Food crisis: UNICEF grapples with therapeutic food supply challenges

Soaring food and fuel costs mean that therapeutic foods used to treat acute malnutrition are becoming increasingly expensive and hard to source for the Horn of Africa, which faces the worst drought on record, according to UNICEF. Christiane Rudert, the agency’s regional advisor on nutrition for Eastern and Southern Africa, told Devex that demand for nutrition treatment has reached “unprecedented levels” in countries including Somalia, Kenya, and Ethiopia. At the same time, responding to this demand has become harder due to rising production and transport costs for ready-to-use therapeutic foods, or RUTF, she explained. To reduce costs, the agency has boosted its procurement of RUTF locally — as of September, it was procuring nearly three-quarters of its supplies either in-country, or close to the country of delivery. But with demand continuing to increase and insufficient funding, the agency only narrowly avoided a stock-out in Ethiopia. This interview is part of a Devex Pro series on how organizations are responding to the food crisis. The conversation has been edited for length and clarity. In what ways is the food crisis affecting your work? The drastic food and fuel price increase has been compounding … a perfect storm in the Horn of Africa … where we’ve had five failed rainy seasons, which is unprecedented. Then of course [the situation] in Somalia and Ethiopia is compounded by ongoing conflict and lack of access. So the food and fuel crisis has really come at the worst time. We work with governments and partners to provide preventive and treatment services [for malnutrition]. Across the Horn, the increase in estimated numbers [of acutely malnourished children] has been unprecedented … It’s around two million in the whole of the Horn — we’ve never seen such high numbers before. Higher fuel prices also increase the cost of doing business and getting supplies out … In May, we projected that the price of RUTF will increase by 16% over six months … including the projected increase in the cost of ingredients … as well as material to package the sachets. But that [16%] doesn’t include increased logistics cost — both international freight and local logistics, which [requires] fuel for trucks. Another issue is that instead of being able to distribute on a quarterly basis [as is normal], we’ve had to distribute on a monthly basis because the production capacity was stretched beyond the usual ability to deliver what was needed. Both WFP’s and UNICEF’s needs had increased exponentially. We’ve been lucky that we have the big Insta Products EPZ factory in Kenya that delivers to the whole region and they’ve been … increasing their capacity … We are looking to increase regional production, which reduces the freight costs and countries can access RUTF hot off the production line. There’s also the Hilina Enriched Foods factory in Ethiopia [but] that is smaller and has been constrained … by restrictions on foreign currency. A lot of our supply capacity is now local. This year, as of September 1, UNICEF delivered 30,176 metric tons of RUTF to 46 countries, 73% of which was produced locally or close to countries where the needs are … Local production of RUTF has been encouraged and supported by UNICEF for many years … We target countries for new production facilities that have a significant caseload of wasting themselves, an existing base of food processing companies, and proximity and transport connections to export to other countries. For example, we have been targeting Uganda and also Tanzania. How is UNICEF coping with the rising numbers of children with severe acute malnutrition? In the first half of the year, it was very challenging to secure the funding to enable us to keep up. Of late, more funding has come through, but the numbers keep increasing … we are constantly having to adjust the funding needs. We always try to ensure efficiency as far as possible in having quarterly distributions and warehouses with prepositioned stock. But in Ethiopia, in particular, because the numbers are so large, that has been tough to do and they came close to having zero stock. If the numbers keep increasing we will really have to keep up the momentum of sourcing funding. What do you think needs to happen long-term to prevent this happening again? Having stronger systems in place is one of the things we would focus on. The fact that Kenya has a much stronger health system is helping it to avoid the excess mortality that we always see … with Somalia, which has the weakest systems. Strengthening systems could include the resilience of existing systems; the expansion of community health services; expanding social safety nets … and making sure … the provision of those safety nets allows for displacement. In Ethiopia, the beneficiaries of the social safety net program have to be where they are registered and when they move, they drop off the eligibility. So [we need to look at] fixing those kinds of things. Finally, the resilience of the food system which is really challenging in the arid areas of the Horn, where the pastoralist livelihood and lifestyle seems to be becoming less tenable. We need to find alternative livelihoods for those displaced populations who have stayed … We also need to look at ways the food system can be diversified … [such as growing] more nutrient-dense foods for children. But so far, the investment for resilience has fallen really far short of what we had appealed for and it’s a long-term intervention that’s needed to prevent this happening again. UNICEF’s resilience appeal of $500 million is currently only 3% funded.