Tag: UNICEF

Micronutrient Forum Conference: Vitamins and Minerals in the Changing Environment

October 8, 2026    Nutrition specialists gathering in Accra last week returned to a recurring challenge: how to translate evidence on preventing malnutrition into policies and programs that reach people at scale.   Several thousand nutrition and aid specialists participated in person and online in the Micronutrient Forum’s 7th Global Conference, held in Accra, Ghana, from September 28 to October 1.     With the theme “Nutrition at the Frontiers of a Changing Environment,” the conference brought together research, policy, and program experience across nutrition, food systems, climate, and development.

Presentations examined climate-resilient, nutrient-rich crop varieties; improvements in food storage and processing; and innovative financing. Across these topics, speakers emphasized the importance of political leadership, sustained investment, and coordination.

Presenter Ziauddin Hyder reflected on the event:

“Ending malnutrition requires more than isolated projects. It demands strong political leadership, sustainable domestic financing, and coordinated action across sectors. Bangladesh is committed to transforming this vision into action by integrating nutrition into primary health care and ensuring that multisectoral investments converge to improve maternal and child nutrition.”

Participants included Action Against Hunger, World Vision, Catholic Relief Services, the Hunger Project, GAIN, Population Action International, AGRA, iDE, UNICEF, IFPRI, FAO, WFP and the Ghanaian Government.  Private sector participants included BioAnalyt Gmbh, Hexagon Nutrition, and Particles for Humanity.  A number of presentations were by the Consultative Group on International Agricultural Research (CGIAR) or IFPRI. The Government of Ghana, the African Union (AU), and the African Development Bank (AfDB) were major participants as well.

Dr. Saskia Osendarp, who is Executive Director of the Micronutrient Forum, called on the international community to not only take stock of progress but also translate evidence into actionable recommendations for research, policy, and programs, while building on and celebrating African leadership in nutrition.

Presentations covered a wide range of recent progress in battling malnutrition, spanning climate change, behavior change, processed foods, testing for deficiencies, fortification, nutrient supplements and funding.

FORTIFICATION

A widely echoed takeaway from the forum was the growing body of evidence on what works: across diverse contexts, food fortification emerged as one of the most cost-effective and impactful public health interventions, especially when implemented with mandatory legislation.

The Food Fortification Initiative presented a systematic review about the effectiveness of large-scale food fortification across 10 fortification vehicles, plus reviews on milk fortification, fortified soy/fish sauce, the impact of mandatory folic acid fortification on neural tube defects, congenital heart defects, and clefts, folate status, methods for estimating fortified-food coverage, integration of fortification into food systems, and a new rapid spot assay for zinc in fortified grains.

The ten-person CRS delegation concluded that: “We know what works. Now is the time to scale it,” supported by abstracts from their fortification work in Madagascar, Niger, and Ghana.  CRS highlighted how its fortification programming in West Africa,  built with governments, regional institutions, the private sector, and civil society, has strengthened policy frameworks, regulatory monitoring, quality assurance, and compliance, improving access to micronutrient-rich foods “for millions of vulnerable populations.”

Gaps in Compliance:  Research from countries like Bangladesh and Nigeria revealed significant compliance gaps, particularly highlighting the disparity between branded and unbranded staple foods (like edible oil and salt). Experts noted that markets frequently fail to deliver adequately fortified foods to consumers due to these blind spots.  From Cambodia, a 2023 cross-sectional assessment of vendors in about 150 public rural primary schools, related to unhealthy school foods found that 98% of vendors said they knew the directive, and most could identify sugary and energy drinks as prohibited.  Yet, that awareness did not change what was sold.

A rapid zinc test may make food-fortification monitoring much easier.  The Food Fortification Initiative featured an abstract about developing and validating a qualitative spot assay for zinc in fortified cereals. The associated method uses xylenol orange, which produces pink or purple spots when added zinc is present in refined wheat flour or fortified white rice. Testing takes only 10–15 minutes, excluding reagent preparation.  This gives millers and inspectors a relatively inexpensive screening tool for checking whether zinc was added. It detects presence, however, rather than establishing that the food contains the legally required concentration.

GAIN’s contributions included Svenja Jungjohann’s presentations on discrepancies between market assessments and household exposure in Bangladesh, and compliance gaps in branded and unbranded oil and salt in Bangladesh and Nigeria. Annette Mongina Nyangaresi presented implementation research about digital fortification-quality systems.

Latin America has been a historic pioneer in large-scale food fortification (vitamin A–fortified sugar in Guatemala, near-universal salt iodization, wheat flour fortification in 18 countries.  Rice fortification (already mandatory in Costa Rica, Nicaragua and Panama, and being developed in the Dominican Republic, Brazil and Colombia) was flagged as an underused frontier.

SUPPLEMENTS FOR A WIDE RANGE OF VITAMINS AND MINERALS

There was a heavy push for expanding distribution of “multiple micronutrient supplements” (MMS) for pregnant women, with  48 countries now exploring or implementing it, noting that women prefer a full 180-day supply, which supports adherence.   Vitamin Angels, profiled earlier in Hunger Notes, presented about scaling up multiple micronutrient supplements, and Ghana’s phased rollout of Multiple Micronutrient Supplements (MMS) focused on evidence building and system preparedness.

Participants noted that supplement packaging is a sensitive part of nutritional efficacy: repackaging can reduce vitamin potency.

A poster looked at the effect of nutrition education on multiple micronutrient supplementation knowledge, attitudes, and practices among pregnant women in Abuja, Nigeria.  In selected antenatal clinics, structured nutrition education produced large gains: about 89% reached a good knowledge score and 81.6% a positive attitude toward use of multiple micronutrient inputs.

One session moderated by Jian Yan and Parul Christian of Johns Hopkins, addressed dose-response trials in undernourished women. A supplement’s nominal nutrient content does not by itself establish whether it corrects deficiency. Dose-response research seeks amounts that achieve adequate status without excessive exposure.

UNDERSTANDING MICRONUTRIENT DEFICIENCIES

UC Davis and Cambridge experts underscored that half the world has inadequate intake of at least one micronutrient, and biological stressors amplify these gaps.  Sight and Life  presented about anemia among women, noting that anemia is the #1 global cause of lost DALYs for adolescents 10–19,  University researchers emphasized that blood loss, infections, and genetic conditions are major contributors to anemia—often overshadowing simple iron deficiency narratives.  This has implications for screening, treatment protocols, and national anemia strategies.

Dr. Parmi Suchdev presented about “Micronutrients, inflammation, and life-course vulnerability,” explaining how systemic inflammation can change or obscure bio-markers of nutrient deficiencies.

CHILD NUTRITION

The Child Health and Mortality Prevention Surveillance (CHAMPS) team presented key research highlighting maternal health and life-course vulnerabilities: Malnutrition is the main underlying cause in older children. It was the most frequent underlying cause among infants and children (20.8%), with sepsis and pneumonia more often the final event. An earlier analysis found malnutrition causal or significant in 39.5% of these deaths, 89.1% of which also had an infectious cause.

World Vision presented about father-to-father support groups which helped exclusive breastfeeding increase from 64.8% to 94.7%, while women meeting minimum dietary diversity increased from 11.2% to 54.9%.  WV also presented about strengthening RUTF supply chains for continuity of care of child wasting, with West Africa as their example.

CLIMATE CHANGE IMPACTS

University scholars presented evidence that climate change is reducing the micronutrient content of staple crops.   Crop science experts showed that rising CO₂ levels and erratic rainfall patterns lower iron, zinc, and protein density in cereals.  At the same time, rapid dietary transitions in African cities are reducing micronutrient diversity, increasing reliance on processed foods, and stressing traditional food systems.

The AGRA Regional Director, Sunil Dahiya:  “Higher carbon dioxide levels reduce the zinc and iron in staples like rice and wheat. The bowl looks the same, but there is less nutrition in it.  ….The crop is changing.”

DATA AND LEARNING

Discussions emphasized the urgent need to improve the timeliness, availability, and sourcing of data feeding into the Global Fortification Data Exchange (GFDx) to help policymakers track scaling progress in real-time.

The Nutrition in City Ecosystems (NICE) Project emphasized south-south learning between Asian and African cities, showcasing how urban areas can lead in addressing micronutrient deficiencies.

Action Against Hunger, PAI, CORE Group, FP2030, HMHB, and SUN’s Civil Society Network co-convened an October 2 follow-up gathering on linking nutrition, family planning, and maternal and child health.

Overall, the conference reinforced the need for a unified, evidence-based agenda linking nutrition directly to improved child health outcomes and survival rates.

Overall, the conference reinforced the need for a unified, evidence-based agenda linking nutrition directly to improved child health outcomes and survival rates.

FURTHER INFORMATION

In the future, presentations will be available at:  https://mnfconference.org/

The program is seen at:  https://booklet.kenes.com/export/mnf26

See also:  https://www.myjoyonline.com/measure-food-systems-progress-not-only-by-productivity-but-also-ability-to-deliver-healthy-diets-agra/

GAIN’s poster presentations and side event about business:  https://www.gainhealth.org/events/micronutrient-forum-7th-global-conference-mnf#gain-participation

AGRA’s presentation:  https://youtu.be/4SjNVlZyjb8

Food Fortification Initiative:  https://ffinetwork.org/micronutrient-forum-7th-global-conference/

IFPRI:  https://www.ifpri.org/event/ifpri-micronutrient-forum-7th-global-conference/

– Edited by Steven Hansch of the World Hunger Education Service

Micronutrient Supplements from Kirk Humanitarian

September 10, 2026     One of the least known players in fighting global hunger is a quiet foundation based in Salt Lake City, Kirk Humanitarian, which buys micronutrient supplements from commercial manufacturers and donates them to UNICEF and to NGOs including Vitamin Angels, Direct Relief, Sight and Life, World Vision, and Americares, which in turn distribute them to mothers in lower-income countries.

Kirk Humanitarian, a private family foundation, acts as the leading advocate and donor for the UNIMMAP MMS formulation, shown at right, which it describes as a global gold standard for prenatal nutrition. It is a bottle for an entire course of pregnancy of 15 vitamin and mineral prenatal supplement formula, originally established by the WHO, UNICEF, and United Nations University in 1999.

Multiple Micronutrient Supplements (MMS) address widespread “hidden hunger.”  Sub-clinical (no outward signs) micronutrient deficiencies affect an estimated 2 in 3 women of reproductive age and 1 in 2 preschool children globally.  Sub-clinical deficiencies affect far more people than those with obvious signs, but impair essential metabolic, immune, and developmental functions during pregnancy.  The UNIMMAP MMS formula addresses these underlying gaps cheaply and effectively through key doses of 15 “essential” vitamins and minerals that every human requires.  Because fetal development relies on a full spectrum of micronutrients (including zinc, iodine, copper, selenium, and vitamins D and E), MMS has reduced the risks of low birthweight, preterm birth (<37 weeks), and small-for-gestational-age (SGA) births.  The vitamin C included is protected from degradation.  Vitamin C is notoriously difficult to fortify with as it does not survive well in sunlight or air.  The provided folic acid is beneficial, but the timing of the MMS provision is too late to prevent Spina Bifida.
…
Origins and Model:   Kirk Humanitarian was established in 2002 by Spencer F. Kirk and his wife, Kristen Kirk, as a family-funded private operating foundation.  Spencer Kirk is an entrepreneur and philanthropist who previously co-founded Megahertz Corporation in 1985 and served as CEO of Extra Space Storage, Inc. from 2009 to 2016.
…..

The Kirks identified maternal malnutrition and hunger as a critical, under-addressed gap in low- and middle-income countries (LMICs).  They use family capital to make advance-purchase commitments with pharmaceutical manufacturers.  Over the past two decades, this model has scaled from small donation efforts to supplying millions of pregnant women across dozens of countries to replace traditional iron-folic acid (IFA) supplements.

The foundation tries to work with NGOs that collaborate with national ministries of health to transition from traditional iron supplements to UNIMMAP MMS.  It increasingly works through multilateral mechanisms like UNICEF’s Child Nutrition Fund (CNF).  Their MMS have been distributed in over 111 countries and it now targets 12 million more women.

Impact:  Over its tenure, the foundation has assisted 80 million pregnant women with 14 billion tablets.  This translates to Kirk Humanitarian having averted approximately 12-20 million disability-adjusted life years (DALYs) since 2002.

Of equal importance going forward, the foundation has driven the cost of MMS down on a global level, through their large-scale advance purchase arrangements.   It claims “a little over $0.01 per dose,” a cost-reduction roughly fourfold since their founding.

Collaborations and Programs:  In November 2025 Kirk committed an additional US$50 million in prenatal vitamins and minerals, accessible to more than 60 countries through the UNICEF-led Child Nutrition Fund, aimed at 23 million pregnant women, bringing the total to $92 million committed to UNICEF and the Child Nutrition Fund since 2024, providing product to 43 million women.

Kirk Humanitarian partners with groups like UNICEF and the Gates Foundation to improve manufacturing quality and standardize product labeling through a new USP verification program.  In 2024, the Eleanor Crook Foundation, Gates Foundation, Children’s Investment Fund Foundation, and Kirk Humanitarian jointly released an investment case/roadmap to scale MMS.  It works with the Healthy Mothers Healthy Babies Consortium (Kirk is a founding member, plus a member of the MMS Technical Advocacy Group and Stronger Foundations for Nutrition).

Countries targeted: 

      • Asia:  Afghanistan, Bangladesh, Mongolia, Myanmar, Nepal, Pakistan, Philippines, and Sri Lanka;
      • Sub-Saharan Africa:  Burkina Faso, Ethiopia, Madagascar, Nigeria, Rwanda, Somalia, and Tanzania;
      • Latin America:  Venezuela.

Note:  Kirk Humanitarian declined World Hunger Education Service’s request for an interview for this Hunger Notes article.

– by Steven Hansch, contributing member of the WHES board

New National Nutrition Survey Results From Haiti

September 4, 2026      The rate of life-threatening, acute (wasting) malnutrition among children in Haiti has grown from 7.2% in 2023 to 9% in 2026, alongside worstening dietary diversity, according to the latest national survey findings which began in January and were just released.

Most of the increase in malnutrition was in the form of moderate wasting malnutrition, from which most preventable deaths occur.  Haiti’s Ministry of Public Health and Population (MSPP), through its national food and nutrition coordination unit (UCPNANu), released preliminary results of the 2026 national SMART nutrition survey on August 28.  Data were collected from 1 to 16 July 2026 across 18 strata, the nine provincial departments, eight communes of the Port-au-Prince metropolitan area, and the balance of Ouest department, from a planned sample of 16,176 households in roughly 1,206 clusters, including 105 reserve cluster.

See:  https://weshare.unicef.org/CS.aspx?VP3=SearchResult&STID=2AM40870CZ3M&_gl=&WS=SearchResults

Wasting malnutrition was the worst where gangs interfere with health care.  The Port-au-Prince metropolitan area records the highest malnutrition rate of any stratum at 8.8 percent, ahead of Artibonite (8.7), Reste-Ouest (7.8), and Grande Anse (7.2).  The traditionally food-insecure Nord-Ouest sits at 6.4 percent, while Nord, Sud, and Sud-Est cluster near 3.1 percent  the “low” band.

Applied to a population of roughly 1.1 to 1.2 million children aged 6–59 months, a 7.4 percent point prevalence implies on the order of 85,000 children wasted at any moment.

The government’s nutrition report adds that “UNICEF’s Haiti appeal was 87 percent unfunded at the end of the first quarter, and the nutrition sector was funded at 16 percent in 2025.  A survey documenting a 45 percent rise in child wasting has landed in a [ongoing aid] response that cannot currently treat the [full] caseload it already knows about.”

Within the metropolitan area the gradient is steep and tracks territorial control almost exactly.  Cité Soleil (gang-controlled) has 11.4 percent malnutrition, the only zone in the country in the UN’s “high” category, with moderate malnutrition alone at 10.5 percent. Delmas follows at 9.6, Port-au-Prince commune at 8.8, Croix-des-Bouquets at 8.7, Carrefour at 8.0; Kenscoff records 3.4.

Early initiation of breastfeeding rose from 48 to 68 percent, and exclusive breastfeeding under six months nearly doubled, from 17.5 to 33 percent.

UNICEF’s latest brief about their work in Haiti reports:  “To ensure the continuity of nutrition services despite ongoing humanitarian and logistical challenges, UNICEF supported the prepositioning of 34,222 cartons of Ready-to-Use Therapeutic Food (RUTF) including those sourced by local partner Meds and Foods for Kids (MFK) and essential medicines across the country’s ten Supply and Input Distribution Centers, followed by their onward distribution to health facilities to prevent stockouts.  Of this total, 19,909 cartons were strategically pre-positioned in priority locations across the country based on humanitarian and climate-related risks, while the remaining quantities were retained to support ongoing supply needs and replenishment efforts.
“As part of preparedness, risk mitigation, and response efforts, 9,750 cartons were strategically pre-positioned in the departments of Ouest, Artibonite, and Centre, which continue to face significant access constraints and humanitarian needs due to insecurity.  In parallel, 10,159 cartons were pre-positioned across the four
departments of the Grand Sud (Grand’Anse, Nippes, Sud and Sud-Est) and the Northwest department in preparation for the hurricane season.”

 

– Contributed by WHES Board member Steve Hansch

Book Review: “Food Fight” by Stuart Gillespie

August 14, 2026     Agribusiness is out of control, according to  “From Plunder and Profit to People and Planet”, Stuart Gillespie’s 2025 book, “Food Fight” which argues for a new, common vision of human and planetary health in where power over food systems is better balanced.  He writes building on a tradition, which he cites, from Susan George’s “How the Other Half Dies.“

Gillespie argues that the modern food system, as shaped after World War II to mass-produce cheap calories and avert famine (with geopolitical aims), has become a major driver of harm.

His main criticism is aimed at the concentration of food companies on a global scale:  “Five companies – ADM, Bunge, Cargill, Cofco and Louis Dreyfus – control 70-90% of the global grain trade… Never before have we seen such a hyper-concentration of power at all points from farm to fork… Another four companies – ChemChina, Corteva, Bayer and BASF – control 66% of the world’s agricultural chemicals market, while a similar cluster… owns 53% of the global seed market.”   Gillespie details corporate political tactics (analogous to those historically used by the tobacco industry) and policy inertia, while highlighting citizen movements, local successes (e.g., city-level strategies), and practical levers for change such as public procurement, taxes with revenue recycling, marketing restrictions, conflict-of-interest rules, and broader mobilization.  The book mixes exposé with a call for structural transformation toward a system that prioritizes people and planet.  He concludes:  “The large-scale damage done to people and planet is a feature of our food system, not a bug.”

He particularly criticizes global trends in the consumption of ultra-processed foods.

“Governments need to act because malnutrition represents what economists call a market failure, a negative externality – and what the rest of us call an injustice.”    He adds that “malnutrition is multi-causal in nature,” requiring a whole of government response, and “Economic growth won’t fix it.  nor will technology.”

He criticizes nutritionists who promote national food fortification schemes or other efforts to provide vitamin and mineral supplements for involving the private sector (corporations).  Yet he explains the importance of micronutrients:  “micronutrient malnutrition also travels through generations.  A lack of essential vitamins and minerals can be devestating for a pregnant woman and her unborn child.  The micronutrient-deficient mother is more likely to have complications in pregnancy and more likely to die giving birth.  Iron-deficiency anemia causes one in four maternal deaths around the world.”

Some of his history is confusing, such as when he writes about the Bay of Bengal famine “starting” in 1943, when the conditions leading to it began in 1942, and he refers to the United Nations in the same breath, though the U.N. was not founded until 1945.  Yet, he is critical of the donors and aid agencies helping, referring to “white saviourism.”

He correctly critiques an obsession in the 1950s and 1960 with a “protein gamp” and notes how in 1974, Donald McLaren “blew the protein obsession out of the water.”

His recommendations span all of society to take more responsibility and he addresses NGOs like Save the Children, and repeatedly UNICEF.  He seeks a revolution in the governance of for-profit corporations.  Though citing examples in a few countries, his book is generic, about the world.  Though a preponderance of his interviews, analyses and criticisms are targeted to one country, the United Kingdom.

He recommends four “Ins” incentives, institutions, information and interests.  He recommends the use of taxes and subsidies to reshape the food environment.  Governments should tax products and practices that damage health or the environment, especially ultra-processed foods and sugary drinks, and earmark the proceeds to make nutritious foods more affordable for low-income households.

–  Contributed by WHES board member, Steven Hansch

Specialty Foods for Malnourished Children (Plumpy’Nut and RUTF)

August 2, 2026        Highly-enriched foods tailored to the biological needs of severely malnourished children are a major form of international aid.  At the 2025 roundtable about America’s  comparative advantages for solving hunger, food insecurity and nutrition overseas, organized by World Hunger Education Service with other sponsors,  participants agreed that America should keep providing quantities of “Ready to Use Therapeutic Foods” (RUTFs) as a magic bullet for fighting hunger.

Indeed, aid agencies, foundations and the U.S. Government have provided more and more of this peanut-based, fortified paste around the world in programs of “targeted feeding” that enroll children suffering from wasting (“acute”) malnutrition, which is life-threatening.   Wasting malnutrition is one of the top three main causes of deaths in famines, refugee flight, and complex emergencies.

HISTORICAL BACKGROUND:    Over the last half century, NGOs, governments, and INCAP in Central America have experimented with novel new approaches toward developing foods that best save the lives of severely malnourished children and ensure their recovery.  For most of that time period, the standard food for supplementary feeding for undernourished children has been porridge, frequently corn or wheat-based porridge, supplemented with vegetable oil and sugar. The USG. report, Beyond Child Survival, cataloged other earlier initiatives such as Fafa in Ethiopia and Likuni Phala in Malawi, which were effective at treating malnourished children.

A major step forward came in 1996, when Michel Lescanne of Nutriset and French pediatric nutritionist André Briend came up with a new formulation called “Plumpy’Nut” that closely matched the WHO-recommended formula, “F-100” for inpatient (hospital) treatment of malnourished children.  For children with shrunken stomachs and limited appetite, it optimized the child’s chance to survive and recover from malnutrition.

Plumpy’Nut, produced in France by Lescanne’s production organization, Nutriset, was designed to have a long shelf life, to be appetizing for even malnourished children with reduced appetite, to taste good, and to have the right balance of fats, vitamins and minerals that a malnourished child should have.  The idea was to create a food that could be handed to a family once a month, with sachets that a small child could open and eat each day.

Plumpy’Nut became the first in a line of products collectively referred to as “ready-to-use therapeutic foods”, which share similar nutrient compositions and are now used at large scale by groups like UNICEF, MSF, Concern, Action Against Hunger, and Save the Children.

In the last two and a half decades these RUTFs have become a core part of a new model for reaching children with malnutrition, known today as “Community Management of Acute Malnutrition,” or “CMAM.”  This model does not require family members to take time to bring young, malnourished children to a central feeding center, which had been the previous main model.  Children are still observed, measured and given medical attention, but monthly, not daily, and via an outpatient, or mobile community model.

NGOs give families supplies of these 92-gram sachets at a community clinic, mobile van or displacement site. The child eats the paste directly, without cooking, clean water, refrigeration, or admission to a hospital.  A standard sachet supplies approximately 500 kilocalories and comprises:  Peanut paste, Skimmed-milk powder or other dairy ingredients, Vegetable oil, Sugar, and vitamins and minerals from a commercial premix powder.

CONSCIOUSNESS

There’s something about RUTF and Plumpy’Nut that resonates with people and encourages them to donate.  Plumpy’Nut has proven to be popular among the public, media and donors.  World Vision uses Plumpy’Nut to focus attention and drive private fundraising.  A CBS 60 Minutes episode about the use of Plumpy’Nut in Niger, West Africa was reportedly the most popular episode in the decades-long history of that television show.

SCALE AND COVERAGE

While UNICEF promotes supplies of RUTF across lower-and middle-income countries (LMICs), it is too expensive for poor households to purchase and does not reach most of the children who need it.  Most RUTF has been used in emergencies, where international NGOs tend to be more present, and where malnutrition is often more concentrated.  Despite the increased scaling of RUTF, in most years 80% of malnourished children don’t get any.

In the last few years, governments have been increasingly supportive of RUTF, increasing donations to UNICEF and NGOs to several hundred million dollars worth.  The Eleanor Crook Foundation has sought to engage private foundations and companies to donate.  RUTF is on the approved commodity list of foods that NGOs can request from Food for Peace at USDA.

PRODUCTION

In the early 2000s, there was essentially one qualified international source of RUTF, i.e. Nutriset in France.  Nutriset and donors have encouraged other factories to start up.

By 2025, UNICEF reported more than 20 suppliers across Africa, Asia, Europe, and the Americas. Roughly half of UNICEF-procured RUTF is estimated to be from suppliers in low- and lower-middle-income countries such as Ethiopia Burkina Faso, Kenya, Madagascar, Niger, India, Haiti, Sudan.

In the United States, there are three certified producers: Edesia in Rhode Island, recently profiled by Hunger Notes; MANA Nutrition, based in Georgia, and  Tabatchnick, in New Jersey.  Between 2022-2024, Edesia shipped over 6 million cases (or 900 million sachets) of RUTF, while MANA shipped 300 million packets.

COSTS

Costs of producing RUTF had been steadily declining from the 2000s to 2020, as seen in the graph at right.  However, the cost of food ingredients, such as dairy milk, has increased in recent years, forcing up the cost of producing RUTF.

Production in LMICs has been limited by the high costs of quality control, ensuring none of the food is contaminated, and the import costs of key ingredients.  The costs of production locally often tend to exceed the costs of importing from France, the U.S., Norway, India, or South Africa.

UNICEF is the world’s largest buyer of RUTF, at around 49,000 metric tons each year, deploying cartons to some 3.5 million children.  A graph of estimated annual production of RUTF appears at right.

ALTERNATIVES

As noted in the recent Hunger Notes article about Tufts University’s Food Aid Quality Review, controlled studies of field effectiveness and efficiency suggest that more children could be reached, and lives saved, with other formulations and foods, taking into account the cost.  For example, Tufts noted that Corn Soy Blend Plus was more efficient in the recovery of wasted children.

NGOs are partnering with researchers in finding new solutions.  Edesia Nutrition is working with Action Against Hunger in  “Novel RUTF” development, such as alternative protein sources (e.g., plant-based soy/maize to replace or reduce expensive milk powder) for lower cost, local producibility, climate resilience, and acceptability while meeting nutritional specifications.  They are pursuing microbiome-directed enhancements (e.g., via partnerships with OpenBiome, a U.S. nonprofit microbiome research organization) to incorporate beneficial microbial communities or prebiotics into RUTF-like products.

Ongoing field research is testing the scalability, bio-utilization, and overall benefits of RUTF variants.  One experimental form is MDCF-2, a microbiota-directed food based on chickpeas, soy, and green banana, recently noted in the New England Journal of Medicine.  This MDCF-2 represents a new line of thinking, with fewer calories as it reframes “recovery” to include the microbiome, the plasma proteome, address environmental enteric dysfunction, and durability — not just weight-for-height.

The dairy ingredients in/of RUTF are expensive.  Alternatives that do not use milk replace it with crystalline amino-acid fortification, with alternative bases such as oats or fish.   A recent fish-based paste (NumTrey, Cambodia) matched weight gain among children, when compared with standard RUTF, but suffered intra-household sharing/acceptability problems (other children ate it).

Many locally-produced variants increase the density of the least-expensive inputs.  Mark Moore of MANA wrote, “Most of the newer, lower-cost formulas achieve savings by increasing the cheapest ingredients. Sugar and oil are incredibly cheap most everywhere.”  But, he continues, “If this were my child who was severely malnourished, would I rather have a product built primarily around sugar and oil because it is cheaper, or would I rather have the original formulation with 35-40% peanuts and other more nutrient-dense ingredients?”

The Mark Manary Lab has promoted a new formulation that adds pre-formed DHA (omega 3) needed for brain development.  Using more omega-3 fatty acids and less omega-6 fatty acids adds 6-15 IQ points to every child treated.  Trials in Malawi suggest it led to superior cognitive, brain outcomes 6 months post treatment, compared to standard RUTF.  An MFGM-enhanced variant adds milk fat globule membrane to support brain development.  Separately, a rice-bran-enriched RUTF (SEHAT) was tested in Indonesia and showed increased weight gain among children.

Other advances include the use of additional inputs, as child recovery may be limited due to bacterial infection and gut inflammation, not just nutrients.  An oral antibiotic has been seen to reduce the death rate of children from 7% to 3.5%  So, amoxicillin (antibiotic) provision improved recovery and cut mortality.  An azithromycin trial  in Niger hinted at mortality benefit in underweight children, tempered by antimicrobial-resistance concerns.

–  Contributed by WHES board member, Steven Hansch

 

Most of Yemen is Now Hungry, UN Declares

June 17, 2026    Yesterday, the UN was advised that the extent of food insecurity in Yemen had ratcheted up further:  “The hunger crisis in Yemen is worsening sharply, with the share of people unable to meet basic food needs rising from about half to nearly 60 percent within a month,” UN Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator Tom Fletcher warned on Tuesday, calling for urgent funding to prevent further starvation.  “The number of Yemenis facing the most severe levels of deprivation has increased from one in four to nearly one in three. More than 18 million people, …are now experiencing acute hunger, ” Fletcher told the UN Security Council during a June 16 briefing.

Over 2.2 million children under five are acutely malnourished, including more than half a million in the severe, life-threatening form. Nearly half of all children under five suffer chronic malnutrition (stunting), locking in lifelong disadvantages for a generation. In hard-hit areas, half of households with young children report at least one malnourished child, while one in four has a malnourished pregnant or lactating woman.

The Integrated Food Security Phase Classification System (IPC) of famine predicts and projects a growing number of regions moving into Phase 4 — Emergency, shown in red in the map at right — for the period September to December 2026.  The Orange Zones are very food insecure and Red are emergency.

The 2026 Yemen Humanitarian Needs and Response Plan of the U.N. requested $2.16 billion for aid in order to reach 12 million of the 22.3 million people in need of assistance.  Yet, donor fatigue and competing global crises threaten another shortfall. Recent floods have destroyed displacement camps and livelihoods, while economic pressures and regional shipping tensions continue to inflate food and fuel prices. In government-controlled areas alone, nearly half the population now are now suffering crisis-level acute food insecurity, with emergency levels expected to climb through the lean season.The country’s arid climate, limited arable land, and chronic water scarcity have always constrained domestic production. Yemen has long depended on imports for over 90 percent of its food, especially wheat, of which it imports around 96 percent, leaving it acutely vulnerable to global price spikes, shipping disruptions, currency collapse, and fuel shortages that drive up transport costs.  War has only deepened this dependency.

The current civil war, fueled by Iranian support to Houthi rebels, has made humanitarian aid more difficult.  NGOs that had been building long-term food resilience for years had to shift to more short-term life-saving aid.  Damaged irrigation, lost livestock, displacement of farmers, and soaring input costs have left cereal production well below average. Even when commercial imports through Red Sea ports remain adequate in volume, economic collapse and rial devaluation put basic staples beyond reach for millions.

The chart at right comes from the CEOBS Report: Yemen’s agriculture in distress – ceobs.org

What is new and especially alarming in 2026 is the sharp contraction of the humanitarian response itself. In January, the World Food Programme announced it was terminating operations and contracts for its 365 staff in Houthi-controlled northern Yemen, home to roughly 70 percent of the country’s humanitarian needs—after repeated obstructions, arbitrary detentions of aid workers, and an increasingly impossible operating environment. This followed earlier suspensions and adds to chronic underfunding.  The 2025 appeal was only 29 percent funded, forcing agencies to scale back nutrition, health, and food programs nationwide.

Yemen’s food insecurity has deep roots, but the convergence of aid cutbacks, operational halts in the areas of greatest need, economic freefall, and climate shocks risks erasing fragile gains in nutrition and pushing more families beyond their breaking point.

Aid agencies helping to address malnutrition in Yemen include:  the International Committee of the Red Cross, Action Against Hunger, Save the Children, the International Rescue Committee, Médecins Sans Frontières, CARE, Norwegian Refugee Council, Danish Refugee Council, Oxfam, Islamic Relief, Medair and the Adventist Development and Relief Agency.  Relief International is working with WFP in food aid in the south of Yemen.  UNICEF coordinates much of the nutrition programming for children and mothers, and the U.N. Nutrition Cluster (led by UNICEF), which reports for 44 operational nutrition partners in Yemen.

Further information, see:  https://www.nutritioncluster.net/country/yemen

and https://fscluster.org/yemen

–  Contributed by WHES board member, Steven Hansch

 

Interview: Edesia’s Maria Kasparian & Specialty Nutrition Foods

April 20, 2026      The WHES board met with and interviewed Maria Kasparian, expert about Plumpy’Nut which has become one of the most recognizable tools in the fight against severe acute malnutrition among young children around the world.  Plumpy’Nut is one brand of the broader food type called “Ready to Use Therapeutic Food”, or “RUTF.”  RUTFs have been a key topic in recent articles in Hunger Notes; nonprofits have used RUTFs in the Sudan, Gaza, Haiti, Afghanistan and in other countries in need.

In the United States, one of the leading producers is Edesia, the Rhode Island–based nonprofit that manufactures Plumpy’Nut and related products for UNICEF,  the World Food Programme, and NGO partners, while also participating in a wider global network of therapeutic food producers.
Following are selections from WHES’ interview with Ms. Maria Kasparian, Edesia’s Executive Director in 2023, about Edesia and now head of Strategic Partnerships.  The interview highlights several of these trends: rising interest in alternative formulations using ingredients such as soy, corn, chickpea, or millet; debate over procurement rules; the slow pace of agency adoption; and growing recognition that the challenge is not only making therapeutic food, but also building efficient supply chains that can deliver it where children need it most.

WHES: Thank you so much for taking time out to talk with us today. What should our readers know about Edesia?

Kasparian:  One of Edesia’s mandates is to educate and advocate global nutrition. We have school field trips, work with senators, channel our programming through Scouting America, and we do advocacy work in DC.
We produce in the US, taking with PL 480 (Food Aid) funds. We are producing 1.2 million packets of Plumpy’Nut each day. Edesia has had a ticker of how many children that our products have reached since we started producing in March 2010 – and distributing through partners. Today we are at 19.9 M children reached with full treatments. Our goal is to reach a total of at least 10 M more children within 2023 and 2024.

We’re also part of the “PlumpyField network” of partners in ten partners, spanning Madagascar, India, and other countries. We work to help these producers in other countries, such as Ethiopia and Haiti. For instance, we support Meds and Foods for Kids in Haiti. There are now 22 producers worldwide of RUTF, and each uses slightly different formulations.

WHES: Do all the producers of Ready to Use foods follow the same formulae?

Kasparian: Across the 22 suppliers of foods, there are no two formulas that are identical. But as long as we meet the robust recommendation, we’re okay.
Even within the PlumpyField Network, there are tweaks. There are differences, depending on what’s available locally. For example, you have to achieve certain omega-3 to omega-6 balance with the fats. You need to do that. The vegetable oils are important. You can get different kinds of vegetable oils depending where you are. There might be some variety there. You might have different forms of milk powder available. You might have different forms of whey available that have different amounts of protein. You’ve got to balance the formulas, depending on what ingredients you have available. But they’re very similar. We’ve actually done taste tests where we meet and have everybody’s and we blindly try to guess whose is who. So, they’re a little different, but the difference is small. But the formulations do vary a little bit. There will be a greater degree of difference with those outside the network formulations are.

WHES: Thank you. So, how do donors specify what they want or accept new ideas for specialty foods to address malnutrition?

Kasparian: Well, the Interagency oversight group (UNICEF and WFP) have discussed for many years, having a common standard. It’s the long game. Over time, things do get accepted. Governments and the U.N. don’t move quickly. So generally, though, progress does happen. It just happens slowly. You keep pushing, and over time, things do improve. So you must continue innovating.
The Tufts Food Aid Quality Review study comparing the effectiveness of different foods looked at RUTF (compared Corn Soy Blend or CSB+ with fortified vegetable oil (CSB+ w/oil), Corn soy whey blend (CSWB) with fortified vegetable oil (CSWB w/oil), and Super Cereal Plus with amylase (SC+A)) for the treatment of moderate malnutrition.  The cost-effectiveness was similar between the products, and caregivers had a slightly lower of their own opportunity costs when using RUTF.  The main conclusion was that NGOs/programmers should pick the products that would be most appropriate for their contexts.

WHES: Is it only about the formula of the food composition?

Kasparian: The ecosystem is not only about making RUTF, but also about improving the supply chain. Customs fees for incoming fees mean that local production is not necessarily cheaper. You know, it’s cheaper to get our foods from here to South Sudan than it is from Khartoum to South Sudan. As well, we’re shipping a lot to Somalia right now.

WHES:  Has demand grown for your RUTF?

Kasparian: We have doubled the numbers of kids getting treatment. Most of it goes to Africa, over 70%. Our main goal is to reach more kids. The price of RUTF was going down significantly before the Covid-19 pandemic. As background, 70% is the cost of the ingredients. In 2005 a box of RUTF cost $55 but we brought that down to $35 a box in 2019.

WHES: How is it working with UNICEF and WFP?

Kasparian: One of the barriers we face is the way that Unicef and WFP work together. They work differently and in different places.

WHES: How do you relate to other producers in other countries?

Kasparian: We are a U.S.-based producer. We’re a non-profit U.S.-based producer, and that we care a lot about having a good balance of what’s coming from the U.S. and what is coming from local and regional procurers, and that balance is really important. And we do various things to support these
suppliers in other countries. We work particularly closely with Meds and Food for Kids in Haiti. We help them with their formulations. We just help them to get their codex, upgraded codex specification in order. We help them with procurement of raw materials. We help them troubleshoot from a maintenance engineering perspective.

WHES:   Edesia has a history going back to Tanzania, right?

Kasparian: Yes.  Before we set up a factory in the U.S., we established one in Tanzania, which, unfortunately, is no longer operational, but was, for about five years.  Thus, our experience kind of went that way. Our founder, Navyn Salem, has family roots in Tanzania.  Her father and three generations of the family are Indians who lived in Tanzania for a period of time. Ms. Salem’s father was born and raised in Tanzania before he came to the U.S. on a USAID scholarship for college.  This leads me to another interesting part of the story: USAID is really responsible for Edesia’s existence. Her father, and therefore she, would not be in the U.S. if not for USAID. The U.S. factory, Edesia, was an afterthought to Tanzania because, at the time, USAID’s Food for Peace, was looking to have RUTF and RUSF suppliers in the U.S. because they wanted to be able to use the Title II PL-480 funds for nutrition-specific commodities like RUTF, RUSF. Which, at the time, this is 2008, 2009, at the time, no one was making in the U.S. And there was a push to improve the food aid basket of what was coming out of the U.S. And to take more vulnerable groups into account and to add these nutrition-specific commodities. So, they kind of approached us and others to say, hey, can you do this in the U.S.?

WHES: Do you engage much with the public here in the U.S.?

Kasparian: Our factory doors are open. We have school field trips come through. We have senators and congresspeople whenever we can. We have Scouting America, Rotary Clubs, and the like. And then we also do advocacy work in D.C. around global nutrition.

New Approach to Controlling Malnutrition in Somalia

Childhood malnutriiton can be addressed by their communities via an initiative in Somalia developed by the “Maternal, Infant, Young Child and Adolescent Nutrition (MIYCAN) working group and fostered by UNICEF and the federal department of health of Somalia in the Horn of Africa.

As of early 2026, the malnutrition has grown in Somalia, driven by a combination of persistent conflict, high food prices, and climate-related shocks like the failure of recent rainy seasons.  In the current cycle (extending through July 2026), an estimated 1.85 million children are estimated to be suffering from acute malnutrition, a 12% increase compared to previous seasons.  Of these, an estimated 425,000 severely wasted.

Potentially a model for other countries, MIYCAN moves beyond treating sick children at clinics to preventing malnutrition via Community Health Workers. It integrates nutrition with early childhood development, play, and disability-inclusive care.

Rolled out in January 2026 this new framework includes “a standardised five‑day training curriculum that strengthens pre‑service and in‑service capacity.  The framework reinforces the role of Community Health Workers (CHWs) as frontline nutrition counsellors, supported by 40 newly developed, culturally appropriate counselling cards designed to enhance caregiver engagement and promote positive behaviour change at both household and community levels.”

It represents Somalia’s first national guidance for feeding infants and young children with physical or neurological difficulties, ensuring “no child is left behind.”

It occurs as UNICEF and its partners increase their use of SQ-LNS (Small Quantity Lipid-Based Nutrient Supplements) and Mother-Infant MUAC Tape.

see:  https://www.unicef.org/somalia/press-releases/somalia-redefines-child-survival-launch-2026-maternal-infant-young-child-and

Key U.N. Updates Show Alarming Hunger Trends

December 2025      Recent UN annual reports and updates about global hunger highlight several important issues and trends as we move into 2026:

WFP will prioritize feeding 110 million in 2026 despite larger need: Declines in global humanitarian funding are forcing WFP to prioritize food assistance to roughly one-third of those in need. In 2026, the agency aims to reach 110 million of the most vulnerable at an estimated cost of $13 billion, but current funding forecasts indicate WFP may only receive close to half that goal. (Source: here)

318 Million People Acutely Food Insecure: WFP also tried to explain updated statistics about hunger such as “Across 68 countries where WFP operates and data is available, it is estimated that 318 million people will be acutely food insecure in 2025.” (Source: here)

Malnutrition in Darfur: There are no WFP humanitarian partners left on ground and no verified reports that any community kitchens are operating, and WFP assisted around half a million people in the Tawila in November. Across Darfur we have consistently reached around two million people per month – half of whom are in North Darfur, in areas surrounding El Fasher.” (Source: here)

Myanmar faces rising displacement and unacceptable hunger levels in 2026: The people of Myanmar already face dire levels of hunger; a place where mothers cannot afford enough food to sustain their health, and malnutrition has become a new reality for thousands of children. More than 400,000 young children and mothers with acute malnutrition are surviving on nutrient-deprived diets of plain rice or watery porridge.  “Conflict and deprivation are converging to strip away people’s basic means of survival, yet the world isn’t paying attention,” said Michael Dunford, WFP Country Director in Myanmar. “This is one of the worst hunger crises on the planet, and one of the least funded. We cannot allow this level of suffering to remain invisible. The scale of need is far outpacing our ability to respond.” (Source: here)

Drought conditions are intensifying in Somalia: UN OCHA finds that Because of funding shortfalls, the number of people receiving emergency food assistance in Somalia has plummeted from 1.1 million in August to just 350,000 in November. Puntland authorities report that 89 supplementary feeding sites and 198 health and stabilization centers are experiencing severe shortages of supplies. Forecasts indicate the situation could worsen further. In a forecast covering 13 to 18 November, the FAO Somalia Water and Land Information Management (SWALIM) program projected that dry conditions will persist across much of Somalia, with isolated light rains in southern regions. Central and northern regions will remain mostly dry and hot.   The drought comes in the midst an already dire humanitarian situation. At least 4.4 million people—more than one-fifth of Somalia’s population—are projected to face high levels of acute food insecurity between October and December. An estimated 1.85 million children under 5 are expected to suffer acute malnutrition through July 2026. (Source: here)

Surging conflicts, rising hunger, global funding cuts, and collapsing basic services are driving humanitarian needs for children to extreme levels worldwide: UNICEF’s Dec. 10 annual Humanitarian Action for Children 2026 (HAC) appeal launched asking for US$7.66 billion is urgently required to provide life-saving assistance to 73 million children – including 37 million girls and over 9 million children with disabilities,  across 133 countries and territories next year.  Global humanitarian funding has deteriorated dramatically in 2025. Announced and anticipated funding cuts by donor governments are already limiting UNICEF’s ability to reach millions of children in dire need. Severe shortfalls in 2024 and 2025 are forcing UNICEF to make impossible choices. Across UNICEF’s nutrition programming alone, a 72 per cent funding gap in 2025 forced cuts in 20 priority countries – reducing planned targets from more than 42 million to over 27 million women and children. (Source: here)

FAO’s new Global Emergency and Resilience Appeal seeks $2.5 billion to support 100 million people in 54 countries: FAO’s December Global Emergency and Resilience Appeal for 2026 finds that acute food insecurity has tripled since 2016, even with high levels of humanitarian funding. The current model simply does not keep pace with today’s realities” the Director-General said. “Supporting farmers to maintain production is critical to ensure food availability. When farmers can keep producing, communities stabilize and the path to resilience becomes real.”  Around 80 percent of people facing acute food insecurity live in rural areas, relying on farming, herding, fishing or forestry. Yet only 5 percent of humanitarian food-sector funding supports agricultural livelihoods—a persistent imbalance that traps families in a cycle of crisis and dependence. Strengthening local food production improves food availability, supports markets, creates jobs, and stabilizes communities—especially in countries such as Sudan, South Sudan, Afghanistan and the Democratic Republic of the Congo. (Source: here)

Hunger Increases Even Further in The Sudan

August 28, 2025:  Aid agencies estimate that malnutrition in Sudan increases in scale, depth and scope.  Much of the reporting comes from the far western region of Darfur, where, between January and May 2025, North Darfur saw a 46% increase in children admitted for SAM treatment at health centers compared to the same period in 2024 — with over 40,000 children treated in just that region.

As a result of 2 1/2 years of civil war, over 14 million Sudanese have been displaced by violence, both internally and across borders.  In the largest camp for displaced persons, Zamzam in North Darfur,  Médecins Sans Frontières (MSF) reported devastating malnutrition rates — as high as 29–30% acute malnutrition, and high mortality (e.g., one child dying every two hours.  Similarly,  Save the Children reported a nearly fourfold increase in severe acute malnutrition cases seen in one South Kordofan clinic from June 2023 to June 2024, with 1,457 children admitted in June 2024 alone.

Though access by international organizations to children in this large, rural country is limited, UNICEF estimates that some 3.2 million children under 5 may have  acute malnutrition in 2025, including about 770,000 experiencing Severe Acute Malnutrition, meaning they are extremely wasted.

The U.N.’s advisory body about famine, the Integrated Food Security Phase Classification (IPC) reported 25.6 million people in the Sudan are food insecure, and of those, 8.5 million are in Emergency (Famine degree Phase 4) and another 755,000 are in Catastrophe/Famine (Famine degree Phase 5).

Humanitarian access is greatly constrained, with persistent fighting preventing deliveries of food or supplies into many areas, notably in Darfur, Khartoum, and regions with large numbers of internally displaced person.

Concern Worldwide is supporting 81 health facilities across Sudan, particularly in West and Central Darfur, treating children under five for acute malnutrition, with a focus on delivering ready-to-use therapeutic food (RUTF).  Despite the destruction of Sudan’s only RUTF factory in 2023, Concern has secured and delivered 10 metric tons of RUTF to vulnerable communities. In 2024, they reached nearly 484,000 people with lifesaving health and nutrition support.