Letter |

Open Letter to WHO on food aid quality and supplemental food for addressing malnutrition

Dr. Ala Alwan
Assistant Director-General
Non-Communicable Diseases and Mental Health
World Health Organization
Avenue Appia 20
1211 Geneva 27

Geneva, 12 October 2011

Dear Dr. Alwan,

In October 2008, the World Health Organization (WHO) gathered a meeting of international experts to review specifications of food supplements used for the management of children with moderate malnutrition. Yet three years later, no guidance has yet to be published on this matter by your organisation.

In March 2011, Médecins Sans Frontières (MSF) wrote to your Department to highlight this situation. In May 2011, we received a response informing us that such guidance was in the process of being written, and would be submitted to the Guidelines Review Committee for final clearance. A document was expected to be made public in May 2011 – but five months on nothing has yet been published.

Today, the most commonly used form of supplemental food for the management of moderate acute malnutrition, which is also used as a proxy in programmes that aim to prevent malnutrition amongst young children, is still corn-soya blend (CSB). The specifications of CSB are known to be inappropriate for the management of malnourished children.

In the absence of any formal guidance from WHO, it will be difficult to ensure that more appropriate food supplements become the mainstay of programmes that address malnutrition. Many high burden countries are expecting such guidance from your side and are therefore hesitant in switching to better products. A direct consequence of the absence of WHO guidance can be seen in the extensive negotiations and discussions necessary to import and distribute optimal products in East Africa this summer.

MSF runs extensive programmes targeting malnutrition in 28 countries, and in 2010 the organisation treated 309,684 cases of severe acute malnutrition and managed 20,411 cases of children affected by moderate wasting, while 151,514 children under two received the latest generation of nutritionally enhanced supplements. Often our own efforts to use enhanced supplements for infants under two or wasted children are slowed down because of the lack of clear guidance on this issue.

In 2010, MSF launched a social mobilisation campaign called “Starved for Attention” to push for a change in the nutritional quality of the foods used by most programmes funded by international donors and destined for young or moderately wasted children. Close to 130,000 people have since signed a petition joining us in our request that such improvements be made.

On the eve of World Food Day, we call on you to ensure that the conclusions of the WHO-led expert consultation on specifications for food supplements for moderate acute malnutrition be finally published, as the continued lack of guidance from WHO is now slowing down the process of improving the quality of foods that children exposed to malnutrition can access.

I hope you will share our concerns and can take them into consideration.

Yours sincerely,

Tido von Schoen-Angerer, MD, MSc
Executive Director, Campaign for Access to Essential Medicines
Médecins Sans Frontières International CC
Dr Francesco Branca, Director, Department of Nutrition and Health Development, WHO

Open Letter to WHO