Decision on use of RUTF: It is not sustainable, does not have evidence and full of conflicts of interest

Decision on use of RUTF: It is not sustainable, does not have evidence and full of conflicts of interest

- in Analysis, Special Post

Recently A letter by Ashwani Mahajan, the co-convenor of Swadeshi Jagran Manch have sent to our Honourable Prime Minister Narendra Modi Ji, to draw their Attention on the decision: On the use of Ready to use therapeutic food, Here is the letter which is addressed.

Ashwani Mahajan, co-convenor,
Swadeshi Jagaran Manch
“Dharamakshetra, Sector-8, R.K. Puram, New Delhi
Ph. 011-26184595,

Dated: 21 November 2017
Shri. Narendra Modi
Hon’ble Prime Minister of India
South Block, Raisina Hill, New Delhi – 110011

Subject: Decision on use of RUTF: It is not sustainable, does not have evidence and full of conflicts of interest.

We want to draw your kind attention to media reports indicative of a recent decision taken in the Prime Minister’s Office regarding use of ready to use therapeutic foods (RUTF) in children with severe malnutrition:”In a 4 November meeting chaired by the Principal Secretary to the Prime Minister on nutrition, the PMO said that “the decision to provide RUTF (ready to use therapeutic foods) may be left to the discretion of individual states”—thus paving the way for such foods to be provided to children suffering from severe acute malnutrition (SAM).”

The report also suggests that Ministries of Health, Women and Child Development and NITI Aayog participated in arriving at this decision. We are concerned with the decision taken especially with inputs from NITI Aayog, who had recently constituted a working group on nutrition, riddled with conflicts of interests. This is in spite of the fact that National Nutrition Strategy launched by the Deputy Chairperson of NITI in September, recommends to avoid conflicts of interest in its guiding principles.

According to another media report “In India, the global collaborative Scaling Up Nutrition (SUN) movement has tied up with Maharashtra, Uttar Pradesh and Jharkhand to promote therapeutic food as a solution to malnourishment. Pilot projects to treat SAM children with RUTF have been undertaken in all three states and in Bihar.”SUN has clear conflicts of interest having RUTF manufacturers like Amul, Valid Nutrition, Nutriset, and Edesia as the members of SUN business network (SBN). Other food industryin SBN includes Pepsi, Cargill, Britannia, Unilever, General Mills, Glaxo SKB, Mars, Indofood, Nutrifood, and DSM.

Within the backdrop of recent decisions taken by the MoHFW and WCD stating that RUTF is not to be used in children with severe malnutrition, it would not be prudent to leave this decision to states.

We do feel it will allow as an entry point of all ‘nutrition products’ may it be for moderate or mild under nutrition. This situation will only lead to a slow and steady termite like erosion of our national sustainability and self-sufficiency with no value for money for our human resource and capital. If we cannot get basic foods and health care to the deprived, commercially vested products will not solve the problem!
We believe that States do not have the required technical capacity and are potentially susceptible to the vested influence of international agencies and the commercial sector. This is a game- changing mission of food industry to introduce RUTF as a life saving magic bullet; which it is not.

We would therefore request you to please revert the decision on use of RUTF in the best interest of the Indian child.

The salient aspects leading us to the above contention are:
1.​Scientific evidence is not in favour of RUTF use and several scientists wrote to Sh. JP Nadda Hon’ble Minister of Health, Government of India, who responded on 18 August 2017 stating ”RUTF may not benefit a common household in developing appropriate food habits for children against home augmented food.”

2.​The evidence quoted by the global agencies has been challenged by a national think tank Nutrition Advocacy in Public interest (NAPi).

3.​According to Government of India led Indian trial on RUTF, it is not a sustainable solution, children lapse back into severe malnutrition after 3-4 months of stopping product intake. One course of “therapeutic treatment” has prohibitive costs.(About Rs. 12000/- per child in Rajasthan). Home foods work equally well, are much cheaper and do not disrupt the usual feeding practices.

4.​Short and long-term health risks of use of RUTF have not been adequately addressed.

5.​We believe that the ground reality and benefits are being substantially magnified through scaremongering by global agencies to create an illusion that RUTF is a workable and magical quick fix.

6.​Finally, in a response to parliament question in 2010, answered by the then Minister of External Affairs Sh. SM Krishna, confirms that UNICEF distributed RUTF in contravention to Government of India guidelines and was asked to ship it out. Further the minister said, “As the nodal Department for external multilateral and bilateral assistance, the Department of Economic Affairs (DEA) has issued instructions from time to time to the State Governments requesting them not to negotiate any kind of assistance with external agencies without routing the same through the DEA”.

We once again appeal to you to revoke any such an advisory issued for States as it opens up use of RUTF in children with severe acute malnutrition, making is clear at the same time that use of RUTF in SAM children in the community is not a Government of India policy.


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