PHA-Exch> MSF criticises Lancet undernutrition series (2)

[Claudio Schuftan]

From: Leela McCullough leela at healthnet.org

MSF criticises Lancet undernutrition series

Bibi-Aisha Wadvalla
 SciDev.Net
http://www.scidev.net/News/index.cfm?fuseaction=readNews&itemid=4195&language=1

A series of articles on maternal and child undernutrition in The Lancet has
drawn a severe rebuke from Médecins Sans Frontières (MSF).

In a press statement released last week (13 January), the non-profit medical
organisation said the series fails to address key areas of treatment, mainly
home-based care and ready to use food treatment (RUF), and is actually
"undermining efforts to promote urgently needed change".

Milton Tectonidis, nutrition advisor for MSF's campaign for access to
essential medicine says, "Frankly, the series is out of date. It fudges the
numbers of deaths by wiping off kwashiorkor [a form of malnutrition] and by
using prevalence figures instead of incidence figures to calculate the
annual death toll."

"Home-based care with RUF revolutionised the treatment of severe acute
malnutrition in young children. As a supplement to breastfeeding and
traditional complementary foods, these spreads are highly effective in the
first two to three years of life," he adds.

With regard to home-care as opposed to hospital care, Tectonidis says, "It
is impossible to expect to treat all these children with therapeutic milks
in hospitals. Outpatient treatment encourages earlier presentation and
improves programme results."

Zulfiqar Bhutta, professor of paediatrics and child health at Aga Khan
University in Pakistan, and one of the authors of the Lancet series, says,
"Our estimates represent the most unbiased and up-to-date numbers on severe
acute malnutrition using accepted and comparable criteria in various
populations."

"We reviewed all available evidence on the use of RUF in both facility and
community settings. MSF may have additional unpublished data of which we are
unaware, but if they do not make it public then we cannot be expected to
refer to it," he adds.

"We hoped MSF would have engaged in a scientific debate through genuine
discourse instead of going public with a press release," Bhutta told
SciDev.Net.

Esté Vorster, director of the Africa Unit for Transdisciplinary Health
Research at NorthWest University in South Africa says she cannot understand
why MSF is criticising the Lancet series.

"The Lancet is a respected journal and is placing undernutrition ­ a largely
ignored factor ­ on the agenda. Although some information is outdated, it
doesn't change the message," she says. "For too long, developing countries
have not paid attention to malnutrition. It is now being considered, and
that's what's important."
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