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Somalia famine revives debate: is it acceptable to patent aid?

Somalia's famine has boosted demand for the malnutrition treatment Plumpy'nut. But a patent curtails production – and has sparked intense debate over balancing business interests with humanitarian need.

By Staff writer / October 3, 2011

In this photo from Aug. 3, mothers from southern Somalia hold their children at medical center in Mogadishu, Somalia. The UN has said that Somali children are more likely to die before they turn 5 than those in any other country in the world.

Mohamed Sheikh Nor/AP/File

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Providence, R.I.

In Providence, R.I., a small factory is running 21 hours a day, six days a week, to meet the intense demand for Plumpy'nut, a candylike paste that has been heralded as a game changer for treating the kind of severe malnutrition racking Somalia and other drought-stricken areas.

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But even with Edesia's expanded hours, churning out what is essentially peanut butter pumped full of nutrients, there isn't enough Plumpy'nut – or its generic equivalents, known collectively as ready-to-use therapeutic foods (RUTFs) – to meet the demand in East Africa, let alone help feed the estimated 20 million children worldwide who are extremely malnourished.

The reason: Plumpy'nut, the original RUTF, is patented. That patent bars operators in North America and most of Europe from large-scale production of RUTFs that could drive down the price. Companies in developing countries, meanwhile, are allowed to produce Plumpy'nut but can't yet make it cheaply or in large quantities.

That tension has spurred a vociferous debate: How can the need for affordable humanitarian relief be balanced with a profit motive that spurs innovation – and a business model that promotes industry in developing countries – but stymies more efficient production?

"It doesn't matter if people are priced out of the market for an iPad," says Owen Barder, a senior fellow and director for Europe at the Center for Global Development. "But it's not at all fine when it's a vaccine or Plumpy'nut."

A new model for malnutrition care

The Plumpy'nut formula is simple: peanuts, sugar, milk-based proteins, vegetable oil, and a mix of vitamins and micronutrients. Each serving comes in a foil packet. It needs no refrigeration and is ready to eat.

With three daily packets of Plum­py'nut, the recommended regimen, a child can make enormous strides in just a few weeks, says Stéphane Doyon, the nutritional team leader at Doctors Without Borders (MSF).

What makes RUTFs truly transformative for aid organizations is the way they changed the model of care for malnutrition, allowing for treatment at home. Children and their mothers no longer have to remain in hospitals for weeks at a time, which can pose a health threat and strain staff resources, Mr. Doyon says.

Shifting to RUTFs also eases demands on staff in the field. In 2002, MSF needed 2,000 staff to treat 8,000 children. In 2004, MSF's first time using the paste on a large scale, it treated 10,000 kids with only 120 staff. In 2005, it treated 40,000 children.

The patent that protects Plum­py'nut and three similar products is owned by the French company Nutriset. The company sharply restricts patent licensing in industrialized countries, but readily licenses companies in the developing world, providing them with the technology and training they need to produce it. Nutriset sees its patent as "a tool to promote development" and to increase "nutritional autonomy." Generics cannot be made in or shipped into countries with local producers of Plumpy'nut.

Nutriset says that by restricting licensing in industrialized countries that can manufacture its products inexpensively on a massive scale, it is protecting local producers in places like Malawi and Niger, where a lack of infrastructure limits the scale of production. That makes Plumpy'nut 10 to 15 percent more expensive there, according to UNICEF. Without the patent, European and American producers could flood local markets with cheaper products, driving domestic producers out of business.

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