition has traditionally been treated with therapeutic milk and required hospitalization.[9] Unlike milk, Plumpy'Nut can be administered at home and without medical supervision.[2] It also provides calories and essential nutrients that restore and maintain body weight and health in severely malnourished children more effectively than F100.[6]

The United Nations has recognized this utility, stating in 2007 that "new evidence suggests... that large numbers of children with severe acute malnutrition can be treated in their communities without being admitted to a health facility or a therapeutic feeding centre,"[10] as was implemented in 2007 by UNICEF and the European Commission’s Humanitarian Aid Department in Niger to address a malnutrition emergency.[11] Plumpy'nut conforms to the UN definition of a Ready-to-Use Therapeutic Food (RUTF).[2][10]

Plumpy'nut is not intended for routine nutrition, or for malnutrition in non-famine situations.[12] Peanut allergies have not been found to be a problem in usage due to a lack of allergic reactions in the target populations.[13]

Composition

The ingredients in Plumpy'Nut include "peanut-based paste, with sugar, vegetable oil and skimmed milk powder, enriched with vitamins and minerals".[2] Plumpy'Nut is said to be "surprisingly tasty".[3]

Production

While the majority of Plumpy'Nut was made in France as of 2010, this therapeutic food is easily produced[3] and can be made locally in peanut-growing areas by mixing peanut paste with a slurry of other ingredients provisioned by Nutriset.[14]

A number of partner companies and one non-profit organization in the U.S state of Rhode Island make Plumpy'Nut; six of the factories are in African countries (Niger, Burkina Faso, Ethiopia, Sudan, Madagascar, Kenya), one is in Haiti and another one in India.[14]

Plumpy'Nut is distributed from the manufacturer to geographic areas of need through a complex supply chain. Forward information flows, such as projections of need, order processes, and payment information, and backward information flows, including stock monitoring, quality assurance, and performance data occur through information exchange vulnerable to errors or tardiness associated with supply chain fragmentation.[15][16] Factors affecting potential for loss of efficiencies in the supply chain are information flow on orders, basis of need, forecasts, flow upstream from field officers and country offices to parties controlling regional distribution and manufacturing by Nutriset, downstream flow of information on delivery times and order status.[15][16]

A complete two-month regimen for a child costs US$60 c. 2010.[3]

History
Woman giving Plumpy'Nut nutritional aid to her children in Kenya.

Inspired by the popular Nutella spread,[3] Plumpy'Nut was invented in 1996 by André Briend, a French paediatric nutritionist, and Michel Lescanne, a food-processing engineer.[2] Nutella is a spread composed of sugar, modified palm oil, hazelnuts, cocoa, skimmed milk powder, whey powder, lecithin, and vanillin. In contrast, Plumpy'Nut is a combination of peanut paste, vegetable oil and milk powder, without including chocolate, but containing sugar, vitamins and dietary minerals.

Skippy may have developed a similar product in the early 1960s, according to a former employee, although it was never released.[17]

Patent issues

Nutriset holds or held patents in many countries (including US patent 6346284, published in 2002) for the production of nut-based, nutritional foods as pastes, which they have defended to prevent non-licensees in the United States from producing similar products.[8] In places where Nutriset does not hold a patent, manufacturers of similar pastes have been stopped from exporting their products to places where Plumpy'Nut is patented.[18] In at least 27 African nations, any non-profit (including NGOs) can make the paste and not pay a license fee.[19]

In 2010, two US non-profit organizations unsuccessfully sued the French company in an attempt to legally produce Plumpy'Nut in the US without paying the royalty fee.[8] Mike Mellace, president of one of the organizations claimed that “some children are dying because Nutriset prevents other companies from producing a food which could save their lives.”[20] Invalidation of the Nutriset patent may have a positive impact on populations affected by famine, and studies by humanitarian organizations support the idea that having a single, dominant supplier in Nutriset is undesirable.[21] Critics of Nutriset argue the US patent is “obvious in light of prior recipes” and “that the patent has essentially conferred monopoly power on Nutriset and thus violated the Sherman Act".[22] By definition, a patent grants a temporary monopoly, and Nutriset won the case. Some have suggested a similarity between pharmaceutical company compulsory licensing agreements, in place under the WTO TRIPS Agreement, and Plumpy'Nut.[22]

Following a threat of legal action against a Norwegian company that was exporting a similar product to Kenya, Nutriset was criticized by Médecins Sans Frontières,[21] which stated in an open letter that "Nutriset has been asked repeatedly by us and others for simple, reasonable licensing terms... Instead it appears that [Nutriset has] decided to adopt a policy of aggressive protection of [its] patents that could be considered an abuse in relation to humanitarian products."[23] A UNICEF study, commissioned at Duke University and the University of North Carolina, recommended a diversified supplier base of RUTF products to better serve global needs.[24] In response to the criticism, Nutriset has allowed companies and NGOs in some African countries to make the paste and not pay license fees.[19]

The Plumpy'Nut patents in the USA expired in 2017 (US patent 6346284), and in the UK and the European Union in 2018 (EP patent 1032280).

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See also

References
  1. "Plumpy'Nut®". Nutriset. Retrieved 4 April 2018.
  2. "Plumpy'Nut®: Ready-to-use therapeutic food (RUTF)". Nutriset. Archived from the original on 30 September 2011. Retrieved 2 August 2011.
  3. Rice, Andrew (2 September 2010). "The Peanut Solution". New York Times Magazine. Retrieved 2 September 2010.
  4. "BP-100™ RUTF Therapeutic food". Compact for Life. Retrieved 10 April 2012.
  5. "MSF: Nutriset patent impeding access to treatment of Severe Acute Malnutrition". Retrieved 8 Nov 2015.
  6. Diop el HI, Dossou NI, Ndour MM, Briend A, Wade S (August 2003). "Comparison of the efficacy of a solid ready-to-use food and a liquid, milk-based diet for the rehabilitation of severely malnourished children: a randomized trial". American Journal of Clinical Nutrition. 78 (2): 302–7. doi:10.1093/ajcn/78.2.302. PMID 12885713.
  7. "Nutrition facts for peanut butter, smooth style, without salt, USDA Nutrient Database SR-21". nutritiondata.com. Conde Nast. 2014. Retrieved 3 May 2014.
  8. Schofield, Hugh (8 April 2010). "Legal fight over Plumpy'nut, the hunger wonder-product". BBC. Retrieved 3 August 2011.
  9. Creek, T. L.; Kim, A; Lu, L; Bowen, A; Masunge, J; Arvelo, W; Smit, M; Mach, O; Legwaila, K; Motswere, C; Zaks, L; Finkbeiner, T; Povinelli, L; Maruping, M; Ngwaru, G; Tebele, G; Bopp, C; Puhr, N; Johnston, S. P.; Dasilva, A. J.; Bern, C; Beard, R. S.; Davis, M. K. (2010). "Hospitalization and mortality among primarily nonbreastfed children during a large outbreak of diarrhea and malnutrition in Botswana, 2006". Journal of Acquired Immune Deficiency Syndromes. 53 (1): 14–9. doi:10.1097/QAI.0b013e3181bdf676. PMID 19801943.
  10. Community-Based Management of Severe Acute Malnutrition (PDF). World Health Organization, World Food Programme, United Nations System Standing Committee on Nutrition, The United Nations Children’s Fund. May 2007. p. 2. ISBN 978-92-806-4147-9.
  11. "ECHO and UNICEF promote Plumpy'nut production to improve child nutrition in Niger". United Nations International Children's Emergency Fund. 18 May 2007. Retrieved 24 May 2016.
  12. Sachs J, Fanzo J, Sachs S (6 September 2010). "Saying "Nuts" to Hunger". The Huffington Post, Washington, DC. Retrieved 3 July 2016.
  13. Klonick K (1 October 2006). "Peanut Paste Saves Starving African Children". ABC News. Retrieved 3 June 2014.
  14. "The PlumpyField network : how it works". Nutriset. Retrieved 3 August 2011.
  15. Swaminathan JK (2009). "UNICEF's Plumpy'Nut supply chain" (PDF). University of North Carolina, Kenan-Flagler Business School, Center for Sustainable Enterprise. Retrieved 3 June 2014.
  16. Swaminathan J (13 October 2010). "Case study: Getting food to disaster victims". Financial Times. Retrieved 3 June 2014.
  17. Krampner, Jon (2013). Creamy & Crunchy: An Informal History of Peanut Butter, the All-American Food. Columbia University Press. p. 218. ISBN 9780231162326. According to former plant manager and engineer Frank Delfino... In the late 1950s and early 1960s, Skippy worked on and formulated a product that was essentially the same as... Plumpy'nut
  18. "FOOD: Making peanut butter gets stickier". IRIN: humanitarian news and analysis. UN Office for the Coordination of Humanitarian Affairs. 11 November 2009. Retrieved 8 May 2014.
  19. "Nutriset/IRD's Patents Usage Agreement". Nutriset. Retrieved 10 August 2010.
  20. Staff. "Plumpy'Nut goes to court". vita.it. Archived from the original on May 5, 2014.
  21. Lavelle, Janet (January 16, 2010). "Child malnutrition center of legal battle". utsandiego.com. The San Diego Union-Tribune. Retrieved 25 May 2016.
  22. Bakhsh, Umar R. "The Plumpy'Nut predicament: is compulsory licensing a solution?" (PDF). Chicago Kent Journal of Intellectual Property. Retrieved 4 May 2014.
  23. von Schoen-Angerer, Tido. "MSF: Nutriset patent impeding access to treatment of Severe Acute Malnutrition" (PDF). Campaign for Access to Essential Medicines. Retrieved 1 May 2014.
  24. Team Praescient. "UNICEF'S Mission to End Hunger: Leveraging Analytic Methodologies to Advance Development Goals". praescientanalytics.com/. Retrieved 4 May 2014.
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