Plumpy'Nut bars manufactured at the Edesia Nutrition plant in Rhode Island. Has the "ready-to-use therapeutic food" - credited with an 80 to 90% recovery rate among malnourished children - been caught up in the U.S. aid cuts? Gabrielle Emanuel/NPR hide caption
Fatima Jubril lost her husband when the militant group Boko Haram attacked their farm in northeast Nigeria last September. Fleeing her village with her four children, she found shelter in a displaced persons camp - but then came another monumental challenge: Jubril came dangerously close to losing her 2-year-old son, Ibrahim.
Jubril says the food rations in the camp were not enough so she was not producing sufficient breast milk for her young child. Ibrahim started losing weight. She remembers he was crying and irritated all the time. He was diagnosed with acute malnutrition at the local aid clinic.
What saved him from starvation, she believes, are little packets of Plumpy'Nut - a nutrient-dense paste made up of peanut butter, powdered milk, oil and sugar, fortified with vitamins and minerals.
Plumpy'Nut is one of the brand names for a ready-to-use therapeutic food. USAID has been a big supporter of RUTFs - ordering them from factories and helping to distribute them around the world. But now RUTFs have been caught up in the Trump administration's dismantling of USAID and, aid workers in crisis zones say, these lifesaving packets aren't always getting to the kids who need them.
Plumpy'Nut was developed in France and since 2001 has become the go-to intervention for malnourished children. Each packet is about the size of the bag M&Ms you'd buy at the candy counter and costs roughly 30 cents to produce. A typical regimen is two or three packets a day for six to eight weeks.
The therapeutic food is prescribed if a child's arm measurements or height-to-weight ratio are significantly below average.
With a smooth, slightly grainy consistency, it's definitely ready-to-eat and appealing to kids. "Rip the corner and suck it out," says Dr. Mark Manary of Washington University, a longtime booster of the product. "It's really, really sweet."
Within three weeks of starting his Plumpy'Nut diet, Ibrahim rapidly improved. "After he started taking the packet, I noticed he started gaining weight," Jubril said. "He also stopped crying all the time, and I was really happy."
Ibrahim is one of millions to benefit. "Since 2001 we would estimate 40 million children treated," says Dr. Manary, who ran the first Plumpy'Nut trial that year.
Over the years, studies have shown that this product is dramatically effective in areas struggling with child malnutrition. Independent researchers have determined that the survival rate for severely malnourished kids was about 25% in the pre-Plumpy'Nut era - and the use of RUTFs has boosted that number to 80 to 90%.
"RUTF has been a game changer in saving children from being malnourished and subsequently dying," says Nadia Akseer, an associate scientist at the Johns Hopkins Bloomberg School of Public Health who researches maternal and child health and malnutrition in lower income countries. "Children who take RUTF have high recovery rates, end up bouncing back and being able to survive and thrive."
This photo taken on June 14, 2016 shows a woman feeding her child suffering from malnutririon with a pack of "Plumpy Nut" food, which contains vitamins, proteins and all neccesary nutriments, in the pediatrics unit at the Niamey hospital. Plumpy Nut is now manufactured locally, a few kilometers away in the industrial area of Niamey, by the Societe de Transformation Alimentaire (STA, or Food Transformation Company. Niger has been repeatedly plagued by food and humanitarian crises, as more than 300,000 people have been displaced. 240,000 have fled the atrocities of the Nigerian Islamist group Boko Haram in the southeast, while 60,000 have fled to Niger to escape the Islamist groups in Mali. Issouf Sanogo/AFP via Getty Images/AFP hide caption
In the past few years, the number of kids using RUTFs has increased dramatically - from an average of about 5 million in the early 2020s to 9 million in 2024.
That's due to "the generosity of the American people," says Manary, citing increased USAID support for manufacturing and distributing the products.
Has the rapid-fire disruption of cuts and reinstatements at USAID had an impact on the manufacture and global distribution of this product?