Request for Expression of Interest for Prequalification of Ready-to-Use-Therapeutic Food (RUTF)

UNICEF
Request for Expression of Interest for Prequalification of Ready-to-Use-Therapeutic Food (RUTF) Request for EOI

Reference: REOI/SD/NUT/2023/4
Beneficiary countries or territories: Multiple destinations (see the Countries or territories tab)
Published on: 09-May-2023
Deadline on: 26-May-2023 23:59 (GMT 2.00)

Description

The purpose of this REOI is to assess readiness of the existing and possible new RUTF suppliers to produce RUTF compliant to the UNICEF specification based on CXG 95-2022 (Guidelines for Ready-to Use Therapeutic Food), by the end of 2023. Manufacturers with products evaluated as acceptable in this REOI will be eligible for long term awards (LTA) starting January 2024. 

1. Background

Globally, at least 13.6 million children under the age of 5 suffer from severe wasting[1]. WHO recommends that all children aged 6 months to 59 months with severe wasting and/or nutritional edema, also referred to as severe acute malnutrition (SAM), without medical complications are treated with ready to use therapeutic foods (RUTF) [2]. RUTF is a fortified high energy food and is one of the critical life changing innovation products that has increased the efficiency and effectiveness of therapeutic care of children with severe wasting. Over the last four years, UNICEF provided life-saving therapeutic feeding to 3.5 million

children with severe wasting and procured an average of 49 000 metric tons (MT) of RUTF[3].

 

At the 45th session of Codex Alimentarius Commission on 21 November 2022, the Codex Guideline for Ready to Use Therapeutic Food (RUTF) was adopted. Previously, there was no internationally accepted standard for RUTF and CXG 95-2022 complements existing WHO guidelines for the treatment of severe acute malnutrition.

The Codex guideline defines RUTF as a food for special medical purposes (FSMP) and sets out the rules for food safety and requirements for nutritional composition. The RUTF Codex guideline is developed based on UNICEF’s existing RUTF specification, as well as recommendations taken from FAO and WHO texts that outline the nutritional needs of children with malnutrition. Since 2016 the industry have been informed of the upcoming changes to the product requirements as a result of the development of the RUTF guideline.

There are some specific formulation changes because of the Codex Guideline adoption that are now required in RUTF procured by UNICEF. This guideline establishes that a protein quality score (using the Protein Digestibility Corrected Amino Acid Score (PDCAAS) greater than 0.9 is mandatory. The guideline states that a PDCAAS value of 0.9 or more ‘can be achieved’ by including a minimum of 50% of protein from dairy sources, in addition to proteins from seeds, cereals and legumes. The guideline also permits the addition of amino acids, to reach the desired level of PDCAAS. The n-3 & n-6 fatty acid requirement was also adjusted to better support the child’s cognitive development. The maximum levels of vitamin A, vitamin D, potassium, magnesium and calcium were slightly increased to allow for raw material and processing variability during manufacture. The development of the guideline is a critical step in enabling governments to regulate the quality and safety of RUTF during its production and distribution.