When Life-Saving Treatment Disappears: A Child Crisis Looms

A young boy in Mozambique sleeps next to a bag of food aid donated by USAID and distributed by the UN’s World Food Programme.

On July 1st, USAID officially shut down and transferred operations to the U.S. State Department. Amid growing uncertainty about the future of U.S. foreign assistance structures and funding, supply chains that deliver life-saving treatment to malnourished children worldwide have broken down, triggering a global nutrition crisis.

We are witnessing the dismantling of a system that has saved millions of children’s lives for decades. The consequences will reverberate across the world: from peanut farms in Georgia to remote clinics in South Sudan, creating a humanitarian catastrophe that could have been prevented.

For more than two decades, the American people have supported the production, shipment, and administration of treatment packets, called ready-to-use therapeutic food (RUTF), to save the lives of children suffering from a severe form of malnutrition, which affects 19 million children worldwide at any given moment.

These RUTF packets of specially formulated, nutrient-dense paste, often branded as “Plumpy’nut,” boast recovery rates exceeding 90% and can bring a child from medical crisis to health in as little as 45 days. Without treatment, survival rates are low, as a malnourished child is 11 times more likely to die than a healthy one.

Today, it all hangs in the balance. Our world has seen immense progress in preventing child deaths from malnutrition; unless we act fast and funding cuts are reversed, all our progress will regress 30 years seemingly overnight.

The numbers tell a devastating story. The closure of USAID and transfer of operations to the U.S. State Department has left 90% of all USAID contracts terminated, including $1.4 billion in emergency nutrition programming that, in part, supported approximately 50 percent of the global RUTF supply.

As a result, production of RUTF has halted, with most manufacturers receiving no new orders since December 2024. Eighteen countries face RUTF stockouts set to begin this month, creating a shortage of over two million cartons that could treat over two million malnourished children.

With supply chains requiring 3 to 6 months to produce, transport, and deliver the life-saving treatment to children who need it, time has run out.

Countries like South Sudan, Ethiopia, and Nigeria that are already grappling with conflict, climate shocks, and displacement will be among the first and hardest hit. In South Sudan alone, nutrition response funding has been slashed nearly in half, leaving one in two severely malnourished children without treatment. UNICEF estimates that Ethiopia will run out of RUTF supplies imminently.

The reality on the ground is stark: RUTF stockouts mean mothers will bring their children to health and nutrition centers only to be turned away because there’s no available treatment. Even before the current crisis, millions of children would lose the fight against malnutrition, given limited resources. Now, that number is going to rise rapidly.

Nutrition and health services have always been integrated: malnourished children with medical complications often require referral to health facilities for further medical care in addition to the nutrition treatment. A malnourished child with a weakened immune system who contracts malaria may not survive because their body cannot fight off the simple illness.

But now, funding cuts for health programs have drastically reduced treatment for illnesses such as tuberculosis, malaria, and HIV, which, alongside cuts to nutrition programs, create a perfect storm. These preventable, treatable conditions become matters of life and death.

RUTF’s introduction nearly 30 years ago has revolutionized our fight against child mortality. Experts estimate that before RUTF, child survival from malnutrition was about 25%; with RUTF, it’s over 90%. Leading scientists and researchers were conducting rigorous research investigating how to optimize the dosage of RUTF and piloting new formulations to make limited resources stretch to reach more children in need of treatment.

Other innovative research on preventing relapse through gut microbiome restoration was showing tremendous promise for sustainable solutions and conserving resources. Together with improved public health programs, our world has seen annual child mortality rates drop from 12.9 million in 1990 to 4.8 million in 2023.

With the current uncertainty around U.S. humanitarian aid funding, the immediate outlook is very bleak, and doubts grow every day regarding the longer-term projections for any continuation in reducing child mortality worldwide. From a humanitarian perspective, it’s criminally irresponsible to stop trying to give every child a chance at life past their fifth birthday.

The crisis is not confined to remote nutrition clinics in foreign countries. American agricultural communities that supply raw ingredients for the life-saving RUTF are also hit hard. Peanut farmers in rural Georgia and dairy farmers across the country, critical to the RUTF supply chain, now face canceled contracts and uncertain futures.

MANA Nutrition in Fitzgerald, Georgia — which has produced RUTF to treat 10 million children across the globe since 2010 — estimates it has enough cash to keep running through August at best if no new contracts materialize.

The irony is profound: feeding children, mothers, and families has always been a deeply bipartisan American value. Emergency food assistance aligns with foreign policy priorities: it’s measurable, cost-effective, and builds lasting goodwill. These relationships also helped American farmers put food on their own families’ tables.

Other efforts were ongoing to increase local production of RUTF in countries where it is needed the most, creating jobs, bolstering local economies, and establishing self-sustaining solutions within each country’s challenges. But these smaller and newer RUTF manufacturers in the global south can only supply a fraction of what’s needed and have fewer reserves to be able to withstand the gap in revenue.

Earlier this month, the U.S. State Department announced approval of $50 million for RUTF, representing 1.4 million boxes of the life-saving supplies that could “nourish over one million of the world’s most vulnerable children.” While this represents welcome progress after months of uncertainty, the amount is minimal compared to the need, and still no contracts have been confirmed. So we wait.

Meanwhile, every 11 seconds, a child dies from malnutrition-related causes. These aren’t abstract statistics—they’re preventable deaths of children who could be saved for about $150 a child. The dismantling of USAID represents more than a policy change—it’s a moral choice about America’s role in the world and our commitment to the most vulnerable.

There’s nothing more devastating than looking a mother in the eyes when both of you know that her child probably won’t make it to their next birthday, or perhaps even to the end of the week. Previously, that situation was becoming less frequent. However, now, I shudder to think how many more mothers around the world will be in this situation.

The clock is ticking, and children’s lives hang in the balance. As supply chains collapse and treatment centers close, the time to act is now, before this preventable crisis becomes an irreversible global tragedy.