Confronting SA’s hunger emergency — From constitutional rights to empty plates

South Africa’s Constitution promises the right to sufficient food for every citizen. This is a justiciable constitutional right enshrined in sections 27 and 28(1)(c), which makes basic nutrition for children immediately realisable. Rooted in transformative constitutionalism and international law, the right to food is linked to other constitutional and human rights – education, dignity, equality, health and the right to life, placing clear obligations on government at every level. 

South Africa is also bound by international instruments reinforcing the right to food, including Article 11 of the UN Covenant on Economic, Social and Cultural Rights, which guarantees everyone adequate food and the fundamental right to be free from hunger. This is not charity; it is law. Governments must act urgently and accountably, using maximum available resources to tackle poverty at its roots and make food security real.

In South Africa, the right to food means more than avoiding starvation. It guarantees that every South African should have reliable access to nutritious, culturally appropriate food through their own means – whether by growing it or purchasing it with adequate income. When people cannot feed themselves owing to circumstances beyond their control, the government must step in.

This creates three distinct duties for the state under section 7(2) of the Bill of Rights. First, the government must respect existing food access – no destroying crops, no arbitrary evictions from agricultural land, no cutting social grants without proper justification. 

Second, it must protect citizens from others who might undermine their food security – regulating food safety, preventing land grabs and ensuring markets function fairly. 

Third, and most demanding, the government must fulfil the right by actively creating conditions where people can feed themselves with dignity – through adequate social grants, support for small-scale farmers, school feeding programmes and emergency assistance during crises.

Crucially, certain aspects cannot wait for “progressive realisation”. The government must immediately eliminate discrimination in food access, ensure nobody faces starvation and provide emergency relief when disasters strike. These are minimum core obligations.

Our courts have recognised this. 

Yet enforcement requires monitoring, clear institutional responsibility and accessible remedies when the right is violated.

The Eastern Cape emergency 

As reported for weeks in the Daily Maverick, the constitutional promise stands in contrast to the reality now unfolding in the Eastern Cape, where the South African Human Rights Commission took the extraordinary step of issuing subpoenas to six national department directors-general.

Three years ago, the commission undertook a provincial inquiry into the right to food and child malnutrition. A damning report was tabled in Parliament a year later. Yet, children are still dying. The commission’s language is unvarnished: “slow, fragmented and inadequate” implementation has created an ongoing violation of fundamental rights, including the right of everyone to adequate food and the right to be free from hunger.

The subpoenaed departments – Social Development, Treasury, Basic Education, Home Affairs, Health and the Premier’s office – represent the entire ecosystem of child welfare. Their forced appearance before the commission reveals a systems failure. When a constitutional watchdog must compel government officials to explain why children continue to die from preventable malnutrition, we’re witnessing not just administrative failure but moral collapse. 

The commission has explicitly linked this crisis to four constitutional breaches: children’s right to basic nutrition, the right to sufficient food and water, human dignity, and the right to life itself. 

What makes this particularly damning is the timeline. The 2022 inquiry was not a surprise inspection; it was a thorough, carefully planned investigation. The 2023 parliamentary report was not buried in committee; it was tabled with clear recommendations. In 2025, the commission is now warning that without “urgent and coordinated action”, children will continue to die from hunger.

The threat of criminal prosecution – fines or imprisonment for non-compliance – underscores the gravity of food systems failures. When protecting children from starvation requires legal compulsion backed by criminal sanctions, we must ask: how did the promise of sections 27 and 28 become so hollow that only subpoenas can fill the void?

The numbers 

The commission’s hearings stripped away any remaining pretence about the scale of this emergency. 

Dr Sandile Buthelezi, the national Director-General of Health, delivered the cold arithmetic of state failure: 973 children dead from severe acute malnutrition in just 18 months. These are only the ones who made it to hospital – countless more died at home.

“We are only seeing them when they are already dying,” Buthelezi said. The health system, meant to be a safety net, has become a hospice for the starving.

The Eastern Cape’s 177 deaths place it third nationally, but the geographic patterns reveal something more sinister. 

Nelson Mandela Bay metro – not some remote rural district – now shows among the highest malnutrition levels in the province. When children starve in sight of shopping malls and government buildings, we cannot blame distance or inaccessibility.

Dr Rolene Wagner’s revelation that infants under six months are now presenting with severe malnutrition – previously unseen – signals a new depth to this crisis. These are breastfeeding-age babies, suggesting mothers too malnourished to feed their children, or teenage mothers who do not breastfeed at all. The province recorded 117 births to children aged 10–14 since April alone.

The premier's admission

Premier Oscar Mabuyane’s testimony on 12 September laid bare the structural underpinnings of the situation: 41% of Eastern Cape residents live below the poverty line. A third of the population depends entirely on social grants. Nearly 10% report not having enough food. Stunting affects 33% of children – five percentage points above the national average.

His response? A “command-centre approach” – but crucially, no declaration of a state of emergency. 

This semantic dance around disaster declarations while children die epitomises the bureaucratic paralysis the commission seeks to break.

His observation that”parents must be parents” regarding teenage pregnancies spectacularly misses the point – these are children having children in conditions of such deprivation that both generations face starvation.

The betrayal

What emerges from these hearings is not just administrative failure but systemic betrayal at every level. The bottleneck analysis revealed staffing shortages, inadequate training, stockouts of essential nutrition supplies and barriers to accessing services. 

Commissioner Philile Ntuli’s stark assessment – “This is not a natural disaster. It is a failure of the state” – cuts through the euphemisms. Thirty-one years after apartheid’s end, when hunger was a tool of oppression, South African children still die from malnutrition. The methods have changed; the outcomes have not.

While officials debate formulas and frameworks, 973 families have buried children who died not from exotic diseases but from hunger – in a country that exports food. 

The South African food system embodies a crushing paradox. 

As Africa’s most industrialised nation and an upper-middle income country, South Africa boasts a sophisticated agricultural sector, maintains a positive food balance and has crafted an array of food and nutrition policies. Yet this same system produces severe malnutrition including obesity; destroys agricultural livelihoods whilst exporting produce; and creates stark territorial disparities where plenty and poverty exist side by side. Vulnerable populations including women, children, persons with disabilities, older persons, refugees and students, whose exposure to hunger is intensified by climate change, conflict, pandemics and systemic inequality. 

Clearly, hunger transcends individual circumstances. It is not about personal failure. It’s about a complex web of economic, social and political barriers that prevent citizens from accessing their most basic human right.

Making sense of South Africa's hunger 

Understanding why children die from malnutrition in a food-exporting nation requires examining the structural barriers that prevent citizens from accessing their most basic human right. The critical paradigm shift from the 1970s focus on food availability (Norman Borlaug’s Green Revolution) to Amartya Sen’s emphasis on food access in the 1980s transforms how we diagnose and address hunger.

Grounded in the “capabilities” approach, Sen reframes the right to food as more than the provision of calories or survival rations; it is about real freedom to secure adequate, nutritious, culturally appropriate food in ways that preserve dignity and agency – whether through their own income, production or reliable social support. In this view, hunger is not simply a lack of resources but also a deprivation of basic human capabilities: the ability to be healthy, to learn, to participate in society. Born from witnessing the 1943 Bengal famine where 3 million died despite adequate food supplies, Sen’s entitlements framework identifies three legal routes to food:

• Production entitlements: The ability to grow your own food. In South Africa, this connects directly to land access, agricultural support for small-scale farmers and the legacy of dispossession that removed millions from productive land;
• Exchange entitlements: The ability to purchase or barter for food. This depends on employment, wages and food prices. When the Eastern Cape shows 41% living below the poverty line and a third dependent on social grants, exchange entitlements have collapsed; and
• Transfer entitlements: Access through formal or informal gifts, including government programmes. South Africa’s social grants, school feeding schemes, and emergency relief represent transfer entitlements. The commission’s subpoenas to six government departments reveal how bureaucratic failure destroys these lifelines.

Building on this, the Unicef conceptual framework provides a crucial additional lens that deepens our understanding of why children die from malnutrition despite food availability. The framework’s central insight – that child nutrition requires the simultaneous presence of adequate food, appropriate care, and health services – reveals why single-sector interventions often fail.

The framework’s emphasis on bringing “food, care and health to the same child at the same place at the same time” directly challenges the fragmented response criticised in the commission hearings. When Social Development, Health, Education and other departments work in silos, children fall through the gaps.

‘Abnormalising’ hunger

Perhaps the most insidious aspect of South Africa’s hunger crisis is how normalised it has become. After 30 years of democracy, the fundamental indicator of child wellbeing remains frozen – one in four children still stunted, unchanged since the 1990s. 

Research reveals a devastating psychological reality: hunger has been racialised and internalised. Black South Africans tell researchers, “We were born in hunger, and we will live with it until we die”. They describe food not as a right but “a privilege for us”. This directly undermines the Constitution’s promises of social justice; the promise of rights to not only ensure survival but also to create the conditions for human flourishing – so that every person can live with dignity, develop their potential and participate fully in society.

This psychological acceptance explains the political paralysis. When hunger is seen as inevitable rather than unconstitutional, urgency evaporates. The Child Support Grant falls 33% short of the Food Poverty Line and 44% below the cost of a nutritious diet, yet there is no public outcry. 

The situation becomes more criminal when we consider waste. South Africa discards 10 million tonnes of food annually – 30 billion meals that could feed all 20 million food-insecure people for an entire year. Current laws actually discourage food donation, as companies avoid liability for storage and distribution. France’s Garot Law demonstrates the alternative: mandating food rescue and penalising waste. The challenge is not just redistributing food but redistributing moral responsibility – making hunger socially unacceptable rather than silently tolerated.

Moving from crisis to prevention

While the Eastern Cape emergency demands immediate response, the combined frameworks point towards prevention. Strengthening all three pillars – food security, care practices and health services – before crisis strikes creates resilience. This implies that responses must extend to building systems that prevent children from reaching the point where they arrive at hospitals “already dying”.

The convergence of inadequate food access (Sen’s entitlements failure) with compromised care and health systems (Unicef’s multi-sectoral breakdown) creates the perfect storm, killing South African children. Understanding this convergence transforms how we can act – moving from single-sector charity to integrated multi-sectoral interventions that address the full complexity of child malnutrition.

Brazil’s Zero Hunger programme demonstrates what’s possible with political will. Between 2003 and 2014, the initiative reduced hunger from 10.6% to 2.5% and halved stunting rates through comprehensive architecture: conditional cash transfers reaching 14 million families, school feeding for 43 million children and an inter-ministerial chamber uniting 19 ministries. Brazil achieved its goals ahead of schedule, reducing child malnutrition deaths to 350 annually – less than a third of South Africa’s current toll, despite having four times our population. 

Closer to home, the Western Cape government’s Khulisa Care represents government innovation that works. The programme embodies the integrated approach the frameworks demand – combining monthly food vouchers for nutritious, protein-rich foods from Shoprite with comprehensive primary healthcare support delivered through trained community health workers across urban and rural pilot areas. The Western Cape’s Khulisa Care programme combines monthly food vouchers with comprehensive primary healthcare support, embodying the integrated approach the frameworks demand – bringing food security and healthcare to vulnerable mothers and infants simultaneously. 

A number of NGOs, such as the Inceba Trust, exemplify this multi-sectoral approach, addressing children’s physical health, educational development and emotional wellbeing simultaneously. We should learn from these in terms of supporting children’s physical health through nutritious meals and safe environments, training early childhood development (ECD) teachers in quality learning programmes and strengthening caregiver-child bonds for emotional development. By working simultaneously with homes, ECD centres and communities, Inceba demonstrates how multi-sectoral intervention can create environments where vulnerable children flourish rather than merely survive.

Places to act

The frameworks and models point to three levels of intervention, all necessary. Immediate response means nutritious feeding programmes that provide appropriate nutrients, not just calories. It means health screening at feeding sites to catch malnutrition early. It means improving water and sanitation to break the disease-malnutrition cycle that kills weakened children.

Systems strengthening goes deeper – supporting clinic capacity for growth monitoring, training community health workers to identify at-risk children before crisis strikes and creating school programmes that combine feeding with health education. These are not separate initiatives but integrated responses that recognise hunger’s complexity. 

Addressing root causes requires the longest view but offers the greatest impact. Women’s economic empowerment enhances both household income and care capacity. Food rescue initiatives transform waste into sustenance. Perhaps most importantly, sustained advocacy reframes hunger from unfortunate charity case to constitutional obligation demanding urgent action. The Daily Maverick provides a powerful voice to elevate these issues. 

Single-sector solutions will fail – that much is clear. Ending hunger is not only a policy option; it is a legal and moral imperative that demands shared responsibility between the state, civil society, business, academia and communities. Only integrated multi-sectoral interventions that bring food, care and health to the same child simultaneously can break the cycle. 

What is needed now is the will to transform indignation into action, to abnormalise hunger and to insist that in a country with a constitutional right to food, no child should die with an empty stomach while 30 billion meals rot in landfills. DM