Plumpy'nut: Difference between revisions

Revision as of 14:04, 18 October 2020

Revision as of 21:19, 31 January 2021

Line 3:

| image = [[Image:Plumpy'nut wrapper.jpg|250px]]

| caption = Plumpy'Nut, a ready-to-use therapeutic food (RUTF)

| serving_size = 92 g<ref>{{cite web|url=https://www.nutriset.fr/products/en/plumpy-nut|title=Plumpy'Nut®|publisher=Nutriset|accessdateaccess-date=4 April 2018}}</ref>

| kJ = 2100

| fat = 30.3 g

Line 18:

}}

'''Plumpy'Nut''' is a [[peanut]]-based paste in a plastic wrapper for treatment of [[malnutrition|severe acute malnutrition]] manufactured by [[Nutriset]], a French company.<ref name=off>{{Cite web |title=Plumpy'Nut®: Ready-to-use therapeutic food (RUTF) |publisher=Nutriset |url=http://www.nutriset.fr/en/product-range/produit-par-produit/plumpynut-ready-to-use-therapeutic-food-rutf.html |accessdateaccess-date=2 August 2011 |archive-url=https://web.archive.org/web/20110930141832/http://www.nutriset.fr/en/product-range/produit-par-produit/plumpynut-ready-to-use-therapeutic-food-rutf.html |archive-date=30 September 2011 |url-status=dead }}</ref><ref name=nyt>{{cite news |first=Andrew |last=Rice |title=The Peanut Solution |work=[[The New York Times Magazine|New York Times Magazine]] |url=https://www.nytimes.com/2010/09/05/magazine/05Plumpy-t.html |date=2 September 2010 |accessdateaccess-date=2 September 2010}}</ref> 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.<ref name=off/>

Plumpy'Nut may be referred to in scientific literature as a [[Therapeutic food#Ready-to-Use Therapeutic Food|Ready-to-Use Therapeutic Food]] (RUTF) alongside other RUTFs such as BP100.<ref>{{Cite web |title=BP-100™ RUTF Therapeutic food |publisher=Compact for Life |url=http://www.compactforlife.com/bp-100-rutf/ |accessdateaccess-date=10 April 2012}}</ref>

Nutriset has been criticized by [[Médecins Sans Frontières]] for enforcing its Plumpy'nut patents.<ref>{{cite web|title=MSF: Nutriset patent impeding access to treatment of Severe Acute Malnutrition|url=http://www.msfaccess.org/content/msf-nutriset-patent-impeding-access-treatment-severe-acute-malnutrition|accessdateaccess-date=8 Nov 2015}}</ref>

==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.<ref name=AJCN/> 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 [[vegetable oil|fats]], [[dietary fiber]], [[carbohydrate]]s, [[protein]]s (as essential [[nutrient#Types of nutrient|macronutrients]]), vitamins and minerals (as essential [[micronutrient]]s). 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).<ref>{{cite web|title=Nutrition facts for peanut butter, smooth style, without salt, USDA Nutrient Database SR-21 |publisher = Conde Nast|website=nutritiondata.com| url=http://nutritiondata.self.com/facts/legumes-and-legume-products/4453/2|date=2014|accessdateaccess-date=3 May 2014}}</ref>

Plumpy'Nut has a two-year shelf-life and requires no water, preparation, or refrigeration.<ref name=off/> Its ease of use has made mass treatment of malnutrition in [[famine]] situations more efficient than in the past.<ref name=nyt/><ref name=bbc1>

{{Cite news |last=Schofield |first=Hugh |title=Legal fight over Plumpy'nut, the hunger wonder-product |publisher=BBC |date=8 April 2010 |url=http://news.bbc.co.uk/2/hi/europe/8610427.stm |accessdateaccess-date=3 August 2011}}

</ref> Severe acute malnutrition has traditionally been treated with therapeutic milk and required hospitalization.<ref>{{Cite journal

| pmid = 19801943

Line 87:

}}</ref> Unlike milk, Plumpy'Nut can be administered at home and without medical supervision.<ref name=off/> It also provides [[calories]] and [[essential nutrients]] that restore and maintain body weight and health in severely malnourished children more effectively than [[F-100 and F-75 (foods)|F100]].<ref name="AJCN">{{cite journal|pmid=12885713|url=http://ajcn.nutrition.org/content/78/2/302.long|vauthors=Diop el HI, Dossou NI, Ndour MM, Briend A, Wade S |title=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|journal=American Journal of Clinical Nutrition|volume=78|issue=2|pages=302–7|date=August 2003|doi=10.1093/ajcn/78.2.302|doi-access=free}}</ref>

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,"<ref name=un/> as was implemented in 2007 by [[UNICEF]] and the [[ECHO (European Commission)|European Commission’s Humanitarian Aid Department]] in [[Niger]] to address a malnutrition emergency.<ref name="unicef">{{cite web | url=http://www.unicef.org/nutrition/niger_39675.html | title=ECHO and UNICEF promote Plumpy'nut production to improve child nutrition in Niger | publisher=United Nations International Children's Emergency Fund | date=18 May 2007 | accessdateaccess-date=24 May 2016}}</ref> Plumpy'nut conforms to the UN definition of a [[Therapeutic food#Ready-to-Use Therapeutic Food|Ready-to-Use Therapeutic Food]] (RUTF).<ref name=off/><ref name=un>

{{Cite book |title=Community-Based Management of Severe Acute Malnutrition |publisher=World Health Organization, World Food Programme, United Nations System Standing Committee on Nutrition, The United Nations Children’s Fund |date=May 2007 |pages=2 |url=https://www.who.int/nutrition/topics/Statement_community_based_man_sev_acute_mal_eng.pdf |isbn=978-92-806-4147-9}}

</ref>

Plumpy'nut is not intended for routine nutrition, or for malnutrition in non-famine situations.<ref>{{cite web | url=http://www.huffingtonpost.com/jeffrey-sachs/saying-nuts-to-hunger_b_706798.html | title=Saying "Nuts" to Hunger | publisher=The Huffington Post, Washington, DC | date=6 September 2010 | accessdateaccess-date=3 July 2016 |vauthors=Sachs J, Fanzo J, Sachs S }}</ref> [[Peanut allergy|Peanut allergies]] have not been found to be a problem in usage due to a lack of allergic reactions in the target populations.<ref>{{cite web|url=https://abcnews.go.com/Health/story?id=2497593|author=Klonick K|title=Peanut Paste Saves Starving African Children|publisher=ABC News|date=1 October 2006|accessdateaccess-date=3 June 2014}}</ref>

==Composition==

Line 97:

==Production==

While the majority of Plumpy'Nut was made in France as of 2010, this therapeutic food is easily produced<ref name=nyt/> and can be made locally in peanut-growing areas by mixing peanut paste with a slurry of other ingredients provisioned by Nutriset.<ref name="network">{{Cite web |title=The PlumpyField network : how it works |publisher=Nutriset |url=http://www.nutriset.fr/en/international-networks/plumpyfield-network/plumpyfield-how-it-works.html?searched=plumpyfield&advsearch=oneword&highlight=ajaxSearch_highlight+ajaxSearch_highlight1 |accessdateaccess-date=3 August 2011}}</ref>

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.<ref name=network/>

Line 103:

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 (economics)|fragmentation]].<ref name="unc">{{cite web|url=http://www.kenan-flagler.unc.edu/~/media/Files/documents/cse/unicef-plumpy-nut-supply-chain.pdf|title=UNICEF's Plumpy'Nut supply chain|author=Swaminathan JK|publisher=University of North Carolina, Kenan-Flagler Business School, Center for Sustainable Enterprise|date=2009|accessdateaccess-date=3 June 2014}}</ref><ref name="ft">{{cite web|url=http://www.ft.com/cms/s/0/edb873a2-d6ef-11df-aaab-00144feabdc0.html#axzz33bYXDfd6|title=Case study: Getting food to disaster victims|publisher=Financial Times|author=Swaminathan J|date=13 October 2010|accessdateaccess-date=3 June 2014}}</ref>

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.<ref name=unc/><ref name="ft"/>

Line 115:

===Patent issues===

Nutriset holds or held patents in many countries (including {{cite patent|US|6346284|patent}}, 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.<ref name=bbc1/> 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.<ref name=irin>{{cite web | url=http://www.irinnews.org/printreport.aspx?reportid=86979 | title=FOOD: Making peanut butter gets stickier | publisher=UN Office for the Coordination of Humanitarian Affairs | work=IRIN: humanitarian news and analysis | date=11 November 2009 | accessdateaccess-date=8 May 2014}}</ref> In at least 27 African nations, any non-profit (including [[non-governmental organization|NGOs]]) can make the paste and not pay a license fee.<ref name=twentyseven/>

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.<ref name=bbc1/> 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.”<ref>{{cite web|last=Staff |title=Plumpy'Nut goes to court |url=http://www.vita.it/ultimenotizie/plumpy-nut-goes-to-court.html |publisher=vita.it |url-status=dead |archiveurlarchive-url=https://web.archive.org/web/20140505193540/http://www.vita.it/ultimenotizie/plumpy-nut-goes-to-court.html |archivedatearchive-date=May 5, 2014 }}</ref> 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.<ref name=sandiego>{{cite web|last=Lavelle|first=Janet|title=Child malnutrition center of legal battle|date=January 16, 2010|url=http://www.sandiegouniontribune.com/news/2010/jan/16/child-malnutrition-center-legal-battle/all/?print |publisher= The San Diego Union-Tribune|work=utsandiego.com|accessdateaccess-date=25 May 2016}}</ref> 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]]".<ref name=internatllaw/> 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.<ref name=internatllaw>{{cite web|last=Bakhsh|first=Umar R.|title=The Plumpy'Nut predicament: is compulsory licensing a solution?|url=http://studentorgs.kentlaw.iit.edu/ckjip/wp-content/uploads/sites/4/2013/06/07_12JIntellProp2382012.pdf|publisher=Chicago Kent Journal of Intellectual Property|accessdateaccess-date=4 May 2014}}</ref>

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]],<ref name=sandiego/> 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."<ref name=MSF>{{cite web|last=von Schoen-Angerer|first=Tido|title=MSF: Nutriset patent impeding access to treatment of Severe Acute Malnutrition|url=http://www.msfaccess.org/sites/default/files/MSF_assets/MalNut/Docs/NUT_letter_NutrisetPatent_ENG_2009.pdf|publisher=Campaign for Access to Essential Medicines|accessdateaccess-date=1 May 2014}}</ref> 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.<ref>{{cite web|last=Team Praescient|title=UNICEF'S Mission to End Hunger: Leveraging Analytic Methodologies to Advance Development Goals|url=http://praescientanalytics.com/unicefs-mission-to-end-hunger-leveraging-analytic-methodologies-to-advance-development-goals/|publisher=praescientanalytics.com/|accessdateaccess-date=4 May 2014}}</ref> In response to the criticism, Nutriset has allowed companies and [[Non-governmental organization|NGOs]] in some African countries to make the paste and not pay license fees.<ref name=twentyseven>{{Cite web |title=Nutriset/IRD's Patents Usage Agreement |publisher=Nutriset |url=http://www.nutriset.fr/en/access/patents-for-development/online-patent-usage-agreement.html |accessdateaccess-date=10 August 2010}}</ref>

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