South Africa is currently Sub-Saharan Africa’s leading market for the food and beverage industry. However, this market is failing to deliver nutritious and affordable diets for South Africa’s people. 

Instead, it is encouraging the overconsumption of unhealthy foods. This is driving a triple burden of malnutrition (underweight, overweight/obesity, micronutrient deficiencies), a range of associated diseases (such as diabetes and hypertension) and increasing healthcare costs. 

For example, treating people diagnosed with diabetes already costs taxpayers in South Africa almost R3-billion per year, according to a 2018 Global Health Action study. This would be more than R21-billion per year if undiagnosed cases were included. By 2030, the projected annual bill will be more than R35-billion, which would amount to more than 12% of the total annual health budget for South Africa.

We need to, and can, prevent this. 

The 2021 Access to Nutrition (ATNI), Global Access to Nutrition Index assessed product profiles in 25 countries, including South Africa. Of the 25 largest global food and beverage manufacturers, eleven market their products in South Africa: Coca-Cola, Danone, General Mills, Kellogg’s, Lactalis, Mars, Mondelez, Nestlé, PepsiCo, Suntory, and Unilever. 

Looking across these companies’ product portfolios in South Africa (and among approximately 1,000 different products), over 70% did not meet “healthy” thresholds when assessed against the Health Star Rating (HSR) system. Only five of eleven companies’ products in South Africa meet the World Health Organization’s (WHO) criteria for marketing to children, to reduce the impact of foods high in free sugars, unhealthy fats, and salt. 

Further, using the WHO African regional nutrient profile model (NPM), only 10% of products assessed in South Africa met the WHO criteria for marketing to children. 

ATNI just refreshed its vision and mission until 2030. Our exciting and ambitious vision is a world where markets significantly contribute to providing access to nutritious and affordable diets for all. We aim to transform market performance by driving key actors in the food system — starting with industry — to accelerate access to affordable nutritious foods for all, especially vulnerable consumers, in a sustainable way. We do this by developing and delivering data-driven tools and strategies that influence, guide and measure accountability.

Reforms needed in South Africa

For South Africa, there are several actions which are urgently needed to support a market transformation so that nutritious and affordable foods are available for all. 

First, let’s look at the food industry. 

The private sector, in many regions and countries, has shown that it can, at times and on its own initiative, make progress. For example, Unilever announced earlier this year that it will be the first global foods company to publicly report the performance of its product portfolio against six government-endorsed nutrient profile models. Other companies are working on similar initiatives now. 

Visit Daily Maverick’s home page for more news, analysis and investigations

ATNI encourages all multinational food companies to follow suit and publicly report on the healthiness of their products. We encourage South Africa’s national food companies to do the same. These include Anglo-Vaal Industries, Crookes Brothers, Astral Foods, Distell, RCL Foods, Tiger Brands and Tongaat Hulett. This is good business. 

The multinational and national companies above are all publicly listed. Investors are increasingly placing pressure on food companies to invest in nutrition. Unilever made its decision to report its performance on nutrition partly based on the pressure exerted from its shareholders and based on data generated by ATNI. We will continue to generate data on company portfolios and use this to engage with investors and to place appropriate pressure on industry to change. 

Second, while self-reporting is helpful, it is not enough. Government must also step up and improve regulations. 

There have been recent, commendable initiatives in South Africa. For example, in 2011 legislation was adopted to effectively ban trans fats in foodstuffs and reduce salt in processed foods. And in 2017 the Health Promotion Levy on sugary beverages was approved. However, to date these have not been effectively enforced — or in the case of the Levy — the revenue has not been used for the stated purpose of health promotion. 

Strong political will is required to enact, enforce and monitor food regulations,  including fiscal policies that direct subsidies to the growing or production of healthy foods and implement penalties on unhealthy ones. ATNI aims to increasingly make its data and market analyses available to inform appropriate policy responses that improve markets to deliver healthier foods and diets for all.  

Third and lastly, consumers remain largely in the dark about what exactly is in the food they eat, and what this means for their health. National consumer associations can and should play a much more prominent role to shine a light on healthy diets and to improve the lack of transparency and accountability in industry. 

As ATNI expands its work over time, it will help businesses understand how to assess their portfolios and label their food better. We aim to work with consumer associations to inform the consumer about healthy foods and products and to improve overall nutritional literacy. 

Transforming South Africa’s food systems will not be easy, but it is imperative. It starts with the private sector doing better in delivering nutritious foods. This is essential to ensuring the availability of affordable, nutritious foods for all, including the vulnerable, and to prevent the many diseases and ill health associated with malnutrition. DM/MC

Greg S Garrett is the Executive Director of the Access to Nutrition Initiative (ATNI), an independent foundation based in the Netherlands that develops tools and strategies to drive better market performance and improve the contribution made by the food and beverage sector to addressing global nutrition challenges. 

16 October is World Food Day and Maverick Citizen will be publishing articles throughout the week in commemoration of this which will culminate in a special newsletter on Friday 14 October.