Global Health Controversy: Local vs Imported Solutions – Part One
Two of the most used products for children at risk are plumpy'nut, a ready-to-eat therapeutic food (RUTF), and oral rehydration solution (ORS), a treatment for diarrhea. They are both powerful tools in bringing a malnourished or dehydrated child back to health. And they are both subject to similar kinds of controversy.
Oral rehydration solution can be made in two ways. You can mix sugar, salt, and boiled water, as I describe here. Or you can mix boiled water and the contents of a WHO-approved packet of oral rehydration salts. In the first instance, you use only materials you can access at home. You're not dependent on any outside inputs. But you may mix it wrong, and wrongly-made ORS can make a child sicker. The WHO packer will be mixed right every time, as long as you use the right quantity of clean water. However, it may not always be available; the local clinic may charge for it, you may not be able to get to a clinic or your country or region may be suffering a stock-out on ORS.
Now take plumpy'nut. It's made in a few factories and imported in crisis situations as a food to rapidly return malnourished children to health. It's very, very good at what it does. Better than the old formulas that were used in emergency feeding centers. It stores well, doesn't need to be mixed with water, and kids love it. (Not surprisingly; it tastes like the filling of a peanut butter cup.)
The problem with Plumpy'nut is that it's an imported product. The product is dependent on supply lines to get it to the people who need it, and on NGOs with the money to pay for it. It actually cannot be locally produced, because Plumpy'nut was patented by Nutriset, the company that developed it.
So, why are solutions that depend on imports controversial? I'll address that in my next post.
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