USAID transition stalls action: RUTF warehouses fill as nutrition clinics brace shutdown

With USAID nutrition funding on pause and no clear directives in sight, manufacturers and field teams say the system meant to prevent child deaths from severe malnutrition is grinding to a halt. Edesia, a company that produces therapeutic food for 65 countries, CEO Navyn Salem tells Nutrition Insight that operations have slowed to 40% capacity and warehouses are filling up with products that can’t be shipped.

Meanwhile, Action Against Hunger warns frontline clinics face looming closures and layoffs, raising fears that the funding freeze could cost millions of lives.

Edesia manufactures Plumpy’Nut, a peanut-soy paste with milk powder, sugar, vitamins, and minerals that is produced weekly to help treat and prevent malnutrition. Navyn explains that two things happen inside a factory like hers when funding suddenly disappears while the product demand multiplies.

“You slow down production to give the government more time to give direction,” she says. “Then, with nowhere to go, the product starts piling up in warehouses that cost money, and eventually, you run out of space.”

“We’ve spent about US$450,000 in extra storage expenses this year because it’s not moving. We’ve been running at 40% capacity all year to deliberately slow down orders until we can start shipping again.”

Edesia is fundraising to compensate for the shortfall, working with small NGOs directly.

“This doesn’t solve the problem at a massive scale, but on a smaller scale, it’s helpful in the interim,” adds Salem. “Economists will tell you that treating a child for malnutrition has the highest return on investment that you can make.”

“Building a child’s intellectual capacity is the single most important thing that you can do for a young child. Malnutrition is also the underlying cause of 50% of childhood deaths that wouldn’t happen if a child were well nourished,” she says.

Ready to continue operations 

According to Salem, Edesia has not turned away from urgent ready-to-use therapeutic food (RUTF) requests. She points to the problem of balancing ethical responsibility and financial survival.

Navyn Salem, CEO of Edesia.“If someone comes to us and needs RUTF, we figure out how to get it to them. Financial survival? We weren’t paid for four months — that was challenging. But I’m not making decisions between ethics and finances.”

Edesia has planned every scenario for each product mix and quantity in case the State Department asks. With a two-week shutdown, Edesia is giving the State Department time to complete USAID’s transition from an independent agency — reintroduced as the US Agency for International Humanitarian Assistance, according to reports.

“What’s stopping us from executing on that is a piece of paper with some information on the basic numbers of what they actually need. So when we get those numbers, we plug them into the right scenario, and depending on how extreme that is, it may take time to scale up, but we can increase to our normal capacity within a few days,” says Salem.

She adds that she’s doing what she can to get the life-saving system back on as soon as possible.

“I’ve seen too many times mothers and children coming to clinics who have only hours or days to live if they’re not treated,” continues Salem. “Try to imagine sitting next to someone who’s going to lose their child when the treatment that would save their life is stuck in a warehouse because of poor decision-making.”

“If we could prevent children from suffering from severe acute malnutrition in the first place and put Edesia totally out of business due to lack of need, that is my ideal scenario. But that’s for another day,” she states.

On-the-ground scenario 

Denish Ogen Rwot, South Sudan communication and advocacy lead at Action Against Hunger, tells us that with dwindling supplies, its volunteers and staff face unemployment once RUTF runs out.

South Sudan loses emergency nutrition teams with more shutdowns expected (Image credit: Nicolas Ossard).“We had an emergency team that was 100% USAID-funded for rapid response. This fully equipped team with nutrition specialists, clinical officers, and support staff could deploy and respond to emergencies like cholera outbreaks, floods, or a mass influx of refugees. This team was instrumental for over five years but had to shut down completely.” 

“Communities will keep coming to our marked facilities expecting treatment, but we’ll have nothing. We’ll slowly have to start closing even more locations.”

A new study, published in The Lancet, has found that USAID may cause 14 million additional deaths by 2030 if the abrupt funding cuts over the past few months are reversed.

“Current and proposed US aid cuts — along with the probable ripple effects on other international donors — threaten to abruptly halt and reverse one of the most important periods of progress in human development,” warn the authors.

“For many low-income and middle-income countries, the resulting shock would be similar in scale to a global pandemic or a major armed conflict. Unlike those events, however, this crisis would stem from a conscious and avoidable policy choice — one whose burden would fall disproportionately on children and younger populations and whose consequences could reverberate for decades.”

In a previous interview, Salem told us she remains optimistic, as opportunities may arise with USAID coming under state control this Tuesday. This week, the Fourth International Conference on Financing for Development also took place to raise life-saving funding.