30 years of a lifesaving 'peanut paste'  

This year marks 30 years since the development of ready-to-use therapeutic food (RUTF), a small sachet of fortified 'peanut paste'. Approved in 1996, this lifesaving paste has revolutionised the care of children with severe acute malnutrition, underpinning one of the most significant public health nutrition breakthroughs of our time.  

Over the past three decades, UNICEF has delivered 8.7 billion sachets to children living in the world’s most challenging environments, making UNICEF the largest supplier of RUTF globally. 

This milestone reflects extraordinary progress. But it also highlights how much work remains. 

Today, more than 12 million children are suffering from severe wasting, the deadliest form of malnutrition. Children with severe wasting are dangerously thin for their height, with weakened immune systems that leave them vulnerable to common childhood illnesses. Their risk of death is 12 times higher than that of well-nourished children. 

Ready-to-use therapeutic food has played a critical role in driving down preventable child deaths and transformed how lifesaving treatment is delivered. But how did this miracle ‘peanut paste’ come to have such a profound impact? 

The impact of lifesaving 'peanut paste'

The ‘wonder food’ that saves children’s lives

RUTF is made from peanuts, sugar, milk powder, oil, vitamins and minerals. Each ready-to-eat sachet contains around 500 calories and provides the full balance of nutrients a child needs to recover from severe acute malnutrition. 

Before this sachet was developed 30 years ago, treatment often required weeks of hospitalisation, for both the child and their caregiver. For families living in remote or conflict-affected areas, that often meant treatment was simply out of reach. RUTF changed that. For the first time, children could be treated at home, as the paste requires no preparation, refrigeration, or clean water. 

“It’s made treatment far more accessible,” Alison says. “Being able to treat children at home means we can reach so many more families.” 

With a long shelf life and no need for cooking or water, RUTF can be safely transported and distributed in even the most challenging emergency settings. 

A child’s journey to recovery 

UNICEF Australia Ambassador Adam Liaw has witnessed the lifesaving impact of this 'peanut paste' firsthand during a visit to Burundi, where more than 60 per cent of children under five in rural areas are stunted – a sign of chronic undernutrition that leaves children short for their age and can permanently limit their physical, growth, learning and development.  

During his visit, Adam met a mother of seven whose husband had left, leaving her to care for her children alone. Her youngest child had been hospitalised with severe acute malnutrition and was beginning to recover with the help of RUTF.  

How a small sachet reaches children worldwide 

When this lifesaving 'peanut paste' was first developed, there were no qualified local manufacturers. A single international supplier produced the sachets, which were then shipped around the world.  

Today, that is very different. UNICEF works with 23 suppliers across Africa, the Americas, Asia and Europe. Most are based in lower-income countries, where it can be used locally and exported to neighbouring countries. 

Local production delivers multiple benefits. It allows treatment to reach children faster in emergencies, creates local jobs, strengthens local economies and reduces environmental impact by minimising long-distance transport. 

What’s next for the lifesaving peanut sachet? 

For three decades, ready-to-use therapeutic food has relied primarily on milk powder and peanuts. While highly effective, these ingredients are also costly, accounting for around two-thirds of production, and their availability can fluctuate by country and season.   

To address this, UNICEF is leading the development of new formulations that use alternative, locally available ingredients. The goal is to make RUTF, like the 'peanut paste', more sustainable and affordable especially in countries where malnutrition is highest.  

Soybeans and chickpeas have emerged as promising options. Both are high in protein and widely grown across Africa and South Asia, where the need for treatment is greatest. 

In Ethiopia, UNICEF is supporting trials of a new recipe that uses locally sourced ingredients. As one of the world’s largest producers of chickpeas, a crop that is widely available and more affordable than peanuts, Ethiopia offers a strong case for adapting RUTF to local diets and agriculture systems. 

Similar trials are also taking place in Sri Lanka, where peanuts are not a common part of children’s diets. There, alternative formulations using ingredients such as soybeans, coconut oil and canola oil have been developed and tested, with strong acceptance among families – highlighting the importance of adapting treatment to local diets and preferences. 

What we can continue achieving together 

As we mark 30 years of this low cost and innovative way of treating child malnutrition, we celebrate the millions of children whose lives have been saved, while recognising the urgent work still ahead. 

Today, children around the world continue to suffer from severe malnutrition. In 2025, famine conditions in parts of Sudan have pushed more children to the brink. As this global crisis deepens, projections for 2026 estimates that 33 million children will need to be screened for wasting.  

RUTF remains one of the most effective and accessible solution available. It costs just $64 AUD for a full 6–8-week course of treatment and can help a child recover from the most severe form of malnutrition. 

But reaching every child who needs this lifesaving treatment is only possible through the sustained commitment and generosity of people like you.