Monday, February 4, 2008

"Plumpy"––A Reminder That Good Policy Works on Many Fronts

Brian Klepper joins us again today with a post that reminds us that good health care policy doesn't have to be complicated health care policy and can work for us on many fronts at once.

Plumpy'nut

by Brian Klepper

The NY Times recently had an important op-ed by Susan Shepherd, a pediatrician and medical advisor to Doctors Without Borders. The core of her message is that as the farm bill progresses through Congress, we should focus not only on the quantity of food that is produced and that we export for relief to underdeveloped nations, but on its quality as well.

Dr. Shepherd describes the difficulties in treating children who are victims of severe malnutrition, particularly in areas like Africa and South Asia where milk and clean water can be scarce.

The US and other international donors current supply fortified blended flours for moderately malnourished children. Much better and more accessible nutrition is available through a ready-to-use food called Plumpy'nut (or Plumpy). But Plumpy costs a little more, and current UN and US guidelines restrict its use to the 3% of children who have already descended to the most acute malnutrition.

Ten years ago, a French pediatric nutritionist affiliated with the World Health Organization, Andre Briend, developed Plumpy'nut, a high protein and high energy food bar comprised of peanut paste, vegetable oil, milk powder, powdered sugar, vitamins and minerals, that can be prepared locally and that has a two year shelf life in an unopened package. Children can be treated at home rather than in hospital settings, a critical advance. They receive 2 packets a day. Delivered in combination with Unimix, a vitamin-enriched flour for making porridge, a 2-4 week treatment costs $20 and can allow 90 percent of severely malnourished children to recover.

One of the lessons of Jeffrey Sachs' book, The End of Poverty, is that we now have the tools to stabilize the billion people who remain in extreme poverty, so that we can then help them onto the bottom rungs of the economic ladder, where they have a chance to prosper.

Despite its current economic gloom, America remains a center of prosperity in a volatile world. Think of the goodwill we could create if we resolved to couple our aid with the best we we've learned in food science and other disciplines. The creation of Plumpy is a shining example of what's possible, and the work of Doctors Without Borders and other relief organizations an inspiration for how we can cultivate peace in the world.

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