Transcript of WHO podcast - 22 October 2007
Half a million women still die every year giving birth; a new initiative to get medicines to people with drug-resistant tuberculosis; and peanut butter is used to feed malnourished children.
Iain Simpson: You’re listening to the WHO podcast for the week of 22 October 2007. I'm Iain Simpson.
In this episode:
- why half a million women still die every year giving birth and what can be done about it;
- getting medicines to people with drug-resistant tuberculosis;
- peanut butter could be the best recipe for malnourished children.
The focus in the public health world has been on the extraordinary number of women who still die while giving birth. It is estimated that each year about half a million women die in pregnancy and childbirth. The world set a series of ambitious goals in the year 2000, including cutting the number of women who die in pregnancy and childbirth by three-quarters by 2015. So far, the progress has been slow, and the message was that unless this number changes the goal will be missed and large numbers of women will continue to die while giving birth. Daisy Mafubelu is the WHO Assistant Director-General for Family and Community Health. At a press briefing here in Geneva, she talked about the Women Deliver conference, one of the initiatives being taken to increase the focus on this problem.
Daisy Mafubelu: Over the last few years we have lost many mothers and children due to causes that are entirely preventable. Over the last 20 years, we have produced evidence on interventions that work. So as it is today, we know exactly what works, but, sadly, we still lose a lot of lives. Every minute of every day we continue to lose a woman. A woman dies either during pregnancy or during childbirth. So the question is, if we know the interventions, why do we continue to lose so many lives?
Iain Simpson: Other news now - earlier this month, a new initiative was launched to get drugs to 19 countries for tuberculosis that is resistant to first-line drugs. The project was launched by the Stop TB Partnership and UNITAID. It will benefit three-quarters of a million people who might not otherwise get treatment or could have their treatment interrupted.
Iain Simpson: October 16 marks World Food Day. The theme this year is "the right to food". The United Nations Food and Agriculture Organization used the occasion to call for a renewed commitment to guarantee the right to food for the world's hundreds of millions of hungry people. Part of WHO's work focuses on the needs of malnourished children. The best way to help them is by using a product made out of peanut paste with mineral and vitamin supplements. André Briend was one of the inventors of the product. He came into the WHO studio to tell me more.
You were involved in the development of what has come to be known as the "ready to use therapeutic food", weren't you?
André Briend: The development took place about 10 years ago now. We are talking more about it these days because the idea became more widely accepted.
Iain Simpson: What exactly is it? What is special about this combination of things?
André Briend: About 10 years ago, WHO made a recommendation for treating children with severe acute malnutrition using a diet that was prepared with meal powder, oil, sugar, vitamins and minerals. This diet was working very well but had a problem in that it had to be prepared with clean water, which means it was possible only to use it in hospitals. A few years ago - it was in 1997, I think - I had the idea of changing slightly the recipe. Actually, I had the idea by looking at a jar of chocolate spread when I noticed that the balance between proteins, energy and lipids were more or less the same in this chocolate spread as in the diet recommended by WHO. So, then it came to change a little bit the recipe by replacing part of the dry skim milk with peanut butter and getting something that the child could eat directly without the addition of water.
Iain Simpson: But, as I understand it, WHO is not recommending chocolate spread?
André Briend: Actually, we do not recommend any recipe. What we recommend is a nutritional formulation, and then people can adapt it. This is what I did a few years ago. In practice, what is used most commonly is peanut butter. The advantage of peanut butter is that it has a salty taste and the minerals and vitamins we are mixing have a salty taste, so the two go well together. If you tried to use a chocolate spread with a salty taste it won't work.
Iain Simpson: So how actually is this used? You do not have to mix it with anything?
André Briend: No, it will just be this food, which will come in either a small sachet or a cup, and then the child eats it directly. If the child is severely malnourished, especially if it is not associated with any complication, then the child can consume this food at home. In the old days, not so long ago, it was necessary to keep the child treated as an inpatient for at least three to four weeks. So now, nearly 80% of children are not admitted to a hospital and are just treated at home.
Iain Simpson: So, how widely is it used now?
André Briend: Not widely enough. Now it is increasingly used in a few countries where local production is taking place. I am thinking about Ethiopia, Malawi and Niger; it is being used on a wide scale, but there are many others where it is still unknown.
Iain Simpson: Are there efforts being made to make it more widely available, more widely known?
André Briend: Definitely, and on this we are collaborating very closely with UNICEF. UNICEF has developed a plan to increase production at a country level in all countries with a high prevalence of severe acute malnutrition, and definitely, the use of this kind of product will increase dramatically in the coming years.
Iain Simpson: Thanks for listening to my last WHO podcast. For more information about these stories, and other global public health issues, visit the WHO website, at www.who.int.