Zubaida Baba Ibrahim and Aaron Bawala (Lead writers)
The shortage of life-saving Ready-to-Use Therapeutic Food (RUTF) in health facilities across the northern part of Nigeria, where they are meant to be provided free of charge to malnourished children, has become deeply concerning. With the United Nations Children Fund (UNICEF) warning that more than 400,000 children are at risk due to ongoing stockouts, the situation points to the urgency of addressing gaps in the supply chain.
What makes this even more alarming is that these supplies, meant to save lives, are reappearing for sale in local markets across northern Nigeria. This is as malnutrition rates continue to surge. This not only undermines access for the most vulnerable families but also raises pressing concerns about accountability and the integrity of the supply chain.
Frequent stockouts, compounded by the recent shifts in U.S foreign aid and global health policy, continue to intensify Nigeria’s malnutrition crisis. According to Médecins Sans Frontières/Doctors Without Borders (MSF), at least 652 children have succumbed to malnutrition in Katsina alone between January and June 2025.
Reports of stockouts in PHCs across the north
RUTFs are a specially formulated peanut-butter paste and a cornerstone in the fight against severe acute malnutrition (SAM) and moderate acute malnutrition (MAM), conditions that threatens the lives of millions of children in Nigeria. They contain essential nutrients, including peanuts, milk, and vitamins such as Folic Acid, Vitamins A, D, E, K. According to Action Against Hunger, RUTF has the power to bring a malnourished child from the brink of death to full nutritional recovery in just four to eight weeks.
Through its Community Health Watch initiative Nigeria Health Watch recently reported on a story from Bangi Mariga Local Government Area (LGA) in Niger State, where women expressed concern about the absence of RUTFs in their local Maternal and Child Health Clinic. Although the facility had benefited from the Basic Healthcare Provision Fund (BHCPF) renovations, mothers like Fauziya Suleiman and Fatima Umar stressed that the most life-saving intervention for their children was no longer available.
A similar concern was also raised during a town hall meeting in Kano Municipal Council, where participants reported the alleged diversion of Plumpy’Nut, a UNICEF-supported therapeutic food for malnutrition.
Leakages and accountability gaps
Across many PHCs and malnutrition treatment centres in northern Nigeria, RUTF stockouts are being reported. But in Katsina, the state most affected by child malnutrition in the northwest, a more troubling pattern of RUTF diversion is unfolding, where it is being openly hawked and even advertised for sale on Facebook.
According to Abubakar Babangida, a humanitarian aid worker based in Katsina, leakages occur at multiple points along the RUTF supply chain. Typically, when an organisation partners with a PHC to deliver RUTFs and other malnutrition interventions, it obtains the supplies from donor agencies such as UNICEF and transports them to the clinic, where they are distributed to mothers and caregivers of malnourished children. “Usually care givers are given five to ten at a time, depending [on the extent of the malnutrition case], and then given more during follow ups. So, these leakages, sometime cartons at a time, are from organisations and healthcare workers,” Babangida stated.
However, even some caregivers are actively involved in diverting the supply, “I know of a case of some women in Kaita [LGA in Katsina] that poison their children with bleach in order to have access to RUTFs, some of them even borrow malnourished children from their neighbors and go from clinic to clinic all because they want to gain RUTF so they could sell it,” Babangida added.
Reportedly, a single pack of RUTF sells for about ₦450 to ₦500, while a carton goes for as much as ₦60,000. This raises a pressing question: who is buying at such steep prices? “Of course, they [buyers] are not malnourished people. Some are using it as a bread spread, some pregnant women are eating it to not give birth to malnourished children. It is a very serious situation, you can see it almost everywhere around Katsina,” Babangida explained.
Consequences and possible interventions
In August 2025, the Katsina State Government, in collaboration with UNICEF, committed an additional ₦1 billion to the State’s health sector to address the prevailing malnutrition crisis, but such diversions risk wasting investments.
MSF has reported that in June 2025, nearly 70,000 children with malnutrition had already received medical care in Katsina, including nearly 10,000 who were hospitalised in serious condition. The medical humanitarian organisation also added that, between January and June 2025, the number of children with nutritional oedema, the most severe and deadly form of malnutrition, rose by 208% compared with the same period in 2024.
Apart from investment, Babangida suggests that “there is a need for a proper state law on it, whoever is found selling or hawking RUTFs should be legally punished. And if a health facility finds out a member of staff is involved in the mismanagement, there should be severe consequences against that. Some of them think that ‘even if I was caught selling [RUTFs], the in charge of my hospital is also part of it or top management is part of this’ and they cannot be punished.
“For the community, there is a need for proper sensitisation so they will understand that these RUTFs are not meant for an adult to be eating it with bread, it is meant to save lives. Especially in the rural communities, because those are the areas these malnourished children are.” Babangida added that mismanagement in rural communities often stems from ignorance, and with proper awareness, many buyers would likely refuse to purchase, ultimately reducing demand.
During discussions at a town hall meeting in Kano Municipal Council, Ward Development Committees (WDCs) stated that they worked with women and community leaders to monitor PHCs, showing that leakages can be drastically reduced when local voices are empowered. Through conducting spot checks, issuing direct warnings to facilities, and even testing ill-practices, WDCs demonstrated that vigilance and community engagement can hold health workers accountable and restore trust.
The National Primary Healthcare Development Agency (NPHCDA) can also scale up this model nationwide by embedding WDCs as watchdogs within the RUTF supply chain to ensure the life-saving treatment reaches malnourished children free of charge as intended.
Ultimately, protecting the distribution networks of RUTF is about protecting lives, and empowering communities to demand transparency. This is the most sustainable defence against this life-threatening trade.