Nicolas Dahan, Seton Hall University and Bernard Leca, ESSEC

About 19 million children under 5 around the world suffer from severe acute malnutrition every year. This life-threatening condition kills 400,000 of them – that’s one child every 10 seconds.

These numbers are staggering, especially because a lifesaving treatment has existed for nearly three decades: “ready-to-use therapeutic food.”

Nutriset, a French company, was founded by Michel Lescanne. He was one of two scientists who invented this product in 1996. A sticky peanut butter paste branded Plumpy’nut, it’s enriched with vitamins and minerals and comes in packets that require no refrigeration or preparation.

Health care professionals were quickly convinced of its promise. What was harder to figure out was how to manufacture as many packets as possible while cutting costs. In 2008, ready-to-use therapeutic food producers like Nutriset charged US$60 for one box of 150 packets – the number needed to treat one severely malnourished child for the 6-8 weeks needed for their recovery.

In a study we published in the Journal of Management Studies in October 2024, we explained how the international agencies, nongovernmental organizations, activists and for-profit companies involved in the product’s distribution managed to resolve a public controversy over the use of Nutriset’s patent and its for-profit business model.

Contrary to the expectations of activists and many humanitarian NGOs, this for-profit company managed to reduce its prices down to $39 per box of Plumpy’nut packets by 2019 and keep them consistently lower than any nonprofit or for-profit competitors could, all the while enforcing its patent rights.

We interviewed Jan Komrska, a pharmacist then serving as the ready-to-use therapeutic food procurement manager at UNICEF, the United Nations agency for children; Tiddo von Schoen-Angerer, a pediatrician who was leading the access to medicines campaign at Doctors Without Borders, a medical charity; and Thomas Couaillet, a Nutriset executive. We also studied documents issued over the course of a decade to find out why this company’s unusual approach to intellectual property protection was so successful.

Helping franchisees in low-income countries get started

Nutriset and humanitarian organizations disagreed at the start over how to proceed with the production of ready-to-use therapeutic food.

Doctors Without Borders at first accused Nutriset of behaving like a big drugmaker, shielding itself from competition by aggressively enforcing its patents to charge excessively high prices. The nongovernmental organization demanded that Nutriset allow any manufacturer to make its patented packets, without any compensation for that intellectual property.

By 2012, Nutriset had changed course. It had stopped being almost the sole producer of ready-to-use therapeutic food and instead allowed licensees and franchisee partners, chiefly located in low-income countries, to make the packets without having to pay any royalties. It did, however, make an exception for the United States. It allowed Edesia, a Rhode Island-based nonprofit, to become a Nutriset franchisee.

It also provided these smaller producers with seed funding and technical advice.

Nutriset is still the world’s largest ready-to-use therapeutic food producer, we have determined through our research. It’s responsible for about 30% to 40% of the world’s annual production, down from more than 90% in 2008.

There are some other U.S. manufacturers, such as Tabatchnick Fine Foods, but they aren’t Nutriset partners.

Threatening legal action

At the same time, the company continued to threaten to take legal action against potential rivals located in developed countries that were replicating their recipe without authorization. Usually, cease-and-desist letters were sufficient.

Nutriset implemented this strategy to ward off competition from big multinational corporations that might try to establish their brands in new markets, gaining a foothold before flooding them with imported ultraprocessed food. A big risk, had that occurred, would have been less breastfeeding for newborns and the disruption of local diets.

Nutriset’s strategy of opening access to its patent selectively has enabled UNICEF to double the share of packets it buys from producers located in the Global South.

UNICEF, the world’s biggest buyer of ready-to-use therapeutic food, bought less than one-third of its supplies from those nations in 2011. That share climbed to two-thirds in 2022.

Nutriset’s reliance on local franchisees has helped create over 1,000 jobs in hunger-stricken regions while strengthening the supply chain and reducing the carbon emissions of transportation, according to UNICEF.

Nutriset’s creative patent strategy also helped its partner producers in low-income countries, which include nonprofit and for-profit ventures, compete with large corporations in developed countries by the time its patent expired in 2018.

In this instance, a for-profit company not only managed to keep its prices lower than its competitors, including nonprofits, but used its patent to support economic development in developing countries by shielding startup producers from international competition.

As a result of these successes, we found that nongovernmental organizations eventually stopped criticizing the French company and recognized that high prices were actually not due to Nutriset’s patent policy but rather to global prices of the packets’ ingredients.

In recognition of its contributions and innovation, Nutriset won the U.S. Patent and Trademark Office’s Patents for Humanity Award in 2015.

Offering a cheap, convenient and effective treatment

One of the biggest advantages of ready-to-use therapeutic food is that parents or other caregivers can give it to their kids at home or on the go. That’s more convenient and cheaper than the alternative: several months of hospitalization where children receive a nutrient-dense liquid called “therapeutic milk.”

The at-home treatment works most of the time. More than 80% of the children who get three daily food packets recover within two months.

Severe acute malnutrition deaths remain high because historically only 25% to 50% of children suffering from it get treated with ready-to-use therapeutic food, due to insufficient funding. The treatment programs are run by governments, UNICEF and other international agencies, and NGOs such as Doctors Without Borders.

USAID’s funding role

The U.S. government spent about $200 million in 2024 through the U.S. Agency for International Development on ready-to-use therapeutic food, enough packets to treat 3.9 million children. That’s nearly as much as UNICEF, which treats about 5 million children annually.

It’s unclear whether the Trump administration, which is trying to dismantle USAID, will discontinue its funding of ready-to-use therapeutic food that the U.S. government has purchased exclusively from U.S. manufacturers with U.S.-sourced ingredients.

At a time when the flow of development aid from several wealthy countries is declining, the precedent Nutriset set suggests that humanitarian organizations, by teaming up with international agencies, governments and for-profit companies, can help drive down the costs of saving lives threatened by hunger while increasing the nutritional autonomy of the Global South.

But the funding for ready-to-use therapeutic food and its distribution has to come from somewhere, whether it is from governments, foundations or other donors.

Nicolas Dahan, Professor of Management, Seton Hall University and Bernard Leca, Professeur en sciences de gestion, ESSEC

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Mathew Schmalz, College of the Holy Cross

Pope Francis, who remains in critical condition and hospitalized as he battles pneumonia in both lungs, was elected pope on March 13, 2013, after the surprise resignation of Benedict XVI.

Prior to becoming pope, he was Jorge Mario Bergoglio, archbishop of Buenos Aires, and was the first person from the Americas to be elected to the papacy. He was also the first pope to choose Francis as his name, thus honoring St. Francis of Assisi, a 13th-century mystic whose love for nature and the poor have inspired Catholics and non-Catholics alike.

Pope Francis chose not to wear the elaborate clothing, like red shoes or silk vestments, associated with other popes. As a scholar of global Catholicism, however, I would argue that the changes Francis brought to the papacy were more than skin deep. He opened the church to the outside world in ways none of his predecessors had done before.

Care for the marginalized

Pope Francis reached out personally to the poor. For example, he turned a Vatican plaza into a refuge for the homeless, whom he called “nobles of the street.”

He washed the feet of migrants and prisoners during the traditional foot-washing ceremony on the Thursday before Easter. In an unprecedented act for a pope, he also washed the feet of non-Christians.

He encouraged a more welcoming attitude toward gay and lesbian Catholics and invited transgender people to meet with him at the Vatican.

On other contentious issues, Francis reaffirmed official Catholic positions. He labeled homosexual behavior a “sin,” although he also stated that it should not be considered a crime. Francis criticized gender theory for “blurring” differences between men and women.

While he maintained the church’s position that all priests should be male, he made far-reaching changes that opened various leadership roles to women. Francis was the first pope to appoint a woman to head an administrative office at the Vatican. Also for the first time, women were included in the 70-member body that selects bishops and the 15-member council that oversees Vatican finances. Shortly before his death, he appointed an Italian nun, Sister Raffaella Petrini, as President of the Vatican City.

Not shy of controversy

Some of Francis’ positions led to opposition in some Catholic circles.

One such issue was related to Francis’ embrace of religious diversity. Delivering an address at the Seventh Congress of Leaders of World and Traditional Religions in Kazakhstan in 2022, he said that members of the world’s different religions were “children of the same heaven.”

While in Morocco, he spoke out against conversion as a mission, saying to the Catholic community that they should live “in brotherhood with other faiths.” To some of his critics, however, such statements undermined the unique truth of Christianity.

During his tenure, the pope called for “synodality,” a more democratic approach to decision making. For example, synod meetings in November 2023 included laypeople and women as voting members. But the synod was resisted by some bishops who feared it would lessen the importance of priests as teachers and leaders.

In a significant move that will influence the choosing of his successor, Pope Francis appointed more cardinals from the Global South. But not all Catholic leaders in the Global South followed his lead on doctrine. For example, African bishops publicly criticized Pope Francis’ December 2023 ruling that allowed blessings of individuals in same sex couples.

His most controversial move was limiting the celebration of the Mass in the older form that uses Latin. This reversed a decision made by Benedict XVI that allowed the Latin Mass to be more widely practiced.

Traditionalists argued that the Latin Mass was an important – and beautiful – part of the Catholic tradition. But Francis believed that it had divided Catholics into separate groups who worshiped differently.

This concern for Catholic unity also led him to discipline two American critics of his reforms, Bishop Joseph Strickland of Tyler, Texas, and Cardinal Raymond Burke. Most significantly, Carlo Maria Viganò, the former Vatican ambassador, or nuncio, to the United States was excommunicated during Francis’ tenure for promoting “schism.”

Recently, Pope Francis also criticized the Trump administration’s efforts to deport migrants. In a letter to US Bishops, he recalled that Jesus, Mary and Joseph had been emigrants and refugees in Egypt. Pope Francis also argued that migrants who enter a country illegally should not be treated as criminals because they are in need and have dignity as human beings.

Writings on ‘the common good’

In his official papal letters, called encyclicals, Francis echoed his public actions by emphasizing the “common good,” or the rights and responsibilities necessary for human flourishing.

His first encyclical in 2013, Lumen Fidei, or “The Light of Faith,” sets out to show how faith can unite people everywhere.

In his next encyclical, Laudato Si’, or “Praise Be to You,” Francis addressed the environmental crisis, including pollution and climate change. He also called attention to unequal distribution of wealth and called for an “integral ecology” that respects both human beings and the environment.

His third encyclical in 2020, Fratelli Tutti, or “Brothers All,” criticized a “throwaway culture” that discards human beings, especially the poor, the unborn and the elderly. In a significant act for the head of the Catholic Church, Francis concluded by speaking of non-Catholics who have inspired him: Martin Luther King Jr., Desmond Tutu and Mahatma Gandhi.

In his last encyclical, Dilexit Nos, or “He Loved Us,” he reflected on God’s Love through meditating on the symbol of the Sacred Heart that depicts flames of love coming from Jesus’ wounded heart that was pierced during the crucifixion.

Francis also proclaimed a special “year of mercy” in 2015-16. The pope consistently argued for a culture of mercy that reflects the love of Jesus Christ, calling him “the face of God’s mercy.”

A historic papacy

Francis’ papacy has been historic. He embraced the marginalized in ways that no pope had done before. He not only deepened the Catholic Church’s commitment to the poor in its religious life but also expanded who is included in its decision making.

The pope did have his critics who thought he went too far, too fast. And whether his reforms take root depends on his successor. Among many things, Francis will be remembered for how his pontificate represented a shift in power in the Catholic Church away from Western Europe to the Global South, where the majority of Catholics now live.

Mathew Schmalz, Professor of Religious Studies, College of the Holy Cross

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Rebecca Hanson, University of Florida

The body of former Venezuelan army officer Ronald Ojeda was found on Feb. 19, 2024, in a suitcase buried under 5 feet of concrete. Ojeda, accused by Venezuela of plotting against the government, had gone missing nine days earlier, when men dressed as police broke into his apartment in the Chilean capital of Santiago and dragged him away.

Following a yearlong investigation, authorities in Chile have now pointed the finger at the Venezuelan gang Tren de Aragua, claiming members carried out the assassination at the behest of that country’s president, Nicolás Maduro.

It comes as the relationship between Maduro’s government and criminal gangs is under increased scrutiny, both among regional governments in Latin America and in the United States.

Conservative media outlets in the U.S. and right-leaning groups such as the Heritage Foundation have accused Maduro of sending gang members into the U.S. to destabilize the country.

President Donald Trump has even suggested that Maduro successfully reduced crime by exporting gang members to the U.S. “Crime is down in Venezuela by 67% because they’re taking their gangs and their criminals and depositing them very nicely into the United States,” he told supporters in April 2024.

According to data from the Venezuelan Ministry of Health, shared with me by scholar of Venezuelan politics Dorothy Kronick, homicide rates have indeed come down in recent years. And this trend is confirmed by the Venezuelan Observatory of Violence.

The fall in homicide rates has coincided with Maduro successfully consolidating his authoritarian rule in Venezuela. And explanations of the drop in crime tend to imply that it is the result of the government co-opting and controlling gangs. Some observers have even referred to Venezuela as a “narcostate,” suggesting that drug trafficking in the country is an organized venture between top officials and criminal groups.

I have studied crime, violence and policing in Venezuela since 2011 and know that this narrative is at best oversimplistic, at worst outright mistruth. As I explore in my new book, “Policing the Revolution: The Transformation of Coercive Power and Venezuela’s Security Landscape During Chavismo,” the case of Venezuela is not one of government control over criminal groups. Rather, it is characterized by an unstable and volatile relationship between the government and multiple competing armed actors, including gangs and the police.

Violent, but becoming less so

Falling homicide rates should not mask the fact that Venezuela is still plagued by violence. Since the mid-2000s it has been ranked as one of the most violent countries in the world.

Former President Hugo Chávez was never able to get a handle on crime, particularly violent crime, which increased exponentially under his government. The trend continued during Maduro’s first years in office after Chávez’s death in 2013.

However, all available evidence suggests that Venezuela’s homicide rate has declined since reaching a peak in 2016 – by around 42%.

But there’s no evidence this is because the government is “offshoring” criminals.

Maduro’s own explanation for this decline portrays the government as handily controlling criminals by means of incredibly lethal police raids carried out between 2015 and 2019. In short, Maduro claims that the police have effectively “wiped out” criminal groups.

Competing police forces …

But rather than “wiping out” criminal organizations, the Maduro government has instead maintained volatile relationships with many armed groups, including gangs, nonstate paramilitary groups and even the country’s own police forces.

These relationships have produced significant conflict and dysfunction within state institutions. This is clear when looking at institutions presumed to be synonymous with state control, such as the police.

Chávez’s and Maduro’s governments put more police and soldiers in the streets. They created security institutions, such as the Policía Nacional Bolivariana, or Bolivarian National Police.

However, rapid growth of the security apparatus, amid competing approaches, has generated more conflict than coordination.

Police officers and police reformers I interviewed referred to state security policies and the changes they produced as akin to Frankenstein’s monster – an aberration rapidly outpacing the creator’s ability to control it.

What they mean is the government had created new security institutions so quickly that it is unable to supervise and control them. As one former police officer and Chavista politician told me: “Our challenge now is how to manage the monster we created.”

State policies have also generated significant distrust between the police and the government, and among different police forces.

This distrust has even resulted in police forces coming to blows with each other in the streets on multiple occasions. On Feb. 19, 2020, a section of the Prados del Este highway in Caracas was shut down as officers from Venezuela’s National Police and the country’s investigative police brandished weapons, shoving, punching and wrestling each other to the ground.

… cooperating gangs

It is, as such, highly unlikely that falling homicide rates are the result of policing. Indeed, I interviewed over 200 police officers while conducting research for my book, and most believed that the government’s policing initiatives contributed to crime and violence rather than reducing it.

A more plausible explanation for falling homicide figures is that Maduro’s policies have resulted in more consolidated relationships between criminal groups themselves.

Maduro’s government has built relationships with gangs, but this doesn’t necessarily imply control over them. Since 2013 the government has negotiated pacts with some of the country’s largest gangs, including a gang confederation led by the infamous El Koki in Caracas and the Belén gang in the state of Miranda.

The government agreed to tolerate illicit activities within certain areas and prohibit police from entering gang territory. In exchange, gangs agreed to reduce killings and other highly visible crimes such as kidnapping. As my book and previous research with Verónica Zubillaga, Francisco Sánchez and Leonard Gómez shows, these pacts allowed gangs to consolidate control over territory and illicit markets.

Gangs also negotiated agreements among themselves in case the government pacts fell through. For example, they agreed to divide territory and markets to avoid future conflict and share resources such as weapons and ammunition. This produced less conflict between gangs and less disruption in illicit markets, resulting in fewer homicides.

When pacts have ruptured in the past, the spectacularly violent confrontations that ensued between gangs and the police have shown gangs’ capacity to resist government intervention. Still, the overall effect of pacts and gang consolidation has been a reduction in homicides.

As one neighbor living in gang territory put it: “Before, gangs confronted each other; they killed each other. Now they don’t. Now they are growing.”

‘Mother of all infuriations’

Relationships between the government and various nonstate armed groups, including gangs, have generated enormous discontent within police forces.

As one police officer explained in an interview, these pacts represented the “mother of all infuriations.” For many officers, the goverment’s pacts with other armed groups is tantamount to its sponsorship of criminal activities.

And this discontent has produced sporadic violent confrontations. Even when government-gang pacts are in place, the government has been unable to keep police forces from entering gang territory and engaging in deadly shootouts.

Certainly from the outside, it may look like Maduro’s government has co-opted gangs for political purposes. And with the U.S. government adding Tren de Aragua to its list of global terrorist groups, that could put Venezuela in danger of being labeled a “state sponsor of terrorism.”

However, the Ojeda case in Chile should not be taken as evidence that stable and strong ties exist between Maduro’s government and criminal groups – at least not yet.

Instead, authoritarian survival in Venezuela for now seems to depend on volatile relationships between multiple and competing armed groups that collaborate temporarily with the government when their diverse interests overlap.

Rebecca Hanson, Assistant Professor of Latin American Studies, Sociology and Criminology, University of Florida

This article is republished from The Conversation under a Creative Commons license. Read the original article.