Over 30 years of lifesaving therapeutic food: Why millions of children still need help

For the past thirty years, Ready-to-Use Therapeutic Food (RUTF) has transformed the treatment of severe acute malnutrition in children. Before its introduction in the late 1990s, children suffering from severe wasting often required prolonged hospital stays, intensive medical care, and constant supervision. Today, many of these children can recover safely at home or within their communities under the guidance of trained health workers. This innovation has saved millions of lives across more than 70 countries and changed the global response to child malnutrition.

Severe acute malnutrition, also known as severe wasting, is one of the deadliest forms of malnutrition. It weakens the immune system, slows growth and development, and increases a child’s risk of death significantly. Common illnesses such as diarrhoea, pneumonia, and malaria become far more dangerous when children are malnourished. Globally, undernutrition is linked to nearly half of all deaths among children under five years, with the highest risk among children under the age of two In Ghana alone, an estimated 68,517 children are affected by severe acute malnutrition, according to the 2022 Ghana Demographic and Health Survey.

RUTF has proven to be one of the most effective tools in treating severe wasting, and is central to the Community-based Management of Acute Malnutrition (CMAM) framework — the globally endorsed model for delivering SAM treatment at the community level, outside of hospital settings The peanut-based paste is fortified with essential vitamins and minerals and requires no refrigeration, water, or cooking, making it practical for low-resource settings. When treatment begins early and supplies are consistently available, recovery rates range between 75 and 90 percent, at an estimated treatment cost of approximately USD 45 to 60 per child making RUTF one of the most cost-effective interventions in global health. Children often recover within six to ten weeks, regaining strength and healthy weight rapidly.

Despite these successes, access to treatment remains critically low. Globally, fewer than one in four children who need therapeutic food are able to receive it. The challenge today is no longer about whether treatment works; the evidence is clear. The real challenge is financing and consistent supply.

Many countries, including Ghana, have already taken important steps. RUTF is included in Ghana’s Essential Medicines List and Standard Treatment Guidelines, and hundreds of health workers have been trained to manage severe acute malnutrition within communities, including through Ghana’s Community-based Health Planning and Services (CHPS) compound network. However, procurement of therapeutic food still relies heavily on donor support, making supplies vulnerable to funding cuts and disruptions. As a result, some districts have access to treatment while others do not, even when malnutrition rates are equally high.

Addressing child malnutrition requires stronger political commitment and sustainable financing. Integrating RUTF into national health financing systems, including the National Health Insurance Scheme, could help ensure that children receive timely treatment regardless of where they live. Achieving this would require establishing clear RUTF reimbursement protocols within the NHIS claims framework, alongside dedicated national budget allocations for therapeutic food procurement. The infrastructure and knowledge already exist. What is needed now is sustained investment and prioritization.

Three decades of therapeutic food have shown that severe acute malnutrition is highly treatable. No child should die from a condition that can be managed with proven, lifesaving nutrition support. The progress made is significant, but the revolution remains incomplete until every child who needs treatment can access it.

Feature article by Women, Media and Change under its Nourish Ghana: Advocating for Increased Leadership to Combat Malnutrition project.