With one day to go before the 21 July closing of the public comment period for new draft legislation on mandatory food labelling and restrictions on marketing of unhealthy foods and drinks, the Healthy Living Alliance (Heala) is calling on government to strengthen the proposed marketing restrictions – specifically, to place tougher restrictions on advertising and marketing to children.

The new draft regulations, called R3337, include long-awaited, mandatory front-of-pack warning labels for foods high in added sugars, fats and salt, and on any product containing artificial (non-sugar) sweeteners, to reduce the risks of obesity and non-communicable diseases such as type 2 diabetes and cardiovascular disease.

The draft regulations also propose long-awaited restrictions on the marketing and advertising of foods and drinks to children, who are particularly vulnerable to the influences of marketing, and are often the targets of “aggressive food and beverage advertising campaigns”, Heala says.

But the proposed marketing restrictions make up little more than one page of the 248-page document and do not go far enough, Heala says, because they do not completely ban all advertising to children.

“Evidence shows that the best pathway to restricting advertising of unhealthy products is an outright ban,” Heala spokesperson Nzama Mbalati told Daily Maverick.

Often, he said, where there were some restrictions and not others, industry might find loopholes and still succeed in carrying out indirect marketing.

Read more in Daily Maverick: Draft regulations aim to make warning labels on unhealthy foods mandatory by 2025

The previous food labelling and advertising regulation, 2010’s R146, dealt with “a very narrow concept of false or misleading advertising”, Mbalati said, and that comparing 2010 to the 2023 regulations was “apples and oranges” because the new regulations went much further and overall were a big improvement.

“R3337 serves an entirely different purpose, aimed at better empowering consumers to make healthy choices and protecting children from tactics that have been shown to shape eating behaviours over the life course. These regulations try to limit the marketing techniques that have very little to do with the food itself,” he said.

An example of this is R3337’s prohibition on the use of celebrities, cartoon mascots, competitions or visions of positive family environments (eg “a happy, caring family scenario”, the regulation says) to promote their products.

“This has nothing to do with the food product itself, but can entice children to want products they otherwise wouldn’t buy,” Mbalati said.

This prohibition also aims to prevent creating false associations between the advertised product and healthy or otherwise positive features of the products, for example, when a fast-food company sponsors the Olympics, creating the impression that the foods and drinks they sell may be healthy (though the athletes competing are unlikely to be consuming those foods and drinks).

Proposed new labelling and marketing regulations

The new mandatory warning label and marketing regulations, predicted to be passed into law only in 2025, stipulate prominent front-of-pack positioning of black-and-white triangular labels warning that the product is “high in sugar”, “high in saturated fat”, “high in salt” and/or “contains artificial sweeteners”.

The National Department of Health’s new draft regulations on mandatory warning labels for unhealthy foods require that foods and drinks containing more than a certain specified threshold of sugar, salt, or saturated fat, and those containing any non-sugar sweeteners, carry black-and-white triangular warning labels prominently displayed on the front of the product’s packaging. Photo: National Department of Health

Focus-group studies conducted in South Africa in 2020 and 2022 proved that warning labels – specifically the black-and-white triangular ones proposed in the new regulations – are easily understandable by South Africans and highly effective in changing their food-purchasing choices, away from unhealthy foods and drinks and towards healthier options.

Nearly 80% of pre-packaged foods on South African supermarket shelves are highly processed or “ultra-processed”, containing excessive amounts of added sugars, salt, unhealthy fats and chemical additives that make them irresistibly tasty.

Ultra-processed foods are often stripped of most naturally occurring nutrients and reconstituted with added chemicals such as emulsifiers, flavourants, thickeners, stabilisers, sugars, other sweeteners and hydrogenated fats (example product: A certain wildly popular potato-based snack made of dehydrated potato, modified starches, flavour enhancers, salt and sweeteners, which is moulded into the shape of a “real” potato chip and which seem impossible to stop eating).

Around 13% of children in South Africa are obese – higher than the 10% global average – which places them at high risk of remaining obese and developing type 2 diabetes and other non-communicable diseases later in life.

In 2022, Prof Karen Hofman, director of the Centre for Health Economics and Decision Sciences at Wits’ School of Public Health, told Daily Maverick that if government was “fully on board” with what she called the “true cost of obesity, and… overweight-related conditions to the country… there would be much more control over what was and is being advertised to children”.

Read more in Daily Maverick: Redefining food safety: SA’s laws governing food advertising aimed at children need to be jacked up

Current marketing regulations

South Africa’s current regulations governing the labelling of foods (called R146) were published in 2010 and have not been updated since – even though in the same year, the World Health Organization issued a set of 12 recommendations on restricting or prohibiting the marketing of foods and non-alcoholic beverages to children.

R146 stipulates only the most basic labelling requirements (the product’s ingredients and the manufacturer’s address) but has no marketing or advertising guidance or restriction.

The WHO said at the time it was “deeply concerned that in 2010 it is estimated that more than 42 million children under the age of five years will be overweight or obese, of whom nearly 35 million are living in developing countries”.

The 2010 recommendations recognised the “high and increasing prevalence of noncommunicable diseases [such as type 2 diabetes, high blood pressure and cardiovascular diseases] in low- and middle-income countries which, with the communicable diseases [such as HIV and TB] still affecting the poor, contribute to a double burden of disease which has serious implications for poverty reduction and economic development and widens health gaps between and within countries”.

Read more in Daily Maverick: Taking a spoon to a knife fight – is South Africa ready for rising obesity rates?

The WHO’s 2010 recommendation urges member states to “take necessary measures to implement the recommendations on the marketing of foods and non-alcoholic beverages to children” and to “develop new and/or strengthen existing policies that aim to reduce the impact on children of marketing of foods high in saturated fats, trans-fatty acids, free sugars, or salt”. (In 2022, new research highlighted the negative long-term impacts of non-sugar sweeteners on metabolic and cardiovascular health, which is why the WHO now recommends limiting their use, too).

The WHO’s recommendation also encourages countries to “cooperate with civil society and with public and private stakeholders in implementing the set of recommendations on the marketing of foods and non-alcoholic beverages to children in order to reduce the impact of that marketing, while ensuring avoidance of potential conflicts of interest”.

Conflicts of interest have been a concern for health activists in South Africa, who have alleged that food and beverage companies have inappropriately influenced government policy on food in the past. (One example of this: Revised draft marketing and advertising regulations, an amendment to R146 called R429, was gazetted in May 2014 but then “died”, sources told Daily Maverick, and was never passed into law.)

More recently, researchers have warned that industry influence on health policies “is greatest before draft legislation is ever made public in South Africa,” Daily Maverick reported in May 2022.

Lobbying – attempting to influence public officials’ decision-making – is not illegal in South Africa, and it is largely unregulated.

Daily Maverick requested comment from the Consumer Goods Council of South Africa on the marketing restrictions proposed in R3337, but had not received a reply by the time of publication.

While Heala strongly supports the National Department of Health’s regulation and believes “it can make a positive difference in protecting the health of all South Africans”, it is still calling for “a comprehensive prohibition on child-directed marketing”, including limiting advertising and sale of unhealthy products in or near schools and removing all advertising for unhealthy foods and drinks from television during time windows that feature child- and family programming.

The regulations “are not a complete answer to the harmful effects of the marketing of unhealthy products”, Mbalati said. DM

Consumers are encouraged to submit their comments on R3337, an amendment to the Foodstuffs, Cosmetics and Disinfectants Act of 1972, before midnight on Friday, 21 July 2023 to:

• The Director-General of Health, Private Bag X828, Pretoria, 0001 (for the attention of the Director: Food Control), by email to [email protected], or 
• Via Heala’s public submission campaign at https://awethu.amandla.mobi/petitions/demand-warning-labels-on-all-unhealthy-food.  mobi will be collating all the submissions from Heala’s public submission campaign and will send them to the NDoH. The public can use this page until midnight on 21 July.

R3337 might only be passed into law in 2025, due to the new Tobacco and National Health Insurance bills already in Parliament, Philip Mokoena of the Global Health Advocacy Incubator previously told Daily Maverick. 

Heala’s ‘Think Inside the Box’ campaign runs from 14-27 July at the Sandton Gautrain Station in the heart of the Sandton CBD, and features a series of life-size, 3-D “wire kids”, interactive sculptures filled with junk food and beverage cartons visually representing the composition of unhealthy diets how much unhealthy food we consume. The campaign is to raise awareness about the importance of warning labels on unhealthy foods and drinks.