New York — For three decades, a small sachet of fortified peanut paste has been one of the most powerful tools to combat severe wasting – the deadliest form of malnutrition – in children under five. Today, more than 12 million children globally are suffering from severe wasting. As conflict, climate shocks, and funding pressures escalate, ensuring a predictable and uninterrupted supply of Ready-to-Use Therapeutic Food (RUTF) is more critical than ever.
First developed in 1996, RUTF transformed the treatment of severe wasting by enabling children without medical complications to be treated at home, reducing reliance on hospitalisation, cost to families, and lowering the risk of secondary infections.
Today, RUTF – as part of a community-based approach to treat wasting in children – has transformed the way life-saving care and treatment is delivered. It has contributed to historic lows in preventable child deaths worldwide. While the 30-year milestone marks major progress in public health, it is also a call to action: the full range of nutrition treatment, including with therapeutic milk, must be scaled up so that it can withstand supply shocks, reduce costs, and help ensure every child who needs it has uninterrupted access to therapeutic food.
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“This small, but powerful, sachet of therapeutic food fundamentally changed the way that we treat children with severe malnutrition,” said UNICEF Executive Director Catherine Russell. “I have seen how children suffering from wasting come alive when they’re treated with RUTF. It has empowered families by putting life-saving treatment into their hands. No child should die from malnutrition in a world of plenty.”
Key facts marking 30 years of Ready-to-use-Therapeutic Food:
Children with severe wasting are too thin for their height, their immune systems weaken to the extent that ordinary childhood illnesses can become fatal, and their risk of dying increases by 12 times compared with well-nourished children.
Currently, 42.8 million children are affected by wasting, of which 12.2 million have severe wasting, the deadliest form.
RUTF is highly successful, with a recovery rate of nearly 90 per cent for those suffering from severe acute malnutrition.
In 2025, UNICEF screened 255 million children globally for wasting and treated more than 9 million affected children.
Made from peanuts, skim milk powder, oil, sugar, and essential vitamins and minerals, this therapeutic food is given to children aged 6-59 months with severe wasting.
A 92g sachet of RUTF provides 500 calories, helping severely malnourished children gain weight and build immunity during treatment. Its creamy texture and slightly sweet, savoury taste make it palatable to children.
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RUTF comes as a thick, oil-based peanut paste for a reason – it contains zero water, which means bacteria has nothing to grow in. This formulation helps keep the therapeutic food safe in any environment, including humid conditions, and it does not require refrigeration. It has a shelf life of 24 months.
Today, RUTF remains the only WHO-recommended outpatient treatment for child wasting.
UNICEF is the world’s largest procurer of RUTF. Between 2003 – 2025, UNICEF procured and delivered a total of 8.7 billion sachets of RUTF globally, fuelling recovery for millions of children.
In 2023, UNICEF delivered nearly 1.1 billion sachets of RUTF in response to the global nutrition crisis following the COVID-19 pandemic – making it a record annual quantity.
Ethiopia has received the highest volume of UNICEF-procured RUTF. Based on data from 2003 to 2025, 1.6 billion sachets of RUTF worth US $296 million were delivered to Ethiopia, where at least 500,000 children are treated annually for severe wasting.
A carton of RUTF, containing 150 sachets, is sufficient to treat a child for 6-8 weeks, until recovery, alongside follow-up medical care and counselling.
RUTF is an example of successful public private collaboration. UNICEF procures RUTF from 21 suppliers globally, 18 of which are in, or near, countries with high levels of child wasting. Local manufacturing, with the capacity to supply other countries, is essential for a rapid response to malnutrition crises, especially in the face of global supply chain disruptions.