What is MANA?

MANA is our version of ready-to-use therapeutic food (RUTF), designed to treat children suffering from severe acute malnutrition (SAM). Once packaged and delivered, MANA is ready for consumption — our #1 priority is to get our RUTF off of the factory shelves and into the hands of starving children.

But what exactly is RUTF?

RUTF is peanut butter “amplified.” It is loosely defined as a fortified peanut butter paste rich in vitamins and energy. It is contained in a package that looks like an oversized ketchup packet. RUTF is revolutionary for the treatment of SAM because it allows children to receive treatment in their communities, does not require water, and does not spoil.

Does MANA make other stuff?

MANA RUTF is the first of several products that we have rolled out to serve malnourished children. One of these products is RUSF, a supplementary ready-to-use food designed for moderately malnourished children. We make a line of LNS supplements for the prevention of malnutrition in both mothers and children. We also have developed a product called Humanitarian Supply Ration (HSR). It is a peanut paste fortified with micronutrients that boasts twice the protein of a normal peanut butter. It differs from RUTF and RUSF in that it is not designed to UNICEF specifications and is not designed to treat severely and moderately malnourished children.

What is severe acute malnutrition (SAM)?

Technically, SAM is a condition that affects children from the ages of 6 to 59 months. They have extremely low weight-for-height measurements, visible severe wasting and/or the presence of edema. But, for our purposes, it is more helpful to think of it as a child who is so malnourished that he or she is literally on the brink of death. Twenty million children are currently estimated to suffer from SAM, and most are in South Asia and sub­-Saharan Africa. All of this may seem very discouraging, but the good news is that SAM is not only preventable, but it’s also treatable. And that is where MANA products come in.

What about all the other acronyms and lingo?

The nutrition community is full of insider language. We’ve defined a few more terms to help make sense of it all.

Moderate Acute Malnutrition (MAM) -­ Moderate malnutrition is a low-grade, gnawing hunger that is widely present in many countries. Moderately malnourished kids often suffer from stunting. The distinction is made by using a MUAC bracelet.

Middle Upper Arm Circumference (MUAC) -­ In order to assess a child, clinicians or medical volunteers often use a band called a MUAC bracelet. This band has red, yellow and green sections and allows even a quickly trained person to assess whether a child is suffering from SAM (red), MAM (yellow) or is not yet clinically malnourished (green). The band is placed around the middle-upper arm, just above the bicep and pulled tightly through a small window. The color showing in the window indicates the child’s nutritional status.

Stunting­ – When children are malnourished during critical growth windows, they are often “stunted” and fail to reach full height. Stunting, which is fairly obvious and therefore easy to measure, is used by researchers as an indicator or measurement for other aspects of overall health. Similarly, prevention of stunting is a great way to measure other more hidden health factors.

Lipid-based Nutrient Supplements (LNS) ­- LNS refers to an entire range of fortified lipid-­based products. Lipids are fats and animal­-based protein sources. Different quantities with different vitamin and mineral compositions can be useful for various populations. Some are meant for kids with SAM, some with MAM, and some for pregnant or lactating moms. A helpful definition can be found here.

How long does a child need to eat MANA?

Typically, a child needs to eat 1,0­15 kg of RUTF over a period of six to eight weeks. That’s three packets of MANA per day. According to the American Journal of Clinical Nutrition, 98% of children treated with RUTF were well­-nourished after six months and 96% were well­-nourished after a year. 1 However, treatment cycles can vary in different situations. The good news is that a cycle of RUTF will not only temporarily treat a child but, in most cases, cures them so that they don’t need ongoing feeding. The first 1,000 days of a child’s life are crucial and can determine that child’s full growth prospects. That is why it is critical that we get MANA to malnourished children today.

Can you feed MANA RUTF to anyone who is hungry?

MANA RUTF is not a product designed to address all hunger. MANA RUTF is a product designed to treat the most serious form of hunger—severe acute malnutrition, and RUTF has an impressive track record for correcting this specific condition. Regarding use of RUTF, Dr. Mark Manary says, “Children with SAM rarely relapse, because they are fed to the MAM criteria. Our American Journal of Clinical Nutrition paper found that 98% were well-­nourished after 6 months and 96% were well­-nourished after 1 year.” 1. See our products page for other solutions if you want to help hungry children or adults using similar ready-­to-­use products.

1 – Ciliberto, Michael A.; Sandige (April, 2005). “Heidi”. American Journal of Clinical Nutrition 81 (4): 864–870. PMID 15817865. Retrieved 2 January 2014.

Did MANA invent RUTF? Are there other suppliers? How is MANA different?

No, we did not invent it. Andre Briend, a researcher working with MSF labs, came up with the idea of pouring existing F­100 powdered milk formula into peanut butter to stabilize it. Years before that, Dr. Michael Golden lead a team at MSF to develop F­100, a special super-­milk formula that was amazingly effective at curing and treating malnutrition. Golden promptly offered this “invention” to the world as a public good and a few places started making it.

F­100, however, had its downsides. Mixing powdered milk requires good, clean water and once it’s mixed, F100 offers a very short shelf life. It’s also a challenge for a mother to correctly mix in proportion to a child’s age and weight.

This led Andre Briend to come up with the idea of stabilizing this super­-milk formula in a paste substance. The very first clinical trial that put RUTF “on the map” was conducted by Dr. Mark Manary in Malawi. There is a joint statement about the efficacy of RUTF and CMAM put out by the World Health Organization and many of the references in that statement point to the work of Dr. Mark Manary and Dr. Steve Collins as key innovators and pioneers. In addition, a French company called Nutriset took on the task of making RUTF and now makes a version called “Plumpy’Nut”. It took a team of great humanitarians, scientists and entrepreneurs to think it up, produce it and prove that it actually worked on malnourished children.

As with any good idea, it spread! Now, there are as many as a dozen producers of RUTF around the world. MANA’s headquarters and production facility are both in the United States, which allows us to refine our technology to maximize effectiveness before assisting or opening production facilities in developing countries. Our headquarters is in North Carolina, and our factory is in Georgia. We are actively working with partners like Dr. Manary’s Project Peanut Butter to improve our response to a massive, but solvable problem. We acknowledge that while RUTF is a proven lifesaver, it is not the solution to all world hunger. That is why we do not limit ourselves to helping through our products. We also spread awareness of malnutrition through campaigns and through available forums like Facebook, Twitter, and Instagram.

Does MANA think that making and shipping RUTF from the US is best?

No, we don’t. We think Western countries have a role to play and we think that local suppliers should and must have an increasingly large role to play as well. Ideally, local people would always solve local problems and that is why MANA is actively supporting groups like Project Peanut Butter that are doing the difficult and long-term development work of making RUTF in local settings. These companies and communities not only take pride in solving their own problems and feeding their own people, but they also grow local economies by creating jobs in the factory and throughout the supply chain.

However, the fact remains that there are many places around the globe where a local or even regional supply of RUTF is a long way from reality. A supplier in Africa will not typically use African milk because milk drying facilities on the continent are nearly non­existent. Micronutrient blends and powders are sourced in Europe, and packaging largely in China. Even peanuts are hard to find in Africa due to high aflatoxin levels and difficulty around post-harvest. Peanut harvest problems were only recently solved in the USA.

While none of these challenges should cause us to give up on local production, they all make it difficult and expensive, even if labor and shipping costs are much lower. In the meantime, UNICEF and others have “surge” needs from disasters, drought, war and famine that demand large-scale production and shipping of RUTF in order to save lives. Make no mistake – in the end, if MANA needs to close its doors because local production of RUTF has rendered our Western production unnecessary, we will be among the happiest people in the world, and we’ll be creative and do something world­-changing with our company and factory. Sadly, we are afraid it may be a while before global malnutrition is solved and RUTF supplies are readily available, so we remain determined to make as big of a contribution as we can.

What do you say about the carbon footprint of shipping food aid around the world?

RUTF is pretty simple stuff, composed of about 4 or 5 main ingredients. At the MANA facility in Georgia, we source peanuts right out of our back door. Our non­fat dried milk powder comes from nearby states like Illinois or Kentucky. Our sugar comes from Louisiana or Florida and our packaging comes from nearby facilities as well. The carbon footprint required to assemble our ingredients is incredibly small, as each individual component is individually shipped to us from places that are, at most, a few hundred miles away. We mix everything together and truck the finished product in a container to port in Savannah, GA and then it sails on to ports around the world.

When RUTF is produced in an African country, the individual components are sourced from around the globe. Milk may come from New Zealand, Lithuania or Ireland. Peanuts are almost always from Argentina or the US. The micronutrient powders are from the US or Europe. The packaging is from China. If you think about moving each component separately to be assembled in a small plant in Africa, the overall carbon footprint might be five times or more the total miles of a product compiled in and shipped from Georgia. So, while we agree that local production has many great aspects, and we are determined to support its growth, it is not presently the way to produce a product like RUTF and achieve the lowest carbon impact.

Is MANA Nutrition a nonprofit?

MANA is structured as a 501(c)(3) charitable organization. As such, our full financial information is available here on this site for public scrutiny. Our non­profit status allows MANA to act as a forum for businesses, trade associations, and other non­profits to join forces to help save children from severe acute malnutrition. MANA, however, is proud to be a non­profit run on business principles. The revenue we generate in excess of expenses is re­invested in things like new equipment and additional personnel, which allow us to produce more MANA and to save the lives of more children. Moreover, you will see the “100% Pledge” on our donation page. Our commitment to covering overheads, office space and staff salaries with our factory allows us to put 100% of public donations towards providing RUTF packets to delivery partners that do not have budgets to buy RUTF and as a result, have severe shortages.

Most importantly, as a non­profit we don’t have shareholders who hold our feet to the fire. We do have a board that pushes us to excellence, motivated by the incredible joy that comes from saving the kids we serve. We don’t think profit is bad. In fact, we know it is necessary because it allows us to invest in more equipment and personnel so that we can increase our production capacities and save more starving children. Not everyone needs to operate like we do, but it works for us and, more importantly, we think it works for the children who need our products to survive. Since our mission and values can be successfully accomplished as a non­profit entity, we structured our company as such. Thus, we are the MANA Village, a community that just happens to be a company.

How does MANA reach children in need?

After production, we ship our product to our distribution partners (organizations like UNICEF and USAID, with wide distribution networks and established reputations in our target countries) to make sure that MANA ends up in the right hands. MANA’s partners then coordinate with local organizations (governments or NGOs working on the ground) to get MANA into the hands of starving children. In some cases, MANA is able to secure partners (most of whom approach us) and we work with them directly to get the life­saving supply of RUTF to children in need through their programmatic efforts. These are the partners who receive our donated RUTF from public donations.

Where does MANA Nutrition work?

MANA RUTF has served children in 39 different countries around the globe. Sometimes, if we can figure out the shipping hurdles for smaller quantities, we work with small clinics that understand (or are willing to learn) how our various products work and are best used.

How can I help?

MANA Nutrition welcomes all donations, and, as a 501(c)(3) non­profit organization, all donations are tax deductible. Here, you can choose to make a one-time donation to MANA through PayPal or you can write and mail a check to our office in North Carolina. If you choose, you can also arrange to make a monthly donation.

If you are interested in buying MANA for your organization, please contact us for pricing and order placement. At MANA Nutrition, we also recognize the power of ideas in the fight to save children suffering from severe acute malnutrition. We welcome yours and hope you will contact us.