Project Peanut Butter was founded by Mark Manary, M.D., a pediatrician who currently serves as the Helene Roberson Professor of Pediatrics at Washington University School of Medicine in St. Louis, Missouri.

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In 1985, Dr. Manary and his wife, Mardi Manary, first moved to Africa to work in a rural hospital in Tanzania. It was here that Dr. Manary realized the extent of malnutrition and the inadequacy of the former standard treatment.

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The Manary family moved to Gambia and then New Guinea in the early 90s, where Dr. Manary continued to confront malnutrition.

From 1994 to 1999, Dr. Manary spent time in both Malawi and the United States working with malnourished children and studying the traditional method of treating malnutrition at the time, which consisted of hospital-based care and a milk-based formula.

He was dismayed to find that recovery rates for malnourished children were no better in 1999 than they were when he first worked in Africa in 1985; only about 25-40% of children recovered. He knew he had to come up with a better solution.

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In 1999, Dr. Manary spent 10 weeks living in a village in Malawi, becoming familiar with the lives of rural Malawians and what an effective treatment of malnutrition needed to entail. He concluded that the therapeutic food had to be something that didn’t spoil, didn’t need to be cooked, was easy for mothers to give in small amounts to their children at home, and was energy dense.

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Dr. Manary's early exploration of home-based therapy evolved into a successful, long-term collaboration with colleague Dr. André  Briend, who worked with the World Health Organization, and Nutriset, a French company that produced early versions of Ready to Use Therapeutic Foods (RUTF).

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From 2000 to 2004, the doctors and their small teams tested various formulas with thousands of malnourished children in a series of controlled clinical trials within Malawi. The results of these trials were striking: 95% of these children recovered! Compare that to the 25% to 40% who fully recovered using traditional hospital therapies, and as Dr. Manary said, "You don't need to be a statistician to know this is different and powerful."

Project Peanut Butter was officially founded and began producing food in Malawi in 2004. In 2007, the United Nations, World Health Organization, and World Food Programme recognized RUTF with home-based therapy as the standard of care for severely malnourished children worldwide.