Localized or centralized control of food production for treating severe acute malnutrition: echoes of a past child survival revolution?

摘要

Severe acute malnutrition (SAM) affects nearly 20 million children under 5, causing over 1 million deaths per year ( ; ) and many more cases of stunting, developmental deficit, and other adverse individual and societal effects ( ; ). While effective treatments are available, and the need to tackle SAM is well recognized ( ), the logistics of addressing a problem of this magnitude are challenging. With the Millennium Development Goals' deadline fast approaching and the urgency to globalize feeding programmes increasing, this editorial asks whether lessons from history could inform current strategy and decision making. In particular we consider whether the current ‘globalized’ modes of ready‐to‐use therapeutic food (RUTF) production are optimal in light of existing economic evidence and the lessons learned from the oral rehydration solution (ORS) campaign.