Somalia's famine has boosted demand for the malnutrition
treatment Plumpy'nut. But a patent curtails production - and has
sparked intense debate over balancing business interests with
In Providence, R.I., a small factory is running 21 hours a day,
six days a week, to meet the intense demand for Plumpy'nut, a
candylike paste that has been heralded as a game changer for
treating the kind of severe malnutrition racking Somalia and other
But even with Edesia's expanded hours, churning out what is
essentially peanut butter pumped full of nutrients, there isn't
enough Plumpy'nut - or its generic equivalents, known collectively
as ready-to-use therapeutic foods (RUTFs) - to meet the demand in
East Africa, let alone help feed the estimated 20 million children
worldwide who are extremely malnourished.
The reason: Plumpy'nut, the original RUTF, is patented. That
patent bars operators in North America and most of Europe from large-
scale production of RUTFs that could drive down the price. Companies
in developing countries, meanwhile, are allowed to produce
Plumpy'nut but can't yet make it cheaply or in large quantities.
That tension has spurred a vociferous debate: How can the need
for affordable humanitarian relief be balanced with a profit motive
that spurs innovation - and a business model that promotes industry
in developing countries - but stymies more efficient production?
"It doesn't matter if people are priced out of the market for an
iPad," says Owen Barder, a senior fellow and director for Europe at
the Center for Global Development. "But it's not at all fine when
it's a vaccine or Plumpy'nut."
A new model for malnutrition care
The Plumpy'nut formula is simple: peanuts, sugar, milk-based
proteins, vegetable oil, and a mix of vitamins and micronutrients.
Each serving comes in a foil packet. It needs no refrigeration and
is ready to eat.
With three daily packets of Plum-py'nut, the recommended regimen,
a child can make enormous strides in just a few weeks, says Stephane
Doyon, the nutritional team leader at Doctors Without Borders (MSF).
What makes RUTFs truly transformative for aid organizations is
the way they changed the model of care for malnutrition, allowing
for treatment at home. Children and their mothers no longer have to
remain in hospitals for weeks at a time, which can pose a health
threat and strain staff resources, Mr. Doyon says.
Shifting to RUTFs also eases demands on staff in the field. In
2002, MSF needed 2,000 staff to treat 8,000 children. In 2004, MSF's
first time using the paste on a large scale, it treated 10,000 kids
with only 120 staff. In 2005, it treated 40,000 children.
The patent that protects Plum-py'nut and three similar products
is owned by the French company Nutriset. The company sharply
restricts patent licensing in industrialized countries, but readily
licenses companies in the developing world, providing them with the
technology and training they need to produce it. Nutriset sees its
patent as "a tool to promote development" and to increase
"nutritional autonomy." Generics cannot be made in or shipped into
countries with local producers of Plumpy'nut.
Nutriset says that by restricting licensing in industrialized
countries that can manufacture its products inexpensively on a
massive scale, it is protecting local producers in places like
Malawi and Niger, where a lack of infrastructure limits the scale of
production. That makes Plumpy'nut 10 to 15 percent more expensive
there, according to UNICEF. Without the patent, European and
American producers could flood local markets with cheaper products,
driving domestic producers out of business.
Local production eases poverty
A benefit of local production, says Maria Kasparian, director of
operations for Edesia, the only US Nutri-set franchise, is that it
creates jobs and a market for local agricultural products, chipping
away at malnutrition's contributing factors, such as poverty. …