PHA-Exch> MSF PRESS RELEASE: Lancet Series on Undernutrition Off Target To Save the Lives of Millions of Malnourished Children

[Claudio Schuftan]

From: ana beatriz sanchez abszimm at yahoo.com.mx

Doctors Without Borders/Médecins Sans Frontières (MSF)
For Immediate Release
Contact: Michael Goldfarb, +1-212-763-5783
LANCET SERIES ON UNDERNUTRITION OFF TARGET TO SAVE THE LIVES OF MILLIONS OF
MALNOURISHED CHILDREN    (excerpts)
London/New York, January 16, 2008 - A series on maternal and child
undernutrition in the current issue of the medical journal The Lancet
correctly puts the spotlight on nutrition as "a desperately neglected aspect
of maternal, newborn, and child health." However, because of weaknesses in
analysis and outmoded recommendations the series is undermining efforts to
promote urgently
needed change. Médecins Sans Frontières (MSF) teams see first-hand how
malnutrition weakens children's resistance and increases the risk of dying.
They have also documented the dramatic impact of nutrient-dense,
ready-to-use food (RUF) in treating childhood
malnutrition.
A few of the weaknesses in the Lancet series:
- By not including, for example, deaths from nutritional oedema, the
highly lethal form of severe acute malnutrition which predominates in large
parts of central and southern Africa, The Lancet series dramatically
underestimates the number of deaths attributable to severe acute
malnutrition;
- A failure to actively endorse the new WHO, UNICEF, and WFP supported
approach of community/home-based management of severe acute malnutrition
with RUF;
- A focus on hospital-based care in an era when ministries of health, UN
agencies, and NGOs are actively moving to a proven strategy of
community/home-based care with RUF. Only complicated cases are now treated
in hospital;
- The authors justify withholding strong support for community-based care
on a lack of "randomized trials." However, they go on to stress the
usefulness of hospital-based care based on the results of nine studies,
none of which are randomized.
MSF has been treating acute malnutrition with ready-to-use food since 2000
in African and Asian countries. Outpatient/home-based strategies have
permitted
MSF to treat far more children than would have been possible in the past,
when hospital-based treatment was the standard of care.
Results have been most closely monitored in MSF's program in Niger
where hundreds of thousands of patients have been treated since 2001. In
2007, over 22,000 severely malnourished children were treated with a cure
rate of 84 percent and a mortality rate of less than three percent.
Large-scale outpatient treatment of severe acute malnutrition is being
successfully implemented by ministries of health, with support from
implementing partners, in Malawi, Ethiopia, and Niger. However, despite
strong UN recommendations to implement RUF treatment strategies, only about
three percent of children with severe acute malnutrition have access to
therapeutic RUF today.
By failing to strongly endorse and promote community treatment with RUF,
the The Lancet authors are undermining the support for this lifesaving
intervention.
Donors should fund and support recipient countries to rapidly scale-up this
intervention. Implementation of this strategy will mean the difference
between life and death for at-risk children under three.
See:
http://doctorswithoutborders.org/news/malnutrition/FoodIsNotEnough.pdf
and
http://www.doctorswithoutborders.org/news/malnutrition/index.cfm

[*] MSF estimate based on RUF needed to treat all cases of Severe Acute
Malnutrition (258,000 tons for 20 million children at an average of 12.9
kilos per child) and total estimated consumption in 2007 of 8,500 tons.
###
buddhima.lokuge at newyork.msf.org
+1-212 655 3762
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