As the world confronts the ongoing and accelerating hunger and malnutrition crisis, a new, large-scale study by the International Rescue Committee (IRC) and Mali Ministry of Health, shows that simplified acute malnutrition treatment is exceptionally effective and can be delivered even in a fragile context. The peer-reviewed study, released on the heels of an unprecedented mobilization of funds to scale treatment, confirms that this proven solution is more cost-efficient and, if effectively delivered, can save the lives of millions of children.

The study treated 27,800 children with acute malnutrition and observed a 92% recovery rate. Even more promising, all particularly vulnerable sub-groups, including children with extremely severe cases, achieved recovery rates over 85%, well above the 75% Sphere standard—the universally recognized standard in humanitarian response.

“The scourge of acute malnutrition, which impacts the lives and livelihoods of children all over the world, has a clear solution,” said David Miliband, IRC’s President and CEO. “We are facing record levels of hunger and malnutrition and it is unacceptable to continue to leave proven solutions on the shelf. We must bring this evidence to bear on the current crisis and deliver this lifesaving solution to the over 50 million children in need today.”

The study’s positive outcomes were achieved using a novel approach known as a simplified, combined protocol that streamlines treatment and expands access to care. Critically, the study demonstrated that this approach is effective for children with all forms of acute malnutrition and those living in remote and food insecure communities. Children treated by community health workers close to home recovered at rates equal to those treated by formal health workers in fixed treatment centers—a key data point as distance to a health facility is often a barrier to care, at times to a fatal extent. Using a simplified, combined protocol also proved more cost-effective, with costs decreasing by 25% when clinics transitioned to a simplified, combined protocol to treat children with all forms of acute malnutrition.

“With acute malnutrition surging across East Africa and the Central Sahel and new and significant funding directed to scale treatment, now is the time to embrace approaches that simplify delivery and ensure children in the most remote and hard to reach communities can receive the care they need. The simplified, combined protocol was created for this moment and the study’s results validate its effectiveness,” said Jeanette Bailey, Lead Nutrition Researcher at the IRC and co-designer of the simplified, combined protocol.

Bailey and colleagues began testing this approach in 2014 and results from a clinical trial in Kenya and South Sudan found that it was equally effective as the standard approach and required fewer resources per child. The new Mali study, which is the largest scale evidence available to date, proves that excellent outcomes can be achieved in an operational setting on a large scale. IRC and its partners have tested this approach, treating 60,000 children across seven countries, and the resulting evidence is clear: a simplified, combined protocol is equally effective, more cost-efficient, and easier to scale compared to the standard treatment model. Critically, the United States Senate Foreign Relations Committee recently endorsed this approach in a letter to USAID Administrator Samantha Power, urging her to promote scalable and evidence-backed approaches to ensure the best use of the United States’ unprecedented investment in acute malnutrition treatment.

Today in the Sahel and Horn of Africa, more than 8 million children are suffering from the most severe form of acute malnutrition, increasing their risk of death 11-fold. Each year, nearly 2 million children die from this nutritional deficiency. Each of these deaths is tragic and preventable. Ready-to-use therapeutic food (RUTF) is a highly effective, shelf-stable, fortified peanut butter paste that, in a matter of weeks, can fully recover most children. Yet globally, just 20% of children with acute malnutrition access this lifesaving treatment due, in part, to an overly complex system.

The study’s 92% recovery rate and large scale not only demonstrates the safety and efficacy of a simplified, combined protocol but serves as a call to action: we must endorse this model as best practice in treatment and offer governments a real choice in implementing this proven solution. 

To enable the immediate scaling of this lifesaving intervention, the IRC calls for: