Frontline medical workers say the latest impact of the war in Ukraine is a dramatic price rise in an emergency treatment used to save the lives of starving children.
A high-calorie peanut paste called Plumpy’Nut is used by medical staff across the world as the first response to save a severely malnourished child.
But rising prices, scarcity of ingredients and problems with distribution mean that the red and white bags are becoming increasingly expensive just as need is rising, with millions of children facing hunger in East Africa alone.
The paste – peanuts, milk powder, sugar, vegetable oil and minerals and vitamins – is easily transported, has a long shelf life and does not need refrigeration. This makes it ideal for aid workers and organizations to treat children between two and six.
Nutriset, the French manufacturer of Plumpy’Nut – also called ready-to-use therapeutic food (RUTF) – had already been increasing the price of its bars, up by 23% since May 2021. Now Unicef, the UN children’s agency, expects the cost of the product to rise by a further 16% in the coming months, which would mean 600,000 fewer children being given the paste.
Every year Unicef buys almost 80% of the world’s RUTF supply.
Siméon Nanama, a UN nutrition adviser, said the price increase comes at a critical time for many African countries. “It comes on top of already-high-levels of severe food insecurity after years of conflict, climate shocks, drought and the impact of Covid-19,” he said. “As a result, the hardest hit countries are seeing rates of severe wasting soar among children, and it’s predicted to get worse.
“The effect of the war in Ukraine impacts the costs of RUTF and program delivery in many ways,” said Nanama. “In addition to the sharp rise in the cost of raw ingredients, the crisis has also led to an increase in oil prices including in Africa, especially for non oil producing countries. And when oil prices go up, they affect everything due to the increase in the costs of transportation, among others.”
Is Somalia, where four failed rainy seasons have resulted in widespread food shortages, the Somali branch of the aid organization Save the Children said 1.7 million children are malnourished, of which 400,000 are in very serious condition.
“Last year, one box of 150 bars of food cost €35 (£29),” said Binyam Gebru, deputy country director of the charity. “Now that’s €44.”
Save the Children buys from Nutriset, which means the product is dispatched from France. “Instead of four months, it now takes six months for the product to arrive here,” said Gebru. “That is due to the increased demand, but also to a lack of containers and congestion at ports.”
As import prices soar, local production might seem the best solution. Yet African manufacturers are also facing problems. Due to the war in Ukraine, milk, grain and vegetable oil suppliers now sell to the highest bidder.
“This meant massive increases in the cost of raw materials such as vegetable oil and milk solids,” said Riaan Oosthuizen, managing director of the South African RUTF manufacturer GC Rieber Compact. The price of the oil and the milk powder have almost doubled.
He said trying to develop new recipes for RUTF is difficult because the product must meet very high quality requirements.
“It must be kept in mind that the children who need the product do have a very low immune system,” Oosthuizen said: “Any introduction of even very low levels of a pathogen such as salmonella may result in fatalities. For that reason, RUTF is produced under very high hygienic conditions, “bordering on pharmaceutical levels”.
Many African RUTF producers depend on imported raw materials. Nikita Chandaria and her father Dhiren make therapeutic paste in Kenya with their family firm Insta Products. In the past four years, they have invested in groundnut growers, collaborating with communities in the northern Turkana region. But that area has been badly hit by the extreme drought in the Horn of Africa.
“For many of the communities we work with, their peanut harvest was critical to getting through the worst period of the drought because they could consume a lot of the nuts themselves,” said Nikita Chandaria. “We are now seeing that the peanut harvest in those areas can alleviate the effects of rising food costs a little bit. People in rural areas feel the effects of inflation much worse than we do in cities.”
Other producers have also started using local nuts, said Unicef’s Nanama. “We are working with the private sector for the development of new products, including some that use other sources of proteins than milk.”
He says tests are under way to replace nuts with more available ingredients such as sorghum. “We hope that we will soon have other options that are less costly, yet equally efficient to treat malnutrition and save lives.”
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