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This article from Stanford's B-school is all about the financing behind ready-to-use-foods (RUTFs) based on a Norwegian study just released that basically advocates an "all-or-nothing" approach to RUTF distribution. Apparently, the common practice for humanitarian relief agencies is to try to spread out the RUTFs they have as much as possible, meaning that many kids are not getting a full serving. The new study says that if relief workers are forced (by constrained resources) to practice a "triage" approach, they should target the kids "on deaths door" first and to give them full rations. The study says that, ultimately, more lives will be saved with this approach. This approach, however, obviously raises questions about who determines which children are most undernourished and how to actually make this type of potentially heartbreaking distribution happen where you have to actively say to someone, "No, your child isn't starving to death enough, so we aren't giving them these more beneficial RUTFs at all" (they distribute "less powerful" RUTFs to children who are less malnourished).
Here's the summary (from the article) of how they ran the study and their findings:
"The team based its findings on mathematical analysis of data on thousands of undernourished children aged 5 or younger in the Democratic Republic of Congo and in Niger. Their conclusion: An "all-or-nothing" approach, combined with a more comprehensive measure of undernourishment, could reduce deaths and life-limiting disabilities by 9%, compared with current policies. Alternatively, they estimate, relief groups could get the same health results as today but reduce the cost by 61%."
One of this week's articles (De Pee and Bloem) mentions that one of the current "downsides" of RUTFs is their cost and how that limits the production capacity. I also noticed that77% of PlumpyNut RUTFs are produced in France and the remaining 23% is produced by only 10 other countries, mostly in Africa (here's a map of where PlumpyNut is produced).
PlumpyNut has a high peanut content. Nine of the top 10 peanut producers in the world are in developing or transitioning economies (see table below [from Wikipedia... Editor Me would totally not accept this as a valid source... luckily, right now, that chick is unemployed, so she can't say anything). Two of them are in Africa. Even for countries who are not among the top 10 producers, peanuts (aka groundnuts) are a major crop for many African countries (especially in Sub-Saharan Africa). Labor in developing countries is A LOT less expensive than labor in France. The French company that invented PlumpyNut has even waived licensing fees for producers in developing countries. So, the next question is, why not produce RUTFs more in Africa (where a lot of RUTFs are destined anyway)?
A thousand responses probably come to mind:
- poor infrastructure (roads!) = expensive/difficult distribution
- lack of legal/regulatory capacity that favors large-scale production ventures
- lack of skilled workers
- rising food prices (peanuts commodities trades over the last 30yrs: http://www.indexmundi.com/
- etc etc etc
The list goes on and on and the "systems" problem just becomes more and more obvious the more you think about it where poor education/economic/governance indicators lead to missed market opportunities which means missed opportunities for making money/economic growth which means lack of funding for education/health/governance capacity building, etc.
The main point of this post was to share the article since it's a timely story related to this week's readings and topic. But the article also got me thinking about all the connections I'm seeing between our Global Health, Global Food Systems, micro/macroeconomics, and even my security and social enterprise electives (the Stanford article even mentions advanced multiple regression, so, add stats to that list as well, check!). Despite the harrowing prospects of our econ/stats/health exams, the big picture makes it all a little more tolerable to get through (good luck with midterms!).
Link to main article: http://www.gsb.stanford.edu/
Country Production
(Million Metric Tons)
People's Republic of China 14.30
India 6.25
United States 2.34
Nigeria 1.55
Indonesia 1.25
Myanmar 1.00
Sudan 0.85
Senegal 0.71
Argentina 0.58
Vietnam 0.50
World 34.43
Source: USDA Foreign Agricultural Service: Table 13 Peanut Area, Yield, and Production
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