Steve Collins (physician)
Steve Collins (medical doctor)
Steve Collins (born 30 April 1962), is a British medical doctor with a doctorate in nutrition. He has worked in aid and development since 1985 with a focus on treating and preventing malnutrition.
Collins is the founder and chairman of Valid Nutrition and co-founder and executive director of Valid International.
Education and career[edit]
Steve Collins studied an MBBS in medicine at St Bartholomew’s Hospital in London between 1982 - 1989. In 1985, whilst undertaking public health work during his summer holidays, he was caught up in a war in Uganda and forced to travel overland ending up in Darfur, Sudan. Upon his arrival in Sudan in August 1985, he volunteered with the non-governmental agency Save the Children in West Darfur, where he worked for 9 months travelling around by horse to assess food needs, allocate relief foods and to evaluate the response and impact of the relief provided.
After qualifying as a medical doctor, Collins worked for the University Hospital of the West Indies as a medical intern in Kingston, Jamaica and was exposed to the cutting edge research into the treatment of malnutrition that was being undertaken there at the Tropical Metabolic Research Unit (TMRU).
After finishing his internship in Jamaica in 1992, he immediately returned to famine relief, working in the town of Baidoa at the epicentre of the 1992 Somalia famine treating severely starving adults. Over the next 10 years he continued to work as a medical doctor for various non-governmental agencies including Concern Worldwide, MSF, Oxfam, Action Aid, specializing in the set up and management of front line services to treat severe starvation in the famines and wars (Somalia, South Sudan, Angola, Burundi/Rwanda/Zaire, Liberia, Sierra Leone, North Korea). For the first 8 years he specialised in the treatment of severely malnourished adults and adolescents, collecting, analysing and publishing data in peer reviewed journals such as Nature Medicine, the American Journal of Clinical Nutrition and the Journal of the American Medical Association. Through this work, he redefined the accepted thinking around the “limit of human adaptation to survival”[1] in malnutrition, tested new, lower protein treatment diets that proved to be much more effective in their treatment and rehabilitation,[2] and developed faster and more specific tools to screen and monitor starving adults and adolescents.[3]
In 1998, disillusioned with the inherent problems of running inpatient therapeutic feeding centres to treat severe starvation, he devised a model called Community-based Therapeutic Care (CTC)[4] that combined the use of Ready-to-Use Therapeutic Food (RUTF) with systematic approaches to informing and mobilizing communities to seek treatment early. In 1999, he established Valid International to test the model and roll it out across countries where malnutrition was common. Between 2000 and 2005, Valid International, working in partnership with Save the Children, Oxfam and in particular Concern Worldwide, tested the model in multiple sites across sub-Saharan Africa, developing a database of over 25,000 cases. The CTC model, in combination with RUTF, moved the model of treatment for Severe Acute Malnutrition (SAM) from an in-patient (hospital) to an out-patient (community), and brought dramatic improvements in impact: reducing mortality rate and increasing cure rates, improving the coverage of aid interventions, and the proportion of the affected population who could access care.[5] [6] [7] [8]
In 2007, CTC was adopted by the World Health Organization, the World Food Programme, the United Nations System Standing Committee on Nutrition and the United Nations Children's Fund (UNICEF) as the preferred intervention approach for the treatment of SAM in children with uncomplicated forms of the condition, under the name Community-based Management of Acute Malnutrition (CMAM).[9] The approach has since been rolled out in over 65 countries worldwide treating over 3 million children with severe acute malnutrition each year.[10]
The CMAM model uses RUTF, a highly fortified, oil-based nutrient dense paste designed to provide the right balance of nutrients required to treat malnutrition in a safe and easily usable form. Realizing the opportunity to meet a humanitarian need while also fostering local economic and social development in low income countries, Collins began working on the local manufacture of these foods and researching new lower cost recipes that could be more easily made from ingredients grown in malnutrition afflicted countries. [11] In 2005, Steve founded the Irish charity Valid Nutrition to take this work forward.
Steve Collins is a widely published academic and a visiting research fellow at the Institute of Child Health in London. He now lives with his family in West Cork, running an organic farm of traditional Irish Dexter Cattle, blueberries and trees.
Published Work[edit]
Journal articles
Collins S. The limit of human adaptation to starvation. Nature Medicine 1. 1995;810 - 814. doi:10.1038/nm0895- 810. Available from: http://www.nature.com/nm/journal/v1/n8/full/nm0895-810.html
Collins S. Using middle upper arm circumference to assess severe adult malnutrition during famine. Jama 1996;276(5):391-395. doi:10.1001/jama.1996.03540050051023. Available from: http://jamanetwork.com/journals/jama/article-abstract/406043
Collins S, Myatt M, Golden B. Dietary treatment of severe malnutrition in adults. Am J Clin Nutr. 1998 Jul;68(1):193-199. Available from: https://doi.org/10.1093/ajcn/68.1.193
Collins S and Myatt M. Short-term prognosis in severe adult and adolescent malnutrition during famine. Jama. 2000;284(5):621-626. Available from: http://jama.jamanetwork.com/article.aspx?articleid=192939
Collins S, Duffield A, Myatt M. Assessment of nutritional status of adults in emergency-affected populations. RNIS Supplement ACC/Sub-Committee on Nutrition. 2000 Jul; Available from: http://www.unscn.org/layout/modules/resources/files/AdultsSup.pdf
Collins S. Changing the way we address severe malnutrition during famine. The Lancet. 2001 Aug 11;358(9280):498–501. Available from: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2801%2905630-6/abstract
Collins S, Sadler K. Outpatient care for severely malnourished children in emergency relief programmes: A retrospective cohort study. The Lancet. 2002 Dec 7;360(9348):1824–1830. Available from: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(02)11770-3/abstract
Collins S. Community-based therapeutic care - a new paradigm for selective feeding in nutritional crises. Overseas development Institute (ODI): London. Humanitarian Policy Network Paper 48. 2004. Available from: https://www.odi.org/publications/362-community-based-therapeutic-care
Collins S and Henry C.J.K. Alternative RUTF formulations. Emergency Nutrition Network, Special Supplement Series: 2. 2004 Nov. Available from: http://www.ennonline.net/fex/102/4-3-2
Khara T, Collins S. Community-Therapeutic Care (CTC). Emergency Nutrition Network, Special Supplement Series: 2. 2004 Nov. Available from: http://files.ennonline.net/attachments/856/supplement23.pdf
Collins S, et al. Management of severe acute malnutrition in children. The Lancet. 2006 Dec 2;368(9551):1992- 2000. Available from: http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(06)69443-9.pdf
Collins S, et al. Key issues in the success of community-based management of severe malnutrition. UN, Food Nutr Bulletin (27) #3 2006. Available from: www.who.int/nutrition/topics/backgroundpapers_Key_issues.pdf
Collins S. Treating severe acute malnutrition seriously. Archives of disease in childhood. 2007;92:453-461. Available from: http://adc.bmj.com/content/92/5/453
Kerac M, Bunn J, Seal A, Thindwa M, Tomkins A, Sadler K, Bahwere P, Collins S. Probiotics and prebiotics for severe acute malnutrition (PRONUT study): a double-blind efficacy randomised controlled trial in Malawi. The Lancet. 2009 Jul 11;374(9684):136–144. Available from: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60884-9/abstract
Bahwere P, Collins S, Sadler K. Acceptability and effectiveness of chickpea sesame based ready-to-use therapeutic food in malnourished HIV positive adults. Patient Preference and Adherence. 2009 Jan-March;(3). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2778423/pdf/ppa-3-067.pdf
Owino V, Bahwere P, Ghislain G, Mwangi C.M., Collins S. Breast-milk intake of 9-10 month old rural infants given ready-to-use complementary food in South Kivu, Democratic Republic of Congo. AMJ Clin Nutr. 2011;93(6):1300–4. Available from: https://academic.oup.com/ajcn/article/93/6/1300/4597806
Bisimwa G, Owino V, Bahwere P, Dramaix M, Donnen P, Dibari F, Collins S. Randomised controlled trial of the effectiveness of a soybean-maize-sorghum based ready-to-use complementary food paste on infant growth in South Kivu, Democratic Republic of Congo. AMJ Clin Nutr. 2012;95:1157-1164. Available from: http://ajcn.nutrition.org/content/95/5/1157.full?sid=870a655c-cea8-4afc-8512-ffc1b8b63083
Bahwere P, Mtimuni A, Sadler K, Banda T, Collins S. Long term mortality after community and facility based treatment of severe acute malnutrition: Analysis of data from Bangladesh, Kenya, Malawi and Niger. Journal of Public Health and Epidemiology. 2012; 4(8):215-225. Available from: http://www.academicjournals.org/article/article1379674854_Bahwere%20et%20al.pdf
Bahwere P, Banda T, Sadler K, Nyirenda G, Owino V, Shaba B, Dibari F, Collins S. Effectiveness of milk whey protein-based ready-to-use therapeutic food in treatment of severe acute malnutrition in Malawian under-5 children: a randomised, double-blind, controlled non-inferiority clinical trial. 2014 Feb 13. DOI: 10.1111/MCN.12112 Available from: https://www.ncbi.nlm.nih.gov/pubmed/24521353
Owino V, Irena A.H, Dibari F, Collins S. Development and acceptability of a novel milk-free soybean-maize- sorghum ready-to-use therapeutic food (SMS-RUTF) based on industrial extrusion cooking process, Maternal Child Health. 2012. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1740-8709.2012.00400.x/abstract
Owino V, Bahwere P, Bisimwa G, Muwangi C.M., Collins S. Low-cost, ready-to-use therapeutic foods can be designed using locally available commodities with the aid of linear programming. Journal of Nutrition. 2012. Available from: http://jn.nutrition.org/content/early/2012/03/27/jn.111.156943.full.pdf
Bahwere P, Balaluka B, Wells J, Mbiribindi C.N., Sadler K, Akomo P, Dramaix-Wilmet M, and Collins S. Cereals and pulse-based ready-to-use therapeutic food as an alternative to the standard milk- and peanut paste-based formulation for treating severe acute malnutrition: a non-inferiority, individually randomized controlled efficacy clinical trial. Am J Clin Nutr. 2016; 115.119537). Available from: http://ajcn.nutrition.org/content/early/2016/03/16/ajcn.115.119537.abstract
Books
Collins S, Akech S, Berkley J. Chapter in principles of medicine in Africa. 4th Edition. Cambridge University Press, Cambridge UK, 2012.
Collins S. Severe adult malnutrition - The limits of human adaptation to starvation. Lambert Academic Publishing. Germany. 2011. ISBN 978-3-8433-9484-0 Search this book on 
.
Wiesmann D, Sost AK, Schöninger I, Dalzell, H, Kiess L, Arnold T, and Collins S. The Challenge of Hunger 2007 - Global Hunger Index: Facts, determinants, and trends - Measures being taken to reduce acute undernourishment and chronic hunger. 2007 Oct. Available from: http://ebrary.ifpri.org/cdm/ref/collection/p15738coll2/id/125262
Honours[edit]
Steve Collins was appointed Member of the Most Excellent Order of the British Empire (MBE) in 2001 by HM Queen Elizabeth II for services to humanitarianism. In 2010 he was made Senior Ashoka Fellow. In 2012, Steve received an honorary doctorate from Long Island University in the USA.
References[edit]
- ↑ Collins, Steve (August 1995). "The limit of human adaptation to starvation". Nature Medicine (1): 810–814. doi:10.1038/nm0895-810.
- ↑ Collins, S; Myatt, M; Golden, B (July 1998). "Dietary treatment of severe malnutrition in adults". The American journal of clinical nutrition. 68 (1): 193–9. doi:10.1093/ajcn/68.1.193. PMID 9665114.
- ↑ Collins, Steve (August 1996). "Using Middle Upper Arm Circumference to Assess Severe Adult Malnutrition During Famine". JAMA. 276 (5): 391-395. doi:10.1001/jama.1996.03540050051023.
- ↑ Bahwere, Paluku; Collins, Steve; Binns, Paul; Dent, Nicky; Guerrero, Saul; Hallam, Alistair; Saboya, Montse; Sadler, Kate; Khara, Tanya; Walsh, Anne (October 2006). Community-based Therapeutic Care (CTC) - A Field Manual (PDF) (2006 ed.). Oxford, UK: Valid International. p. 1-247. Search this book on
- ↑ Collins, Steve; Dent, Nicky; Binns, Paul; Bahwere, Paluku; Sadler, Kate; Hallam, Alistair (September 2006). "Management of severe acute malnutrition in children". The Lancet. 368 (9551): 1992 - 2000. doi:10.1016/S0140-6736(06)69443-9.
- ↑ Collins, Steve; Sadler, Kate (December 2002). "Outpatient care for severely malnourished children in emergency relief programmes: a retrospective cohort study". The Lancet. 360 (9348): 1824–1830. doi:10.1016/S0140-6736(02)11770-3.
- ↑ Collins, Steve; Dent, Nicky; Binns, Paul; Bahwere, Paluku; Sadler, Kate; Hallam, Alistair (December 2006). "Management of severe acute malnutrition in children". The Lancet. 368 (9551): 1992–2000. doi:10.1016/S0140-6736(06)69443-9.
- ↑ Collins, Steve; Khara, Tanya (November 2004). "Community-based Therapeutic Care (CTC) Community-based Therapeutic Care (CTC)" (PDF). Emergency Nutrition Network (ENN) Special Supplement Series (2): 1-56.
- ↑ WHO/UNICEF/WFP/UNSSCN (May 2007). Community-based management of severe acute malnutrition: A Joint Statement by the World Health Organization, the World Food Programme, the United Nations System Standing Committee on Nutrition and the United Nations Children’s Fund (PDF). Geneva, Switzerland: World Health Organization. ISBN 978-92-806-4147-9. Search this book on
- ↑ UNICEF Supply Division (February 2017). Ready-to-Use Therapeutic Food: Current Outlook (PDF). Copenhagen: UNICEF. p. 1-9. Search this book on
- ↑ Collins, Steve; Henry, Jeya (November 2004). "Alternative RUTF formulations". Emergency Nutrition Network (ENN) Special Supplement Series (2): 35.
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