André Briend, a pediatrician and child-nutrition expert, had worked without success for years to create a ready-to-eat food supplement. One morning, he opened a jar of Nutella, the popular breakfast spread, and came up with the idea for a paste, which, after much trial and error, led to Plumpy'nut.

The product is a blend of peanut butter, dry skim milk, vegetable oil, powdered sugar, minerals, and vitamins. Each foil package is 500 calories. The food does not require cooking, nor does it need to be mixed with water, and that's a tremendous advantage: water in poor countries is often unavailable or contaminated. Also, no refrigeration is necessary, a plus for tropical climates.

What makes the food truly revolutionary, though, is the way it is administered. Parents can take the packets home and feed their own toddlers. The paste is so easy to eat some children even feed themselves. The usual course of treatment is two packets daily for four weeks. Children gain weight rapidly.

Early attention to malnutrition is crucial, Salem said. Studies show that the damage caused by a bad diet is irreversible after the age of two. Lack of vitamin A can lead to blindness. An iron deficiency can damage intellectual development. Undernourished children are thin, short, and more susceptible to disease.

"Whole generations can be lost," says Salem.

Remarkable inventions are usually dogged by controversy, and Plumpy'nut is no exception.

While Briend is the mastermind behind Plumpy'nut, a French company holds intellectual property rights to the paste through a 1997 patent. After his discovery, Briend signed a contract with the Normandy-based Nutriset, a firm that makes food supplements for relief work, and, according to a recent New York Times story about the furor, earned $66 million in sales last year.

The patent has been challenged by two American non-profits that contend Plumpy'nut is nothing more than peanut butter packed with vitamins. The Texas-based Breedlove Foods and California-based Mama Cares Foundation have sued Nutriset, arguing that the patent is too broad and keeps them from making their own versions to ship overseas.

"For years, we've been hung up on all this instead of just being able to fight hunger," says Mike Mellace, executive director of Mama Cares, referring to his legal battle. "There are lots of people that need the product and can't get the product."

That might be true, but not because there isn't enough Plumpy'nut to go around, according to aid workers familiar with the dispute. They say the problem is that the international community either doesn't have the money or the will to pay for malnutrition relief.

"There's not a problem with supply," says Steve Taviner, of the Haitian charity group, Meds and Food for Kids. "It's political that not enough money is being spent on malnutrition throughout the world. We need the will to fund it."

Taviner raves about Plumpy'nut, calling it a "breathtaking" product. He says he is amazed by the transformation: Within weeks, the signs of malnourishment — skeletal bodies and baggy skin — are gone.

"It saves hundreds and hundreds of lives every day," says Taviner. "You hear parents say all the time after they've used it, 'I thought my child was dead and now he's alive.' "

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