Recent Activities

Toddler Food Partners (TFP) has continued our activity in India. Here are some of the highlights.

Plans for 2015-2016

  • Initiate clinical trials with new formulas developed by Sion and IIT Bombay. TFP will provide funds for the cost of the new products as they are not covered by UNICEF grant.

  • Complete large scale field trial in Nandurbar district led by Tata Trust. TFP will continue to work with Hexagon and Tata trust to insure that locally produced MNT is available for the project.
  • Develop a holistic approach to the prevention of malnutrition in India by leveraging locally acceptable products with appropriate fortification. Project under consideration includes treatment of pregnant and lactating women as well as SAM/MAM children. Supplemental nutritional products appealing to the local population are being developed at IIT Bombay. The products will be field tested in several villages in the Ahmednagar district if Maharashtra. TFP will provide technical guidance with project partners—volunteers from General Mills India office, and Tata Center for Technology and Design at IIT Bombay.
  • TFP will continue to work with Hexagon Nutrition to enable them to meet all the International certification requirements for product quality and safety. TFP will assist them as they develop additional trials with MNT to treat SAM children with the State Governments of Maharashtra, Madhya Pradesh and Rajasthan.
  • TFP will continue to explore partnerships with like-minded entities in India to promote the use of MNT for the treatment of SAM children.

TFP Update: India MNT Project in Mumbai, March 2015

The project to introduce RUTF to treat children with severe acute malnutrition (SAM) in Mumbai is going well. Our goal is to create evidence to influence decision makers in India to approve this life-saving product for widespread use.

Ready to Use Therapeutic Foods (RUTF) have been recommended for the treatment of Severe Acute Malnutrition (SAM) by UNICEF since 2007. Typical treatment requires approximately 150 sachets of calorie dense, protein rich fortified food paste given over an 8 week period. For children without other medical complications the recovery rate is greater than 85%. The current International cost of the product itself is approximately $50 per child.

RUTF was banned in India in 2009 pending evaluations by Indian scientific community, clinical trials in India demonstrating its effectiveness versus current practices, evidence of its suitability in local population and indigenous manufacturing know-how. Several large projects were funded by the Department of Biotechnology (DBT) and a scientific panel was set up in 2010 to study the literature and make recommendations regarding the use of RUTF for the treatment of SAM in India. The Indian Academy of Pediatrics published a consensus statement in their journal; Indian Pediatrics April 2013, Volume 50, issue 4, pp 399-404. The statement includes the following;

Management of SAM should not be a stand-alone program. It should integrate with community management therapeutic programs and linkages with child treatment center, district hospitals and tertiary level centers offering inpatient management of SAM and include judicious use of ready-to-use-therapeutic-food (RUTF). All sections of healthcare providers need to be trained in the integrated management of SAM

This statement has opened the doors for the use of RUTF in well-designed programs with proper training and protocol in India.

Toddler Food Partners (TFP), an NGO based in Minneapolis, Minnesota, USA joined hands with IIT Bombay and Sion Hospital to address each of these concerns. A small scale production unit was established on the premises of Sion Hospital in Dharavi and a clinical trial was initiated in 2011 where MNT (Medical Nutrition Therapy; local version of RUTF based on publicly available formulations) was tested versus SNT (Standard Nutrition Therapy) used at the Sion Hospital to treat SAM children. In 2012 a Mumbai based NGO SNEHA joined hands to recruit more SAM children for the study and to test the product in the community (Dharavi and other slums in Mumbai) through an outreach program.

The data from the hospital-based study presented at a Regional Scientific Conference in September 2013 showed that MNT was significantly better than SNT. Further research on improving the cost benefits of the protocol are continuing. The data from SNEHA study is equally compelling and it was shared at a conference in Brazil in 2014. The ongoing work at the Sion Hospital provided key input to the deliberations by the Scientific Committee in preparing the consensus statement.

Tata Trust requested TFP to conduct a scale-up feasibility study to reduce the cost of the product. TFP led a feasibility study along with IIT Bombay. The team included Hexagon Nutrition Private Limited (HNPL), General Mills India office, the State Nutrition Mission and Tata Chemicals. The feasibility study was completed in February 2014. HNPL on their own began researching and acquiring manufacturing know-how from their Sion association and their primary skills as a manufacturer and blender of vitamins and minerals to Government, Industry and International manufacturers of fortified products. TFP agreed to partner with them by providing technical guidance. TFP is consulting with HNPL without any financial considerations. In August 2014 Hexagon reached an agreement with Tata Trust to provide 400,000 sachets of product for the Nandurbar project. HNPL supplied the products in August-September 2014.

TFP visited HNPL's plant in Nashik in February 2015. Several improvements have been made since the initial start-up in August, 2014. The sachet packaging material has been upgraded and the product shelf life has been increased to one year (from six months). Shelf life studies are continuing to assess potential increase to two years so that they could bid for International tenders.

 

TFP Accomplishments July 2014 to February 2015

  • Phase 1 hospital-based clinical trial in Mumbai has been completed. Results were presented at a conference in Nepal in September 2013. Sion hospital has switched to MNT for all their patients since July 2014. A paper has been submitted to American Journal of Clinical Nutrition for publication. It is under peer review.

  • Phase 2 community-based clinical trial with the help of local NGO SNEHA in the slums of Mumbai has been completed. Preliminary data was presented by the Dean of Sion hospital at a conference in Brazil.

  • The Nutrition Research and Rehabilitation Center (NRRC) at the Sion hospital has been upgraded. Funding for the upgrade and ongoing activities at Sion hospital are being provided by UNICEF, Mumbai.
  • A large scale field study with up to 11,000 children in the NanduTFP provided technical guidance to Hexagon Nutrition to scale up MNT production to a capacity of 1,000 Metric Tons/year. This is sufficient to treat 60,000 SAM children.rbar district of Maharashtra has been initiated by Tata Trust in partnership with UNICEF, Mumbai and the State Government. Hexagon Nutrition supplied 400,000 sachets of MNT to the project in 2014. They are likely to supply additional product in 2015.
  • With guidance from TFP, alternate formulas of MNT have been developed by Sion hospital and IIT Bombay. They include soy protein and jiggery as alternate ingredients. The new formulas will have a different flavor profile and they will be less expensive.

 

Clinical Trials

Toddler Food Partners has made significant progress in the TFP funded clinical trial at Sion Hospital in Mumbai. The trial compared our RUTF product (locally called Medical Nutrition Therapy – MNT) with Standard Nutrition Therapy (SNT). Trial results were presented at a regional conference in Nepal and the presentation was well received.

Additional community based studies with MNT are in progress with Sion Hospital's partner SNEHA an NGO working in Dharavi. They are testing three modes of delivery to SAM children in the slums of Mumbai:

  • Setting up special day care centers

  • Using mobile vans to distribute MNT

  • Having field workers deliver MNT for home based treatment

All of these methods will have frequent follow-up. More data will be available in the coming year.

More Partners

A very large philanthropic foundation in Mumbai, Tata Trust, approached TFP to join a feasibility team to scale up MNT production to more than 500 tons annually to reduce production costs. The current plant at Sion produces 15 tons annually with an approximate cost of $0.50 per package ($75 for treating a child). The team completed its feasibility study in March 2014. With a capital investment in the $500K range, it is possible to produce more than 500 tons annually with a lower cost per package.

Hexagon Nutrition, a Mumbai based pharmaceutical company, has stepped up to make the investment and will have the capacity to manufacture 500 to 1000 tons annually. They will supply the product at lower cost per package in 2014. TFP will provide guidance to them so they could be the lowest cost producer of MNT in India by 2016.

More Backing for MNT Use

The Indian Academy of Pediatrics published a new protocol for the treatment of SAM in India. For the first time, it endorses the use of MNT in the treatment protocol. We expect government approval in the coming year.

Goals for 2015-2016

  • Provide technical assistance to the pharmaceutical company to increase production capacity in India and to reduce the cost of the product.

  • Guide our partners to continue clinical trials at Sion Hospital with alternative MNT formulas for children, pregnant women and lactating mothers.

  • Identify new partners to reach out to more SAM children.

  • Participate in a project through Tata Center for Technology and Design at IIT Bombay to develop strategies, policy recommendations and products to address malnutrition and eliminata the prevalence of SAM in India.

Content Archived

Previous content from this page has been removed and archived under the Resources menu.

Archived Recent Activities

 

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In the News

January 2017

TFP board members and several of our partners in India are principal authors of two journal articles. Both discuss the indigenous production of RUTF to address SAM in Indian children.
Click here for the first article. Click here for the second article. Also, both articles can be accessed through our resourses page from the Main Menu>Our Work>Resources.

November 2015

Things are ramping up in Mumbai with local partners: IIT, Sion Hospital, SNEHA, Tata Trust, Hexagon Nutrition and General Mills India. Our testing is convincing the government of the success of MNT in healing toddlers with SAM, production has increased and interest is being generated to expand our work beyond Mumbai's slums. In addition, TFP is working on ways to prevent SAM. More on that to come when our project manager returns from India. More details are posted on the Recent Activities page.

November 2014

The latest activities on our India projects have bee posted on the Recent Activities page.

The Powerpoint presentation used by Dr. Jadhav for her presentation at the regional conference in Nepal is now available on the Resources page of this website.

June 2014

TFP Board member, Bharat Parekh, made a presentation to a Global Solutions - MN group. The presentatin was video recorded and the video may be viewed through this link:

Bharat Parekh Video

November 2013

We have received a video from our partners at Sion Hospital. It shows how children sufferiung from SAM are admitted and treated at the hospital.

Click here to see the video.

October 2013

Visit to Mumbai

Three TFP Board members recently returned from a trip to Mumbai and Nepal. Many meetings were held in Mumbai relating to the project and clinical study we are funding at Sion Hospital.

The first phase of the hospital based clinical trial was completed. This trial compared Standard Nutrition Therapy (SNT) with Medical Nutrition Therapy (MNT - RUTF in India). The results were good showing the MNT was better current protocol with no adverse effects. Results were presented at several meetings and the presentation for the conference in Nepal was fine tuned.

Dr. Alka Jadhav presented the results at a regional conference of International Epidemiological Association in Pokhara, Nepal, in September. TFP had a booth at the conference to increase awaremness of the product for attendees from South Asia.

Click here for a more complete report.

March 2013

Article Added in Resources

In February, a workshop was held at the YMC campus outside of Mumbai. The object was to make rural Self Help Groups (SHGs) aware of nutrition rich food products that can act as dietary supplements. This workshop was a direct result of the work the Dr. Shiv Murty and Director Larry Carpenter did on their recent trip to Mumbai. A report and summary of the meetings is available on our resources page. (Menu::OurWork:: Resources)

January 2013

Article Added in Resources

An article from the NY Times, September 2010, was added to the Resource page. It discusses RUTF, Nutriset, Plumpy'Nut and issues surrounding them, specifically Haiti. (Menu::Our Work::Resources)

December 2012

Recent Accomplishments in Mumbai

A summary of accomplishments from the recent trip to Mumbai by Larry Carpenter and Dr. Shivram Murty can be found through the menu above under "Projects::Recent Activities".

TFP Directors Return from Mumbai

Executive Director, Larry Carpenter, returned from a successful trip to Mumbai in early December.  Board Director, Dr. Shiv Murty, remained in India and will return shortly before Christmas. For both, it was a whilrwind trip whith meetings scheduled nearly every day of their 18 day trip.

MNT Treatment Accepted by IAC

The SAM Management Guidelines of the Indian Academy of Pediatricians (IAP) have gone through a process of critical appraisal and updating since they were first formulated in 2010. These are now accepted by IAP as official guidelines on SAM management. This is an acknowledgment by the IAP that using Medical Nutrition Therapy (MNT) for treating Severe Acute Malnutrition (SAM) is the recommended protocol. This is a big step in getting MNT treatment accepted generally in India. Click here to read the statement by the IAP.

November 2012

Visit to our partners in Mumbai

On 25 November, board members Shivram Murty and Larry Carpenter depart for Mumbai. They will have a busy schedule meeting with some of our partners, CTARA, Sion Hospital and others. At Sion they will work with the expanded production facility and the new equipment that was recently installed. They will also travel to Nagpur to discuss another possible project before returning in December.

 

Give to the Max Day

A big thank you to all of our supporters that donated to Toddler Food Partners on "Give to the Max" day and to all that contributed through our GiveMN.org webpage. Also a big thanks to those that attended our open house on 11 November and contributed then. Your generous sharing will be put to good use specifically to complete the clinical study through Sion Hospital in Mumbai. Executive Director, Larry Carpenter, and Board Director Dr. Shivram Murty will be traveling to Mumbai in late November to work with many of the people and organizations that are using Medical Nutrition Therapy (MNT) to treat malnourished kids from Dharavi.

October 2012

Ribbon Cutting in Haiti

In October, two TFP board members traveled to Cap-Haïtien for the grand opening of the new factory built by Meds and Food for Kids (MFK). Dave Harmann played a big part in coordinating construction of the manufacturing facility. He worked closely with the electrical, plumbing and HVAC contractors. George Farrell helped with many of the final details. Click here for a video of the grand opening.

NPR News Report

NPR ran a report featuring Meds and Food for Kids (MFK), their history, growth and new factory. They also talked about how MFK provides good jobs and works with local farmers to improve their peanut crops. Click here to listen. Toddler Food Partners has worked with MFK since they made RUTF in a rented kitchen. Two of our volunteers will be present for the official opening of the new factory.

Matching Grant Announced

One of our volunteers has again pledged to match all donations up to a total of $5000 that are received before 31 December. All donations that come directly to TFP or are made through our GiveMN.org page will be matched!

September 2012

Grant from General Mills

Toddler Food Partners is pleased to announce that they have received a $20,000 grant from General Mills Incorporated. The grant money is specifically targeted towards the continued production of Ready to Use Therapeutic Food  which is being tested as Medical Nutrition Therapy (MNT) to treat malnourished children.

Public Radio Report

Here is an article on "The World" from Public Radio Inernational (PRI). It tells of Plumpy'Nut being rejected by the Indian government. The clinical study that Toddler Food Partners is supporting is featured in this article. TFP board members, Larry Carpenter and Shivram Murty, will be traveling to Mumbai in late November. They will meet with and work with Dr. Manglani and the aid group SNEHA. SNEHA is doing outreach work in the slum and bringing malnourished children into the clinical study. We expect the results of this study to convince the government to approve the use of locally made RUTF to treat SAM children.

August 2012

New Factory Starts Production

With the help of Toddler Food Partners, our partner in Haiti, Meds and Food for Kids (MFK) started production of Medika Mamba in their new 18,000 sq ft factory on August 3. See Recent Activities under the Projects menu for more details. MFK extends an invitation to attend a ribbon cutting! Click here.

July 2012

New Board Member

Toddler Food Partners wishes to welcome our newest board member: Ms. Indra Mehrotra. See the Board of Directors page under the About menu for her biography. She also comes with a passion for fighting SAM in India.

April 2012

Two New Board Members

Toddler Food Partners wishes to welcome two new board members: Dr. Shivrma Murty and Dr. Bharat Parekh. See the Board of Directors page under the About menu item for biographies. Both of the new board members come with a passion for fighting Severe Acute Malnutrition (SAM) particularly in India.

12 March 2012

One of our partners, Meds and Food for Kids (MFK), has produced a new video that describes how Medika Mamba is saving children in Haiti. Toddler Fook Partners has worked closely with MFK for several years. Some of the equipment you will see in the early factory was procured by TFP. Click here for the video.

26 December 2011

The Mumbai newspaper, Daily News and Analysis, reports today that "Sion Hospital has asked the women and child welfare department to adopt the medical nutrition therapy (MNT) model to provide nutritious food for [malnourished] children". Toddler Food Partners has worked with Sion Hospital and the CTARA Department within India Institute of Technology (IIT) to establish a facility to manufacture MNT at its Urban Health Center in Dharavi. Click here to read full article.

Sierra Leone, December 2011

Larry Carpenter, Executive Director, and a TFP Volunteer, Shiv Murty, have begun discussions with a former student from Larry's years of teaching in Sierra Leone. The student has formed a non-profit, Bedyna, that has helped build primary and secondary schools in his birth village. He has asked TFP to help set up a school lunch or breakfast project that can assure that all students have better and consistent nutrition throughout the year. This partnership is in the beginning stages but we expect the partnership to grow. The first stage of this project will be to obtain a grinder that can be used to process peanuts into peanut butter to provide a high protein snack in the schools.

 

Many thanks to all of you that participated in Give to the Max day by making a contribution to Toddler Food Partners. Your generosity made the day a resounding success!

One of our volunteers has pledged to match all donations up to a total of $5000 that are dedicated to our "MNT for SAM in India" project. All donations that came in on Give to the MAX day were matched! It is still valid and your donations will still be matched.

 

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