{"id":24576,"date":"2017-11-15T18:06:52","date_gmt":"2017-11-15T23:06:52","guid":{"rendered":"https:\/\/digital.hbs.edu\/platform-rctom\/submission\/strengthening-a-supply-chain-to-save-lives-unicef-malnutrition-and-global-warming\/"},"modified":"2017-11-15T22:39:28","modified_gmt":"2017-11-16T03:39:28","slug":"strengthening-a-supply-chain-to-save-lives-unicef-malnutrition-and-global-warming","status":"publish","type":"hck-submission","link":"https:\/\/d3.harvard.edu\/platform-rctom\/submission\/strengthening-a-supply-chain-to-save-lives-unicef-malnutrition-and-global-warming\/","title":{"rendered":"Strengthening a Supply Chain to Save Lives: UNICEF, Malnutrition, and Global Warming"},"content":{"rendered":"<p>While some of us may be agonizing over excess pounds gained during this busy RC fall semester, over 16 million children currently suffer from severe acute malnutrition (SAM) and 1 million will die this year.<a href=\"#_ftn1\" name=\"_ftnref1\">[1]<\/a> In 2007, the WHO formally recommended ready-to-use therapeutic foods (RUTFs) \u2013 a mixture of peanuts, sugar, vitamins, and milk powder inspired by nutella &#8211; for community-based treatment of child malnutrition.<a href=\"#_ftn2\" name=\"_ftnref2\">[2]<\/a> Global demand has since grown from 5,000 MTs to 30,000 MTs \u00a0in 2016.<a href=\"#_ftn3\" name=\"_ftnref3\">[3]<\/a><sup>,<a href=\"#_ftn4\" name=\"_ftnref4\">[4]<\/a><\/sup> The supply chain for RUTF has similarly evolved: until 2005, the French company Nutriset was the only supplier of RUTF. The United Nations International Children\u2019s Emergency Fund (UNICEF), who procures and distributes over 80% RUTF globally, has facilitated the growth of local production and diversified its own supply chain. There are now 19 UNICEF-approved producers, including some countries &#8211; such as Sudan, Haiti, and India &#8211; with the largest RUTF needs.<a href=\"#_ftn5\" name=\"_ftnref5\">[5]<\/a><\/p>\n<p>While there is now production capacity to reach all children in need of RUTF, total funding globally only covers 20% of the current need.<a href=\"#_ftn6\" name=\"_ftnref6\">[6]<\/a><sup>,<a href=\"#_ftn7\" name=\"_ftnref7\">[7]<\/a><\/sup> Given the limited and relatively fixed nature of funds available, <a href=\"#_ftn8\" name=\"_ftnref8\">[8]<\/a>\u00a0any significant increases in supply chain costs could be expected to limit the number of children receiving treatment. With such significant unmet need, it is imperative the supply chain for RUTF be further improved to provide timely deliveries at the lowest cost possible. <strong>But global warming also presents a \u201cdouble threat\u201d to the RUTF supply chain \u2013 exacerbating volatility in demand and threatening the supply inputs \u2013 that UNICEF, in addition to governments and other NGOs, must consider. <\/strong><\/p>\n<ul>\n<li><strong>As the earth warms, shrinking glaciers and erratic rainfall will cause water shortages particularly in the world\u2019s most vulnerable regions.<\/strong> Somalia, Kenya and East Africa countries have experienced below average rainfall since the 1990s, contributing to 30% reduction in crop yields and recent famines, raising the need for RUTFs.<a href=\"#_ftn9\" name=\"_ftnref9\">[9]<\/a> Droughts will further threaten the supply of milk and peanuts, which often lead to significant price spikes.<a href=\"#_ftn10\" name=\"_ftnref10\">[10]<\/a><sup>,<a href=\"#_ftn11\" name=\"_ftnref11\">[11]<\/a><a href=\"#_ftn12\" name=\"_ftnref12\">[12]<\/a><\/sup><\/li>\n<li><strong>An increase in frequency of hurricanes and other unpredictable destructive events have already led to millions of displaced people and threaten public infrastructure<\/strong> essential to last mile delivery of RUTFs.<a href=\"#_ftn13\" name=\"_ftnref13\">[13]<\/a> Climate change is expected to cause more food riots and larger political uprisings, such as those seen in the Somalian and Syrian civil wars. Such events lead to mass displacement, which is associated with significantly elevated risk of malnutrition.<a href=\"#_ftn14\" name=\"_ftnref14\">[14]<\/a><\/li>\n<li><strong>Warmer weather will also allow pests and parasites to thrive, further threatening crop yields and the food security for<\/strong> populations in underdeveloped countries.<a href=\"#_ftn15\" name=\"_ftnref15\">[15]<\/a> Peanuts are also particularly susceptible to aflatoxin, a microbacterial that could cause quality concerns for RUTF supply chain.<a href=\"#_ftn16\" name=\"_ftnref16\">[16]<\/a><\/li>\n<\/ul>\n<p><strong>While UNICEF does not explicitly reference climate change in its 2017 RUTF market report,<a href=\"#_ftn17\" name=\"_ftnref17\">[17]<\/a> existing initiatives will also help to mitigate climate change related concerns including: <\/strong><\/p>\n<ul>\n<li><strong>Diversifying the supply chain to local production.<a href=\"#_ftn18\" name=\"_ftnref18\">[18]<\/a> <\/strong>While 50% of global RUTF demand is still served by Nutriset\u2019s France factory that can \u201cquickly speed up output\u2026in response to emergency orders,\u201d<a href=\"#_ftn19\" name=\"_ftnref19\">[19]<\/a> shipments from France add extra costs, lead times, and greenhouse gas emissions.<a href=\"#_ftn20\" name=\"_ftnref20\">[20]<\/a> Cost estimates suggest that for every child treated by RUTFs procured through emergency air freight orders, nearly two children could be treated with RUTFs procured through local production channels. Investing in local production also furthers economic development and resilience to climate change shocks.<a href=\"#_ftn21\" name=\"_ftnref21\">[21]<\/a><\/li>\n<li><strong>Buffer stocks and stock transfer programs<a href=\"#_ftn22\" name=\"_ftnref22\">[22]<\/a> <\/strong>Increased demand for RUTFs is likely to coincide with events that simultaneously threaten local commodity supply and production capability. Building regional buffer stocks and stock transfer capabilities could help mitigate this risk.<\/li>\n<li><strong>Exploring new formulations to diversify commodity supply <\/strong>(e.g. using chickpeas, non-milk based products)<strong> and extend shelf life <\/strong>could help limiting exposure to commodity supply and price shocks<\/li>\n<\/ul>\n<p><strong>Additional areas for further exploration could include: <\/strong><\/p>\n<ul>\n<li><strong>Medium term (10 year) strategic plan, including financing needs for countries with largest SAM burden under optimistic\/pessimistic climate change scenarios. <\/strong>A more transparent, detailed, picture from UNICEF on future global RUTF funding needs and gaps may facilitate local government investment in production capacity, expanded corporate sponsorships and donations,<a href=\"#_ftn23\" name=\"_ftnref23\">[23]<\/a> or new global initiatives to improve climate change resilience, food security, and RUTF supply chain<\/li>\n<li><strong>Better use of early warning systems to prepare response, inform production, and avoid costs of emergency orders.<a href=\"#_ftn24\" name=\"_ftnref24\">[24]<\/a> <\/strong>The most recent estimates suggest UNICEF places many emergency orders and reports suggest early warning systems are underutilized.<a href=\"#_ftn25\" name=\"_ftnref25\">[25]<\/a><a href=\"#_ftn26\" name=\"_ftnref26\">[26]<\/a><\/li>\n<li><strong>Technology solutions \u2013 e.g. drones \u2013 to reduce costs and time of last mile delivery\u00a0<a href=\"#_ftn27\" name=\"_ftnref27\">[27]<\/a> <\/strong><\/li>\n<\/ul>\n<p>If UNICEF aims to help the world achieve Sustainable Development Goal 2.2 of \u201celiminating child malnutrition by 2030,\u201d<a href=\"#_ftn27\" name=\"_ftnref27\">[28]<\/a> consideration of climate change related threats is imperative. What do you think UNICEF\u2019s most immediate steps should be to further strengthen the RUTF supply chain? More broadly how can UNICEF encourage governments and the private sector to invest in improving food security for the world\u2019s most vulnerable regions?<\/p>\n<p>Words: 798<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Sources<\/strong><\/p>\n<p><a href=\"#_ftnref1\" name=\"_ftn1\">[1]<\/a> UNCEF Supply Division, Ready to Use Therapeutic Foods, Current Outlook, 2017. <a href=\"https:\/\/www.unicef.org\/supply\/files\/Ready-to-use_Therapeutic_Food_Current_Outlook.pdf\">https:\/\/www.unicef.org\/supply\/files\/Ready-to-use_Therapeutic_Food_Current_Outlook.pdf<\/a><\/p>\n<p><a href=\"#_ftnref2\" name=\"_ftn2\">[2]<\/a> UNICEF, UNSSCN, WFP, WHO, Community-Based Management of Severe Acute Malnutrition &#8211; A Joint Statement by the WHO, WFP, UNSSCN, UNICEF, UNICEF, New York, May 2007, p. 2. <a href=\"https:\/\/www.unicef.org\/publications\/files\/Community_Based_Management_of_Sever_Acute__Malnutirtion.pdf\">https:\/\/www.unicef.org\/publications\/files\/Community_Based_Management_of_Sever_Acute__Malnutirtion.pdf<\/a><\/p>\n<p><a href=\"#_ftnref3\" name=\"_ftn3\">[3]<\/a> UNCEF Supply Division, Ready to Use Therapeutic Foods, Current Outlook, 2017. <a href=\"https:\/\/www.unicef.org\/supply\/files\/Ready-to-use_Therapeutic_Food_Current_Outlook.pdf\">https:\/\/www.unicef.org\/supply\/files\/Ready-to-use_Therapeutic_Food_Current_Outlook.pdf<\/a><\/p>\n<p><a href=\"#_ftnref4\" name=\"_ftn4\">[4]<\/a> Manary, Mark. Local production and provision of ready-to-use therapeutic food for the treatment of severe childhood malnutrition. Technical Background Paper for UN, WHO, and UNICEF. 2005. <a href=\"http:\/\/www.who.int\/nutrition\/topics\/backgroundpapers_Local_production.pdf\">http:\/\/www.who.int\/nutrition\/topics\/backgroundpapers_Local_production.pdf<\/a>; RUTF Global Demand, <a href=\"https:\/\/www.unicef.org\/supply\/files\/UNICEF_RUTF_Demand_Sep_2016.pdf\">https:\/\/www.unicef.org\/supply\/files\/UNICEF_RUTF_Demand_Sep_2016.pdf<\/a><\/p>\n<p><a href=\"#_ftnref5\" name=\"_ftn5\">[5]<\/a>\u00a0RUTF Prices and Suppliers. UNICEF. 2017. https:\/\/www.unicef.org\/supply\/files\/Copy_of_RUTF_Prices_for_internet_11.pdf; UNCEF Supply Division, Ready to Use Therapeutic Foods, Current Outlook, 2017. <a href=\"https:\/\/www.unicef.org\/supply\/files\/Ready-to-use_Therapeutic_Food_Current_Outlook.pdf\">https:\/\/www.unicef.org\/supply\/files\/Ready-to-use_Therapeutic_Food_Current_Outlook.pdf<\/a><\/p>\n<p><a href=\"#_ftnref6\" name=\"_ftn6\">[6]<\/a> UNICEF covers 15% of global need, other organizations collectively cover 5%.<\/p>\n<p><a href=\"#_ftnref7\" name=\"_ftn7\">[7]<\/a> UNCEF Supply Division, Ready to Use Therapeutic Foods, Current Outlook, 2017. <a href=\"https:\/\/www.unicef.org\/supply\/files\/Ready-to-use_Therapeutic_Food_Current_Outlook.pdf\">https:\/\/www.unicef.org\/supply\/files\/Ready-to-use_Therapeutic_Food_Current_Outlook.pdf<\/a><\/p>\n<p><a href=\"#_ftnref8\" name=\"_ftn8\">[8]<\/a> Jayashankar M. Swaminathan, UNICEF\u2019S Plumpy Nut Supply Chain, Center for Sustainable Development, UNC Kenan Flagler School of Business. 2009.\u00a0https:\/\/www.kenan-flagler.unc.edu\/~\/media\/Files\/documents\/cse\/unicef-plumpy-nut-supply-chain.pdf<\/p>\n<p><a href=\"#_ftnref9\" name=\"_ftn9\">[9]<\/a> OXFAM, A Climate in Crisis, April 2017. <a href=\"https:\/\/www.oxfam.org\/sites\/www.oxfam.org\/files\/mb-climate-crisis-east-africa-drought-270417-en.pdf\">https:\/\/www.oxfam.org\/sites\/www.oxfam.org\/files\/mb-climate-crisis-east-africa-drought-270417-en.pdf<\/a><\/p>\n<p><a href=\"#_ftnref10\" name=\"_ftn10\">[10]<\/a> Global Peanut Prices, <a href=\"http:\/\/www.indexmundi.com\/commodities\/?commodity=peanuts&amp;months=120\">http:\/\/www.indexmundi.com\/commodities\/?commodity=peanuts&amp;months=120<\/a><\/p>\n<p><a href=\"#_ftnref11\" name=\"_ftn11\">[11]<\/a> Mbazi, Morgan, Milk prices in Uganda shoot up as supply drops due to drought, The East African, March 9 2017,\u00a0 <a href=\"http:\/\/www.theeastafrican.co.ke\/news\/Milk-prices-Uganda-drought\/2558-3843796-j3c2e4\/index.html\">http:\/\/www.theeastafrican.co.ke\/news\/Milk-prices-Uganda-drought\/2558-3843796-j3c2e4\/index.html<\/a><\/p>\n<p><a href=\"#_ftnref12\" name=\"_ftn12\">[12]<\/a> United Nations Childrens Fund. A Supply Chain Analysis of Ready to Use Therapeutic Foods for the Horn of Africa. <a href=\"https:\/\/www.unicef.org\/supply\/files\/SUPPLY_CHAIN_ANALYSIS_OF_READY-TO-USE_THERAPEUTIC_FOODS_FOR_THE_HORN_OF_AFRICA.pdf\">https:\/\/www.unicef.org\/supply\/files\/SUPPLY_CHAIN_ANALYSIS_OF_READY-TO-USE_THERAPEUTIC_FOODS_FOR_THE_HORN_OF_AFRICA.pdf<\/a><\/p>\n<p><a href=\"#_ftnref13\" name=\"_ftn13\">[13]<\/a> Cervigni, et al. Enhancing the climate resilience of Africa\u2019s Infrastructure: the roads and bridges sector. Washington, D.C. World Bank Group. <a href=\"http:\/\/documents.worldbank.org\/curated\/en\/270671478809724744\/Enhancing-the-climate-resilience-of-Africa-s-Infrastructure-the-roads-and-bridges-sector\">http:\/\/documents.worldbank.org\/curated\/en\/270671478809724744\/Enhancing-the-climate-resilience-of-Africa-s-Infrastructure-the-roads-and-bridges-sector<\/a><\/p>\n<p><a href=\"#_ftnref14\" name=\"_ftn14\">[14]<\/a>Mason et al, Child Acute Malnutrition and Mortality in Populations Affected by Displacement in the Horn of Africa, 1997\u20132009. International Journal of Environment Research and Public Health. 2012 Mar; 9(3): 791\u2013806. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3367278\/\">https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3367278\/<\/a><\/p>\n<p><a href=\"#_ftnref15\" name=\"_ftn15\">[15]<\/a> Pereira et al. Climate Change Impacts on Agriculture across Africa, Oxford University Press. March 2017. <a href=\"http:\/\/environmentalscience.oxfordre.com\/view\/10.1093\/acrefore\/9780199389414.001.0001\/acrefore-9780199389414-e-292\">http:\/\/environmentalscience.oxfordre.com\/view\/10.1093\/acrefore\/9780199389414.001.0001\/acrefore-9780199389414-e-292<\/a><\/p>\n<p><a href=\"#_ftnref16\" name=\"_ftn16\">[16]<\/a> Manary, Mark. Local production and provision of ready-to-use therapeuticfood for the treatment of severe childhood malnutrition. Technical Background Paper for UN, WHO, and UNICEF. 2005. <a href=\"http:\/\/www.who.int\/nutrition\/topics\/backgroundpapers_Local_production.pdf\">http:\/\/www.who.int\/nutrition\/topics\/backgroundpapers_Local_production.pdf<\/a><\/p>\n<p><a href=\"#_ftnref17\" name=\"_ftn17\">[17]<\/a> UNCEF Supply Division, Ready to Use Therapeutic Foods, Current Outlook, 2017. <a href=\"https:\/\/www.unicef.org\/supply\/files\/Ready-to-use_Therapeutic_Food_Current_Outlook.pdf\">https:\/\/www.unicef.org\/supply\/files\/Ready-to-use_Therapeutic_Food_Current_Outlook.pdf<\/a><\/p>\n<p><a href=\"#_ftnref18\" name=\"_ftn18\">[18]<\/a> UNCEF Supply Division, Ready to Use Therapeutic Foods, Current Outlook, 2017. <a href=\"https:\/\/www.unicef.org\/supply\/files\/Ready-to-use_Therapeutic_Food_Current_Outlook.pdf\">https:\/\/www.unicef.org\/supply\/files\/Ready-to-use_Therapeutic_Food_Current_Outlook.pdf<\/a><\/p>\n<p><a href=\"#_ftnref19\" name=\"_ftn19\">[19]<\/a> Nutriset Website <a href=\"http:\/\/www.nutriset.fr\/en\/production\/nutriset-industrial-know-how\/\">http:\/\/www.nutriset.fr\/en\/production\/nutriset-industrial-know-how\/<\/a><\/p>\n<p><a href=\"#_ftnref20\" name=\"_ftn20\">[20]<\/a>\u00a0Goentzel,\u00a0Jarrod and\u00a0Swaminathan,\u00a0Jayashankar.\u00a0UNICEF RUTF Supply Chain (B): Developing a Global Supply Network. UNC Kenan Flagler School of Business. January 2015.\u00a0<a href=\"http:\/\/public.kenan-flagler.unc.edu\/Faculty\/swaminaj\/Global-Health\/UNICEF%20Supply%20Network.pdf\">http:\/\/public.kenan-flagler.unc.edu\/Faculty\/swaminaj\/Global-Health\/UNICEF%20Supply%20Network.pdf\u00a0<\/a>; Manary, Mark. Local production and provision of ready-to-use therapeutic food for the treatment of severe childhood malnutrition. Technical Background Paper for UN, WHO, and UNICEF. 2005. <a href=\"http:\/\/www.who.int\/nutrition\/topics\/backgroundpapers_Local_production.pdf\">http:\/\/www.who.int\/nutrition\/topics\/backgroundpapers_Local_production.pdf;\u00a0<\/a><\/p>\n<p><a href=\"#_ftnref21\" name=\"_ftn21\">[21]<\/a> UNCEF Supply Division, Ready to Use Therapeutic Foods, Current Outlook, 2017. <a href=\"https:\/\/www.unicef.org\/supply\/files\/Ready-to-use_Therapeutic_Food_Current_Outlook.pdf\">https:\/\/www.unicef.org\/supply\/files\/Ready-to-use_Therapeutic_Food_Current_Outlook.pdf<\/a><\/p>\n<p><a href=\"#_ftnref22\" name=\"_ftn22\">[22]<\/a> UNCEF Supply Division, Ready to Use Therapeutic Foods, Current Outlook, 2017. <a href=\"https:\/\/www.unicef.org\/supply\/files\/Ready-to-use_Therapeutic_Food_Current_Outlook.pdf\">https:\/\/www.unicef.org\/supply\/files\/Ready-to-use_Therapeutic_Food_Current_Outlook.pdf<\/a><\/p>\n<p><a href=\"#_ftnref23\" name=\"_ftn23\">[23]<\/a> See full list of corporate partnerships here: <a href=\"https:\/\/www.unicef.org\/corporate_partners\/index_25124.html\">https:\/\/www.unicef.org\/corporate_partners\/index_25124.html<\/a><\/p>\n<p><a href=\"#_ftnref24\" name=\"_ftn24\">[24]<\/a> United Nations Childrens Fund. A Supply Chain Analysis of Ready to Use Therapeutic Foods for the Horn of Africa. <a href=\"https:\/\/www.unicef.org\/supply\/files\/SUPPLY_CHAIN_ANALYSIS_OF_READY-TO-USE_THERAPEUTIC_FOODS_FOR_THE_HORN_OF_AFRICA.pdf\">https:\/\/www.unicef.org\/supply\/files\/SUPPLY_CHAIN_ANALYSIS_OF_READY-TO-USE_THERAPEUTIC_FOODS_FOR_THE_HORN_OF_AFRICA.pdf<\/a><\/p>\n<p><a href=\"#_ftnref25\" name=\"_ftn25\">[25]<\/a> OXFAM, A Climate in Crisis, April 2017. <a href=\"https:\/\/www.oxfam.org\/sites\/www.oxfam.org\/files\/mb-climate-crisis-east-africa-drought-270417-en.pdf\">https:\/\/www.oxfam.org\/sites\/www.oxfam.org\/files\/mb-climate-crisis-east-africa-drought-270417-en.pdf<\/a><\/p>\n<p><a href=\"#_ftnref26\" name=\"_ftn26\">[26]<\/a> UN News Centre, Famine signs must never be ignored again as they were in Somalia. September 2017. <a href=\"http:\/\/www.un.org\/apps\/news\/story.asp?NewsID=39835#.WgyudGhSw2w\">http:\/\/www.un.org\/apps\/news\/story.asp?NewsID=39835#.WgyudGhSw2w<\/a><\/p>\n<p><a href=\"#_ftnref27\" name=\"_ftn27\">[27]<\/a>\u00a0Peters, Adele. This Humanitarian, Aid-Delivering Drone Is Going To Be Edible. <a href=\"https:\/\/www.fastcompany.com\/3064094\/this-humanitarian-aid-delivering-drone-is-going-to-be-edible\">https:\/\/www.fastcompany.com\/3064094\/this-humanitarian-aid-delivering-drone-is-going-to-be-edible<\/a> UPS and CyPhy Works Test Drone for Urgent Commercial Last Mile Delivery. September 2016. <a href=\"http:\/\/www.supplychain247.com\/article\/ups_and_cyphy_works_test_drone_for_urgent_commercial_delivery\">http:\/\/www.supplychain247.com\/article\/ups_and_cyphy_works_test_drone_for_urgent_commercial_delivery\u00a0<\/a><\/p>\n<p><a href=\"#_ftnref27\" name=\"_ftn27\">[28]<\/a><a href=\"#_ftnref27\" name=\"_ftn27\">\u00a0<\/a>UNCEF Supply Division, Ready to Use Therapeutic Foods, Current Outlook, 2017. <a href=\"https:\/\/www.unicef.org\/supply\/files\/Ready-to-use_Therapeutic_Food_Current_Outlook.pdf\">https:\/\/www.unicef.org\/supply\/files\/Ready-to-use_Therapeutic_Food_Current_Outlook.pdf<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>UNICEF must address climate change threats to build a more resilient supply chain for ready-to-use therapeutic foods essential to treating malnutrition<\/p>\n","protected":false},"author":9701,"featured_media":24577,"comment_status":"open","ping_status":"closed","template":"","categories":[89,1218,1356,1226,4126,423,4125,4127,4128],"class_list":["post-24576","hck-submission","type-hck-submission","status-publish","has-post-thumbnail","hentry","category-africa","category-climate-change","category-drought","category-global-warming","category-malnutrition","category-ngo","category-peanuts","category-sdgs","category-unicef","hck-taxonomy-organization-unicef","hck-taxonomy-industry-health","hck-taxonomy-country-france"],"connected_submission_link":"https:\/\/d3.harvard.edu\/platform-rctom\/assignment\/rc-tom-challenge-2017\/","yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - 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