Treasury proposes alternatives in fight against child malnutrition

Testifying under a subpoena on Wednesday at the South African Human Rights Commission’s (SAHRC’s) hearing into child malnutrition in the Eastern Cape, Treasury Director-General Duncan Pieterse proposed alternatives to fight hunger as his department couldn’t afford a roll-out of higher child support grants and the expansion of the national school feeding scheme.

Two years ago, the SAHRC found that malnutrition in the Eastern Cape should be declared a state of disaster and should be treated accordingly. 

Read more: Child malnutrition in the Eastern Cape ‘qualifies as a disaster’

The commission also recommended that the Treasury consider increasing the Child Support Grant to above the food poverty line; prioritise children under school-going age for the Child Support Grant increase, and extend the National School Nutrition Programme to early childhood development (ECD) centres.

By September this year, it became clear that many of the recommendations, including those addressed to the Treasury, were not being complied with, even though in some cases a good-faith effort had been made.

Officials subpoenaed

The SAHRC then subpoenaed a number of high-ranking officials, including the heads of the National Department of Health and the Eastern Cape Department of Health, Eastern Cape Premier Oscar Mabuyane and officials from social development and education, to explain whether their recommendations were being implemented and if not, to provide reasons.

Read more: Urgent call for accountability as nearly 1,000 children die from severe malnutrition in SA

At this hearing, head of the National Department of Health Sandile Buthelezi provided the commission with devastating statistics showing that 973 children under the age of five who had severe acute malnutrition had died in public facilities countrywide. This was only nominally lower than the statistics which prompted the SAHRC’s first call for a concerted approach to fight hunger in the country.

Underscoring the extent of the hunger crisis, Buthelezi said the figures excluded children dying at home or in private hospitals. He said the health department was often the last resort for any help for the children.

“We are meeting in solemn and urgent circumstances,” SAHRC commissioner Philile Ntuli said at the previous hearing. “This is not a symbolic hearing,” she said. “We want to secure clear accountability… This is not a natural disaster. It is a failure of the state.”

Read more: ‘We need help’ – Department of Social Development admits to acute Eastern Cape hunger crisis

The Treasury’s Pieterse, who could not attend the September hearings, said on Wednesday that the department had alternative proposals to those made by the SAHRC.

First, he said, was work already being done to address social grant fraud with the South African Social Security Agency (Sassa).

He said that earlier this year, “we started attaching conditions to their allocations for them to tighten social grant beneficiary verification.” Anecdotal evidence, and research, had uncovered a “significant increase in social grant fraud”.

“As a result of increased verification – we have identified significant savings that arise from these efforts to tighten social grant beneficiaries.” Pieterse said verification of 55,000 social grant beneficiaries showed that between 3,000 and 4,000 were not eligible for the social grant.

“We pay well above 20 million social grant beneficiaries every month – that means potentially that better verification … has the potential for savings that can strengthen the grant system and the social wage.”

He said that at the mid-term budget, to be presented later this month, the government would further announce the closure of low-priority and ineffective government programmes.

“That process has started, and we will announce some initial successes, but the process will continue so we can close things that are not working where there is a lot of wastage,” Pieterse said.

Read more: Eastern Cape Treasury concedes fight against hunger is failing, calls for revamped strategy

Income threshold

Another Treasury proposal was to review the income threshold for the child support grant. Currently, a single parent earning less than R67,200 a year, or a couple earning less than R134,400, qualify for a child grant.

Pieterse said if these thresholds were raised, meaning fewer parents or caregivers qualified for the child support grant, the grant could be increased. 

“This way we will target children who are absolutely in need,” he said.

He said better registration and tracking of social grant beneficiaries would also help to eradicate “double dipping” and disqualify ineligible recipients.

The child support grant, at R560 a month, is under the food poverty line. To reach the food poverty line, at R796 a month, will cost the country R31-billion a year to cover 12 million children. 

“One then has to say if we were to make a decision like this, we do not have the revenue, and we are not able to borrow for that additional funding, what are the areas where we can get those funds from?” asked Pieterse.

Early childhood subsidy

Pieterse said that similarly, the logistics costs to extend the school nutrition programme, the country’s most efficient tool fighting child malnutrition, to ECD centres would be prohibitively expensive.

He said the Treasury believed that increasing the early childhood subsidy would be a more efficient way to extend nutritional support to ECD centres. 

“There are over 50,000 ECDs that will need nutritional support. Delivering food to that amount of additional sites will not be affordable due to high delivery cost,” he said. Paying a stipend of R18,000 per food handler at these centres would require another R900-million a year.

“In addition, the majority of ECD facilities do not have safe preparation and storage facilities,” he said. “The additional costs that will be required will dwarf any savings,” Pieterse said.

He said the total cost of expanding the school nutrition programme to the  ECD sector would cost R3-billion over the medium term, at about R4 a child.

Instead, Pieterse suggested the ECD subsidy should be increased as this would reduce barriers of access to the sector and boost nutrition at the creches.

“It is the most effective way to get nutrition to the poorest and most vulnerable children.”

Increasing the ECD subsidy to R24, as was announced in the 2025 Budget, per child per day, was a significant step. 

“There is an enormous amount of literature supporting this and it links back performance in school to ECDs,” Pieterse said, adding that it was an important step towards the success of South Africa’s educational system.

He said this increase, which cost the country R10-billion, had been proposed by the Treasury and accepted by Parliament and the Cabinet.

Of this subsidy, Pieterse said, the conditional grant framework required that 40% be spent on nutrition. “This represents a R4-billion allocation to nutrition,” he added.

Pieterse said the Treasury was responsible for the budget process, but the decision on where resources were allocated was made by the Cabinet. 

“We assess the macroeconomic environment and fiscal sustainability – within that, we provide advice.”

Pieterse said that a cornerstone of budgeting was providing for a social wage, supporting access to education, health and transport. “This social wage constitutes 60% of our non-interest spending,” he said. “It has been a hallmark of our fiscal framework.”

“Even now, as we move to greater sustainability, we do not compromise the social wage,” he added. 

However, he said that there were spending pressures that could not be accommodated within the current fiscal framework.

“We wanted to increase VAT to allow us to spend more, but this was rejected,” he said. DM