The conversation about food has to change to acknowledge that it is the basis of the right to physical and mental health, says Dr Tlaleng Mofokeng, the UN Special Rapporteur on the Right to Health, who launched a new report titled Food, Nutrition and the Right to Health at an event in New York on Friday, 27 October.

The event was hosted by the Aspen Institute, Global Centre for Legal Innovation on Food Environments at the O’Neill Institute for National and Global Health Law, Vital Strategies and Bloomberg Philanthropies. 

Mofokeng was joined by a panel of experts on food policy to dissect how people are in a position to improve their diets only if healthier food systems and environments are created and maintained. Mofokeng noted the intersection of health with climate change, poverty, the burden of illness and gender parities. 

“We need to realise that for many people in crisis – because of climate change, conflict and war, protracted war in places such as Sudan, Syria, Ethiopia – they have very particular needs and challenges,” Mofokeng said, noting that those factors affected food access.

“So for me, it was important to bring that synergy as the world and the UN member states prepare for the [United Nations] Summit for the Future to envision a new world as we think of what new sustainable goals we want to set,” Mofokeng said.

The report highlights that it is paramount to address the global obesity epidemic, which has an estimated global annual economic cost of $2-trillion, which Mofokeng said was a mammoth task “under the deluge of ultra-processed products that make up most of our food intake”.

Through the report, Mofokeng demonstrates how food security and nutrition are necessary elements for global progress towards all 17 of the UN’s Sustainable Development Goals.

Mofokeng is a globally renowned doctor, human rights defender and the bestselling author of Dr T: A Guide to Sexual Health and Pleasure. Her work focuses on sexual and reproductive health rights and food security.

She is experienced in legislative reform, policy, healthcare provision, advocacy and health communication. She is currently a lecturer at Georgetown’s O’Neill Institute for National and Global Health Law and at Stellenbosch University’s Africa Centre for HIV/Aids Management. 

Mofokeng explained that populations across the world did not have access to healthy food and said that if meeting basic human rights was a measure of development, no country across the globe could be considered “developed”.

“The rich countries call themselves developed and the global south is not developed, but if you use human rights as a measure of development there are no developed countries in the world. They are yet to exist,” she said.

Industry lobbying

Dr Neena Prasad, director of Bloomberg’s food policy programme, spoke about forming policies aimed at empowering consumers with knowledge and lessening the availability of ultra-processed foods.

She noted that people might have the knowledge to choose healthier options but did not have the money or access, as ultra-processed foods were often more readily available in lower-income communities.

“We have the exact opposite agenda of the manufacturers of ultra-processed products. We want to reduce consumption and the manufacturers want to increase value; that means more consumption. We want to get to a place where healthy food is the default food for people.”

To promote nutritious foods, Prasad mentioned methods such as taxing sugary drinks to reduce consumption and changing the economic determinants of consuming unhealthy food. Another policy is front-of-package labelling, where policymakers are pushing for simpler, larger labels that tell consumers how much salt, sugar and other adverse ingredients are contained in a product.

“There are a few challenges – the interference of industry in realising these policies. There is a parallel between the tobacco companies’ methods to fight against restrictions [and] ultra-processed product manufacturing and marketing,” she said.

Prasad said the food industry conducted lobbying and funded its own research that was not peer reviewed. She said it also funded front groups that threatened legal action against civil society groups.

“The industry will first try to stop any policy action. They will try to delay it. If they can’t delay it, they will try to weaken the implementation of it and even then they are constantly trying to reverse policy. I just want to give a shout-out to the advocates around the world. Even trying to hold on to a policy win in the face of relentless attacks from the industry is a huge success,” she said.

Prasad said the other challenge was the reformulation of products to circumvent policies, such as using aspartame instead of sugar, and rebranding it as healthier even though it is still bad for consumers’ health. She said policymakers had to widen the scope of the definition of ultra-processed products to leave little room for loopholes. 

Changing the conversation

The report delves deep into the points covered by the speakers.

“The political determinants of health drive particular outcomes around the world. For instance, the liberalisation of trade policies has played a key role in increasing the free flow of unhealthy foods and beverages between countries,” it reads.

“Through foreign direct investments, multinational corporations have purchased and invested in food-processing companies in lower-income countries to sell their products on domestic markets while avoiding tariffs and transportation costs. Food, particularly the distribution of food aid and agricultural inputs, has also been used as a political tool,” it continues.

Mofokeng said the conversation around food had to change to acknowledge that food was the basis of the right to physical and mental health.

“Experiencing famine and starvation can alter the way your DNA, body experiences food. Your body can begin to store fat to keep you alive for when you are not getting food. The body adjusts to that trauma,” Mofokeng said.

She highlighted how the Covid-19 pandemic woke the world up to inequalities and how nutrition was significant for immunity to pandemics.

The report reads: “Malnutrition alters the body’s immune responses, which can protect against viral proliferation, especially in infants, children, adolescents and older adult populations. Two billion people suffer from micronutrient deficiencies, including vitamins A, C and E and the minerals zinc, iron and iodine, which impair the body’s ability to form antibodies and develop a strong immune system.”

Mofokeng said that communities were already finding solutions to the crisis so they shouldn’t be infantilised.

“Let’s not find ourselves having a saviour complex,” she said, explaining that such an approach was problematic and made the implementation of change difficult. 

Recommendations 

Some of the recommended solutions proposed by the report are to:

• “Adopt a comprehensive approach to food systems regulation and the nature and extent of impacts on nutrition and health, from food production to processing and packaging, promotion, distribution, sale and consumption;
• “Analyse food security and nutrition and how they affect health, wellbeing and spaces such as clinical settings in the management of diseases and the promotion of wellness, which must be multisectoral. Access and outcomes such as intra-household distribution of food, consumption and nutritional status must be measured and monitored, and those trends addressed with agility by all stakeholders;
• “Adopt legislative and regulatory measures to protect, promote and support breastfeeding, enabling individuals to deliver this foundational triple duty action; and
• “Design and adopt policies to support small-scale and family farmers, which can link production to local food programmes, including school feeding programmes, and local markets through shorter supply chains. These policies can be designed to increase small-scale farmers’ income while also reducing the cost and other barriers to healthy and nutritious food for consumers. Specifically, such interventions can be designed to support populations that have a strong connection to the land and have also been historically disadvantaged.”

Mofokeng wrapped up the event in a way that humanised the sometimes technical conversation around food, nutrition and health. 

“We need to create conditions that are conducive to a life of dignity and take seriously the fostering of fond memories and family bonding through ‘living off the land’, enabling experiential intergenerational teaching and learning, and promoting resourcefulness and offsetting economic marginalisation,” Mofokeng said. DM