Dr Kopano Matlwa Mabaso is executive director of Grow Great. Nzama Mbalati heads the Healthy Living Alliance (HEALA). Hoodah Abrahams-Fayke is national advocacy manager for Black Sash. Anele Yawa is General Secretary of the Treatment Action Campaign.

 Hunger in South Africa may never be the same after Covid-19, and our food systems shouldn’t be either.

Although food insecurity during the outbreak peaked in the initial phase of infections – when lockdown restrictions were harshest – the level of hunger has remained essentially unchanged over the past year, according to the latest National Income Dynamics Study – Coronavirus Rapid Mobile Survey (NIDS-CRAM). About 10 million people and three million children were living in households affected by hunger as of May 2021. Household and child hunger is now reported at levels higher than pre-2020. A study by Grow Great found that four in 10 women surveyed in the Western Cape went to bed hungry at least once a week at the height of the pandemic.

Covid-19, NIDS-CRAM researchers warn, has ushered in a “new and higher equilibrium level of hunger and food insecurity”. 

South Africans’ inability to access affordable and nutritious food comes when cheap, ultra-processed foods – some intentionally marketed at poor and black consumers – are increasingly available. 

Most food is processed in some or other way, and some forms of processing can contribute to healthy diets, researchers point out in a recent article in the British Medical Journal. Still, some extreme industrial processes use additives to transform things like corn, oil and sugar into cheap, long-lasting but nutrient-poor foodstuffs – think cold drinks, polony and ready-made frozen meals.

These types of diets are associated with both undernutrition and obesity. Several large-scale research reviews show that, over time, a diet high in ultra-processed foods can increase a person’s risk of, for instance, diabetes and cardiovascular disease. Today, conditions such as these are some of the leading causes of natural death in South Africa, the latest data from Statistics South Africa show.   

A 2018 study that measured access to healthy food in Gauteng by mapping fast-food outlets and grocery stores found that wards with the worst formal access to healthy food were predominantly black. However, some but not all of these wards had low population densities. Overall, fast-food outlets in Gauteng outnumbered supermarkets by a ratio of two to one, according to the research published in the South African Health Review. 

But our relationship with food is also complicated. Food can be just as often emotional as it is functional – it can be a reminder of our past, a comment on our present, and it can speak to what we aspire to be. 

For instance, today some people in South Africa equate eating fast-food and drinking sugary cold drinks with wealth, noted a 2016 paper by the University of the Western Cape’s Institute for Poverty, Land and Agrarian Studies. Meanwhile, the report found that decades of public health messaging about the importance of nutrition for people living with HIV or tuberculosis may have inadvertently stigmatised diets high in fruits and vegetables. 

Although consumer preferences like these – or their rejection of them – can shape the food market, food manufacturers also use clever marketing to reinforce notions about food’s aspirational value, for instance. 

For too long, conversations about our health and what we eat in South Africa have focused on the idea that we alone choose what is on our plates. Discussions about food and health implore people to “eat better” or “choose wiser”. The reality is that there is a complex and largely hidden “food system” working behind the scenes to influence your food choices well before you take a bite.

When we think of food, many of us conjure images of farms or food gardens, maybe a grocery store aisle and then, finally, what we put on our plate. Still, the systems that produce, process, price and distribute our food extend far beyond that. 

And these systems globally – and in South Africa – are broken. 

Civil society coalition the Healthy Living Alliance (HEALA) believes that a food-just South Africa can only be achieved when the government supports people’s coping strategies and self-reliance. Moreover, it must implement a mix of poverty-reduction measures, including urgently raising Africa’s Child Support Grant to, at minimum, the food poverty line of R624 and extending the grant to cover pregnancy. 

In South Africa, the government-determined food poverty line is a policy measure used to estimate the average monthly cost of meeting a typical person’s average caloric needs. Many believe that even the recently set food poverty line of R624 per month is woefully inadequate. 

The national Child Support Grant remains a paltry R460. The Covid-19 “emergency” grant is R350 per month. As the only permanent grant below the food poverty line, the child grant should be increased to at least the upper bound of the Statistics South Africa-recommended food poverty line – R1,335.

Given widespread increased unemployment and poverty, an unemployment income grant for those aged between 18 and 59 should also be introduced at this level, as the country works towards introducing a basic income grant. Basic income grants can safeguard people’s health, food security and education while stimulating economic growth. 

But the government must use all of the policy tools at its disposal to help build a healthy food environment that enables all South Africans to achieve their full potential, which means regulating the food environment to curb the availability of unhealthy food. It must start by doubling the health promotion levy on sugary drinks from 11% to 20% to bring it in line with international best practice. 

Second, government officials must ensure all eligible pupils – whether in-school or not because of Covid-19 – receive daily nutritious lunches through the National School Nutrition Programme. Finally, the government must work for consumers and not corporations by implementing easy-to-understand front-of-package labelling and enacting strong advertising and marketing regulations to counteract the industry influence and protect children’s health.  

As the UN meets on Thursday, we ask South Africans to consider the invisible hand of the “food system”, working carefully to influence what foods we eat and how much they cost. That system is broken and hunger and malnutrition, as well as disease, are the consequences. To fix it, South Africa must embark on not only poverty-alleviation strategies, such as implementing a basic income grant, but also better regulation of food systems to ensure they are pro-poor and work for consumers. 

We all deserve a food system that puts health above politics and profits, and that actively dismantles the systemic inequities that limit our country’s potential. The government must act now to ensure that a food-just South Africa becomes a reality. DM/MC