UNICEF Supply Division

NUTRITION SUPPLIER MEETING

14th – 16th June 2017

Codex Guideline for RUTF

Alison Fleet,

Medicines and Nutrition Centre

Video linkhttps://drive.google.com/file/d/0B76Rap3s0HuTWHctTU9ieHZpaVU/view?usp=sharing

Benefits of a Codex guideline for

RUTF- Provides an official international reference for

SAM treatment interventions for use by national

governments to protect consumers

- Gives clarity of regulatory categorization

- Provides guidance for producers

- Can be used to facilitate trade disputes and

importation requirements

- Provides a quality framework for a sustainable procurement of RUTF

November

2014

Proposal for a Codex Standard for RUF

December 2015

Proposal (redrafted) for a guideline for RUTF

December

2016

1st draft guideline presented

Member states in the Electronic working Group for the Codex Guideline for RUTF

Uganda, Senegal, South Africa, European Union, New Zealand, Brazil, Unites States of

America, Thailand, Argentina, India, Norway, Canada, France, Ireland, Grenada, Japan,

Uruguay, Botswana, Mexico, Peru, Ecuador, Austria, Kenya

Codex for RUTF Codex for RUTF Codex for RUTF Codex for RUTF –––– where are we at?where are we at?where are we at?where are we at?Second Consultation Paper of the RUTF Guideline – currently under review

• Introduction or preamble to be included in the guideline to set the scene, and also elaborate on the appropriate use of RUTF products

• Use of the word ‘treatment’ vs ‘management’ in the labelling.

• Labelling as a “Special Purpose Medical food”

RUTF as a special special special special medical purposes medical purposes medical purposes medical purposes (FSMP) as stipulated in the CODEX STAN 180-1991.

Keys areas of discussion – Micronutrient levelsNutrient Current Level Proposed new level

Vitamin A 0.8 - 1.2mg 0.8 - 1.5mg

Vitamin D 15 - 20mcg 15-22mcg GUL 30

Potassium 1100 -1400mg 1100mg - 1600mg

Calcium 300 - 600mg 300 - 785mg

Phosphorus 300 - 600mg 300 - 785mg

Magnesium 80-140mg 70 or 75 or 80 -140 or 225, 235mg

Iodine 70-140mcg 70-160mcg

Keys topics for discussionKeys topics for discussionKeys topics for discussionKeys topics for discussion

Alternative ingredients and new formulations

eWG asked : what evidence is needed? Proposal : published efficacy study and acceptability study for ‘new formulations’ and ‘new

compositions’.

Protein quality measurement

Protein Digestibility Corrected Amino Acid Score (PDCAS) or Digestible Indispensable Amino Acid Score (DIAAS)?

Recommendation is to use PDCASS and include a protein quality score into the guideline, as DIAAS scores have not been developed

Additives

Which additives are ok? Electronic working group still discussing this part of the guideline

Contaminants

Proposal to include aflatoxin (10 ppb)

Keys areas of discussion

50% protein from dairy sources?50% protein from dairy sources?50% protein from dairy sources?50% protein from dairy sources?

No consensus

Labelling of a FSMP

Questions and Answers