Ready-to-use therapeutic foods, better known as RUTF are ready-to-use food products that are specifically designed for the treatment of severe acute malnutrition. However, it has only recently been finally included in the World Health Organization's Model List of Essential Medicines.
Key actors have been working for years to get the RUTF included in the list
For several years now, humanitarian organizations such as Action Against Hunger and many others have been working on this issue. To do so, they assessed the benefits (and risks) of including RUTF in the WHO Model List of Essential Medicines. The objective was to expand coverage for the treatment of severe acute malnutrition.
Also for years, the WHO Expert Committee on the Selection and Use of Essential Drugs rejected the proposal for inclusion. The Committee recognized the efficacy of these products. However, it was concerned about the negative implications of such inclusion. Considering ready-to-use therapeutic food as an essential drug would have obliged its production to meet the same requirements as other pharmaceutical products. It was feared that this could make local production more difficult, increase cost and ultimately reduce access.
By the end of 2021, inclusion had not yet occurred. However, by then, 25 countries (mostly African) had already included RUTF in their national essential drug lists. Most of these countries classified RUTF as a medicine, although others classified it as a food for special medical purposes.
In 2022, the WHO finally accepted the proposal
At the end of 2022, the new Codex Alimentarius guidelines for the RUTF were published. This was a huge breakthrough. a huge breakthrough. With this change, Codex established a new internationally accepted standard category. This was foods for special medical purposes. This avoided the problem that had existed to date. At the same time, Codex established specific provisions for this new type of product. These new requirements included aspects related to food safety and nutritional composition, such as a protein quality index (without limiting possible sources).
This change made it easier for the new application submitted to the Committee of Experts in December 2022 to be successful. In April 2023 the change was finally approved. As a result, the new 2023 WHO Model List of Essential Medicines and the 2023 WHO Model List of Essential Medicines for Children already include RUTF.
Considering RUTF an essential drug will improve access to it
Essential medicines are selected according to public health relevance and their evidence of comparative efficacy, safety and cost-effectiveness. They are medicines that must be available and affordable at all times in health services. The WHO Model List serves as inspiration for the lists of essential medicines that different countries draw up and adapt. For this reason, it is hoped that the new change will encourage more countries to include it in their respective national lists.
It is hoped that this change will translate into greater commitment by governments to make the RUTF available, improving the coverage of the management of malnutrition and the fight against hunger. Moreover, it is a breakthrough that gives legitimacy and a strong technical argument to activists and society organizations calling for public investment in RUTF.
In addition to the above, the new consideration of RUTF as an essential drug and as a food for special medical purposes may also facilitate its production and marketing. On the one hand, the new guidelines can be used to facilitate trade disputes and reduce import difficulties, overcoming logistical difficulties. On the other hand, the market can now be opened to new suppliers, local production and innovative formulations, with greater local acceptability.
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The blog entries in Salud Everywhere expand its content on humanitarian aid and cooperation, health in humanitarian crises and career advice with news, opinion and analysis.
External links
- WHO, 2023. WHO Model Lists of Essential Medicines. 23rd list.
- FAO and WHO, 2023. Codex Alimentarius. Guidelines for ready-to-use therapeutic foods.
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