Of particular interest, when does the Plumpy’nut patent expire? I had assumed a standard term of 14 to 20 years. Needs checking.

Herewith Stephanie’s e-mail (published with permission):

I just read your blog posts. Very interesting topic! Coincidentally, a
colleague and I just gave a two hour presentation on Ready-To-Use Therapeutic Foods (Plumpy’Nut) as an approach to treating children with severe acute malnutrition.

After reading your blog, I had a few initial thoughts and questions to share with you.

First – and you might want to triangulate this statement with other people – Plumpy’nut is considered to have revolutionized the way children with severe acute malnutrition (SAM) are treated. Now, instead of spending 30+ days in the hospital or nutritional feeding centers, they can be treated at home by their primary caregiver. Additionally, children are recovering more quickly, and there is no preparation necessary to give them the PN (i.e., no need to add water). PN is cheaper than the traditional mode of treatment and it tastes better.

However, there is still more research that needs to be done to measure the relapse rate of children on Plumpy’nut. For example, are children treated with PN less likely to relapse than children treated with F100?

Second – have you talked with Nutriset? It would be interesting to know why they decided to patent the formula. Also, what is it about the formula that requires patenting? The proportions of ingredients?

I believe the patent is due to expire next year, so an interesting question to consider is what has been the effect of this patent for the past five years? Were more children excluded? Was PN more expensive than it otherwise would have been? To what extent did patenting limit production?

It’s possible that the implications for the future will be more interesting than the findings on cost and access. Even with some restricted access and slightly higher cost for PN, using RUTFs to treat SAM is still way more effective and less expensive than hospitalizing kids
and treating with F100.

Ex Christine: F100 is a milk-based therapeutic food for the treatment of severe malnutrition. Also, it would be good to contact Nutriset but I think a little more background research is in order first. Of course, given this highly interconnected world we live in, Nutriset may post on the blog first?

I asked Cash after class at Harvard’s School of Public Health earlier this week whether he had ever sought a patent for ORT. He said that as a member of the US Public Health Service (with the NIH) in 1968, he doesn’t think patenting was an option for him or his colleagues. Also, he admitted, it never really crossed his mind. Perhaps if it had, he said with a twinkle in his eye, he might not still be teaching at the School of Public Health.

Did the lack of a patent make it more difficult to get businesses to consider manufacturing and marketing ORT? Yes, at first, he said. Business people he talked to didn’t believe that they could make money through branding the product rather than on the basis of an exclusive monopoly. And yet, “look at aspirin,” Cash pointed out. “There hasn’t been a patent on aspirin for years and yet people still make money selling it.”

ORT, for those who aren’t familiar with it, is a very basic combination of a pinch of salt, a handful of sugar and 500 ml of clean water, that replaces the electrolytes lost during a bout of severe diarrhea. It doesn’t cure diarrhea but it prevents deaths from severe diarrhea, particularly in situations where access to medical care is severely limited. ORT has saved literally millions of lives over the past 40 years.

Cash and others worked with BRAC, the giant non-governmental organization in Bangladesh, to teach women how to stir up their own ORT solutions and treat their children on their own in the 1970s. (Hence the basic recipe of a pinch of salt, a handful of sugar and 500 ml of clean water. How do you get poor women to approximate 500 ml of water when they don’t have measuring cups of their own? You take one measuring cup and fill up each woman’s own pot with 500 ml of water. She then puts a mark on her own cooking pot or pan showing where the fill line is for 500 ml.)

A number of businesses also now sell packets of ORT to NGOs, governments, international travellers and the like. If you’ve ever given Pedialyte (made by Abbott Labs) to treat one of your kids who has been sick all night vomiting or with diarrhea, you can thank Richard Cash and his public health colleagues for figuring out, testing and validating the original formula.

Read more in Peter Calveley’s own words.

Some background: Plumpy’nut is a combination of peanut butter and powdered milk with a few vitamins and minerals thrown in for good measure. Ever since the mixture was introduced to humanitarian organizations a few years ago, it has saved the lives of many malnourished children around the world and garnered Nutriset, the company that makes it, a great deal of positive press. Often overlooked, however, is the fact that Nutriset has patented Plumpy’nut.

The questions we’re trying to explore: What effect–for good or for ill or somewhere in between–has the patent(s) on Plumpy’nut had on meeting the needs of malnourished children? Has patenting Plumpy’nut attracted greater investment in an otherwise overlooked field? Has it hindered the ability of humanitarian groups to make their own peanut-packed mixes? We invite you to help explore these and other questions.