What's Inside the Tiny Miracle Food Pouches That Can Save the Lives of Starving Gazans

WIRED

5 days ago

Aug 4, 2025 7:00 AM Packed with calories and protein, the same magic mixture has successfully treated famine for decades—but due to funding cuts it's now in short supply. Photo-Illustration: WIRED Staff; Nutriset; Getty Images
Take a peanut-based paste packed with 500 calories and nearly 13 grams of protein. Store it in a 92-gram foil pouch, so it can be easily sucked by starving infants on the front line. No water or refrigeration is required, meaning it can be distributed in drought-hit areas and stored at ambient temperature for up to two years. Just a couple of daily sachets can lead to a 10 percent weight gain over six weeks, sustaining recovery from severe acute malnutrition for less than $60 per child. Saving a life, it turns out, literally costs peanuts: just 71 cents a serving.
This life-saving mixture is Plumpy'Nut. Developed by Normandy-based manufacturer Nutriset in 1996 by French paediatrician André Briend, it was the first ready-to-use therapeutic food (RUTF): energy-dense pastes that have boosted survival rates of severe acute malnutrition in children from less than 25 per cent to around 90 percent.
The paste has saved tens of millions of lives. 'It's incredibly effective emergency food,' says medical doctor Steve Collins, founder of advocacy group Valid Nutrition. 'RUTF contains all the essential nutrients required for someone to recover from severe acute malnutrition. They're easy to transport, extremely energy dense, and don't require a cold supply chain or clean water to work.'
While Nutriset's product was the first RUTF to be developed, it is not the only brand in this important field. Mana, for example, is an American-made RUTF produced in Fitzgerald, Georgia. The company states it can make 500,000 pounds of product per day—enough to fill four shipping containers, and feed 10 million children per year.
Before Plumpy'Nut, cases of severe acute malnutrition—primarily occurring among children under 5 years old, diagnosed by very low weight-for-height scores and arm circumference—needed round-the-clock care at therapeutic feeding centres. Nurses at these makeshift hospitals in often remote areas would feed infants F100, a high-energy milk powder also made by Nutriset. Bacteria was often rife. 'There was always a risk that water was contaminated and carried disease,' says Collins. It's one of the reasons why mortality rates for in-patient care lurked at around 20 percent.
Over half of Plumpy'Nut is made from peanut paste and vegetable oils. The nutty primary base contains fat-soluble nutrients, as well as protein, energy, and fatty acids that spark recovery. Nearly a quarter is skimmed milk powder, containing dairy protein and essential amino acids, the building blocks of protein. Another quarter is reserved for sugar—masking the taste of the added micronutrients: potassium, magnesium, calcium, iron, zinc, iodine, copper, selenium, and vitamins A, D, E, B complex, C, and K.
The apocryphal story is that Briend's idea for the marvel that is Plumpy'Nut came from a jar of Nutella. In reality, it came from firsthand experience on the front line in the Sahel: The water-based solution wasn't working—infants were still dying. Working with Nutriset founder Michel Lescanne, his idea was to add F100 to a spread of peanuts (a common crop in areas of malnutrition and a natural protein-rich source) with oil and sugar.
High in calories, low in maintenance, Plumpy'Nut didn't require cooling nor mixing before eating. Its oil base removed the risk of bacterial contamination. And most of its energy is released through fat, meaning quick absorption of micronutrients.
Employees in 2005 at Nutriset working on the peanut-based RUTF Plumpy'nut manufacturing line in Malaunay in Normandy, France. The recipe remains practically unchanged 20 years later. Photograph:The premade RUTF sachet is a magic formula, says Collins. In starvation cases, refeeding syndrome can occur, a life-threatening metabolic condition in which nutrition that's too rapidly reintroduced leads to electrolyte imbalance. But RUTFs mean children can safely gain weight. 'As opposed to highly-concentrated formulas, where a child could easily overeat, parents can simply give their child RUTF and it's safe—the only limiting factor is appetite.'
Collins first came across Plumpy'Nut in the 1998 Sudan famine, where he set up therapeutic feeding centers. 'I quickly realized this was the future,' he says, 'and that these sachets had to be administered at home, not at in-patient facilities.' He helped establish Plumpy'Nut's first widescale rollout during the 2000 Ethiopia famine, and pioneered a new community-based model: Parents would provide the emergency food rather than health care workers. It was adopted by the United Nations in 2004, and mortality rates for severe acute malnutrition with RUTF treatment are now typically under 5 percent.
Besides reduced sachet plastic and minor refinement of vitamin and mineral premixes, Plumpy'Nut remains nearly the same 30 years on. 'No changes to the formulation have ever been done,' says Salima Boitout, group communication manager at Nutriset. It's still the RUTF gold standard. UNICEF is its number-one customer, distributing around 80 percent of the world's supply. It's why, despite the 20-year international patent expiring by 2018, very few alternative products have emerged, as they must meet strict technical composition guidelines set by the WHO and UNICEF.
Some RUTF have reached Gaza—but supplies are rapidly dwindling. Amid mounting evidence of widespread starvation and famine, these sachets are the number one treatment, says Emmanuel Berbain, nutrition adviser at Doctors Without Borders/Médecins Sans Frontières (MSF). 'From what we've seen on the ground, we're in a famine situation already, where deterioration isn't a matter of months, weeks, or days—it's hours.'
There were at least 63 malnutrition-related deaths in the Gaza Strip in July, including 24 children under 5, according to data from the WHO. Since May, aid has been run by the Israel-backed Gaza Humanitarian Foundation (GHF), led by private American contractors. Only four distribution centers are open to feed a population of more than 2 million.
Berbain says plenty of RUTF sachets lie at Israel's borders. More than 6,000 aid trucks, waiting in Egypt and Jordan, some only miles away from the Gazan border, are loaded with emergency food and medicine. But according to the United Nations Relief and Works Agency for Palestine Refugees (Unrwa), Israel has denied entry. Authorities have since announced that a daily convoy of 200 aid trucks can enter the strip. 'We know how to treat starvation, it's nothing new, and used in nearly every humanitarian crisis this century,' adds Berbain. 'Distributing pasta isn't enough—you need to cook it, which isn't feasible for many people. And a diet of just wheat can lead to malnourishment.'
Due to funding cuts, only around 36,000 tons of Plumpy'Nut RUTF was produced worldwide in 2024—approximately 1 million sachets a day. Photograph: Nutriset
As starvation bites and famine takes hold, MSF nutrition clinics in Gaza are fast running out of RUTF stock, claims Berbain. But there are broader supply chain concerns. The shuttering of USAID has led to hundreds of thousands of boxes of Plumpy'Nut sachets collecting dust in warehouses around the world.
With global aid distribution networks throttled, one stockpile includes 5,000 tons of Plumpy'Nut, worth $13 million, that could feed more than 484,000 children, according to US manufacturer Edesia. Part of Nutriset's PlumpyField global network, the Rhode Island site has operational capacity for 1.5 million Plumpy'Nut sachets a day—a sizable chunk of the 134,198 total tons of all Nutriset products processed by producers in 2023. However, due to funding cuts, just 72,000 tons of Nutriset RUTF and supplements were produced worldwide in 2024, half of which was Plumpy'Nut—approximately 1 million sachets a day.
US foreign aid cuts are also depleting UNICEF's RUTF stocks. It warned in March that supply was running short in 17 countries, affecting 2.4 million children suffering from severe acute malnutrition. Widespread famine is also occurring in Sudan. 'The pipeline is drying up,' says Kirk Prichard, vice president of programs for humanitarian charity Concern US. 'Cameroon is expected to run out of RUTF this month, with Nigeria and Somalia soon to follow.'
The US Department of State, which now administers foreign assistance programs following the official closure of USAID on July 1, didn't respond to a WIRED request for comment.
Collins has now developed a plant-based emergency food with similar efficacy to Plumpy'Nut but made with soy, maize, and sorghum. It could be the future of RUTF, provided to children with hidden lactose intolerance or peanut allergies. But funding for the project dried up in 2021, meaning Valid Nutrition's factory in Malawi had to be closed. The group is now exploring third-party processors to manufacture the product.
Collins believes it's symptomatic of a broader problem that's completely man-made: Politics often comes before the lives of innocent, starving people. 'With humanitarian access and space to operate, you could treat all cases in Gaza within a week with RUTF,' he says. 'Without it, recovery rates will be low and slow. They'll be more vulnerable to death.'