Emerging clinical concerns have opened debate on the need for proper nutritional management as part of individual and national health promotion.
To understand nutritional outcomes in the clinical space, it is important to appreciate the role of nutritional supplements and foods for special medical purposes.
Nutritional supplements are any dietary supplements intended to provide essential nutrients that may otherwise not be consumed in sufficient quantities, such as vitamins, mineral elements and amino acids.
These are available in pharmacies and supermarkets as single or combined nutrients in the form of tablets, capsules or syrups.
Food for Special Medical Purposes (FSMP) are evidence-based nutritional preparations for dietary management of specific disorders or disease-related medical conditions.
They are intended for patients with a limited, impaired or disturbed capacity to take, digest, absorb, metabolise or excrete ordinary foods or certain nutrients or metabolites; or with other medical nutrient requirements whose dietary management cannot be achieved by modification of the normal diet alone.
They should be used only under medical supervision and carry labelling information about their intended use.
The FSMPs are used under a wide range of settings. They can partially, or entirely, replace a normal diet to provide patients with the essential nutrients to survive, recover and thrive.
They can even be a lifeline for patients of all ages and include highly specialised foods for hepatic failure, diabetics, renal disease and severe malabsorption, among other clinical requirements.
Depending on factors such as the state of the disease, FSMPs are taken orally or as tube feeds.
Infants and children are not small adults, and their dietary needs are different.
This warrants special FSMP as the sole source of nutrition to satisfy the unique nutritional requirements of newborns with specific diseases, disorders or medical conditions till the introduction of appropriate complementary feeding.
For paediatric patients with inborn metabolism challenges, there are FSMP formulas designed to provide a partial source of nutrition.
All of these are used under the specific recommendation and supervision of a medical doctor, dietician or other healthcare professional, and address the need for extra assistance in obtaining the requisite nutrition for growth and development among the highly vulnerable infants and young children.
Owing to advances in clinical care, various conditions and patients living with cancer or immune deficiency or have undergone major abdominal surgeries, diabetic patients, kidney diseases, liver disease and patients with burns and malnutrition can all use FSMPs.
Due to the lack of proper regulation and classification of these products, FSMP have been mislabelled as food supplements, subjecting them to high import tax (10 per cent import duty, 25 per cent excise duty and 16 per cent VAT, which makes them too expensive for patients who depend on them.
Affordability of healthcare products is a challenge to many Kenyans, especially those with chronic and terminal illnesses whose feeding is dependent on such forms of dietary supplementations.
Deaths have resulted from malnutrition and starvation as patients cannot afford the medical foods.
It’s time the tax regime on FSMPs was reviewed. Whereas use of FSMPs is high in critical clinical settings in the region, Rwanda’s taxes are the lowest, at 0.2 per cent. In Europe, FSMP are not taxed.
Ms Kobe is the regional marketing and sales manager and clinical nutrition consultant for B. Braun Medical Kenya. [email protected]