SA faces triple burden of malnutrition
WORLD Food Day (observed today October 16) is dedicated to highlighting and tackling global hunger.
While South Africa is ranked as the most food-secure nation in Africa and 44th of 133 countries worldwide (according to the Economist Intelligence Unit’s 2017 Global Food Security Index), we are by no means a healthy nation. The triple burden of malnutrition, so prominent in South Africa, is the seemingly contradictory co-existence of under-nutrition or hunger (which results in stunting and wasting), over-nutrition (which results in overweight and obesity) and micro-nutrient deficiencies (which exacerbate the other two).
Put simply, in the same community you have underweight (and underheight) children, obese adults and those suffering from the effects of other deficiencies. Interestingly, these issues are less a result of food quantity or consumption than they are of food choices.
South Africa has a serious health problem. Lifestyle diseases such as diabetes, heart disease, stroke and some cancers are among the top causes of death in the country, at about 40%.
At the same time, the prevalence of overweight and obesity is close on 58% for men and 71% for women. Resultant health risks are most pronounced for women, children and those with low incomes, reflecting and reinforcing historic socio-economic disparities.
As the region experiences rapid urbanisation, a youth bulge and population growth, these changes drive a diet transition whereby more and more people favour low-nutrient, high-calorific convenience foods, exacerbating the triple burden of malnutrition.
The growing health effects of this diet transition, converging on a resource intensive Western-style diet, compounded by associated environmental challenges across the food value chain, are stressing an already over-burdened public healthcare system, reducing population health and well-being and posing a material risk for business and the economy.
More effective government policy and regulatory intervention are critical to addressing some of the systemic issues driving food choices. However, recent research undertaken by Incite on behalf of WWF South Africa and the Southern Africa Food Lab, suggests that in the absence of an enabling policy environment, it is incumbent upon those involved in the food sector to consider the potential role of collaborative industry initiatives.
The research proposed four opportunity spaces: 1) Providing a healthy retail environment; 2) Establishing a collaborative innovation group for food manufacturers; 3) Engaging smallholder farmers and fresh produce markets; and 4) Identifying opportunities for collaborative social marketing.
Firstly, the retail sector can play an important role in the education of the consumer: it can put more emphasis on healthy food and it can contribute to broader education through advertising and the placement of products in its supermarkets.
Providing a healthy retail environment would involve the creation of a collaborative initiative of retailers, manufacturers and local government to encourage increased consumer uptake of healthier baskets.
Secondly, there is a lack of consensus when it comes to a future vision of nutrition in the country. A number of large food manufacturers expressed interest in a collaborative process with other stakeholders to identify potential solutions for meeting a government-developed dietary plan.
A collaborative innovation group for food manufacturers would bring together selected senior management champions and industry leaders, as well as selected representatives from the government with a focus on building a common vision for a healthy and sustainable food system. Thirdly, a long-term solution necessitates an economic system that empowers people.
To this end, local sourcing (though not without its challenges) should be a key focus in terms of reducing costs and increasing local availability.
Engaging smallholder farmers and fresh produce markets will play an important role in meeting the demand for affordable vegetables and fruit, particularly in rural areas and the informal economy.
The development of smallholder agriculture with a focus on ago-ecological practices requires a much larger-scale collaboration. The focus initially would be on inclusion into formal value chains, prioritising the development of alternative and (shorter) local value chains, enhanced local food reliance and affordability.
Finally, identifying opportunities for collaborative social marketing for education and awareness-raising initiatives on nutrition and healthy eating will be a critical focus area and potential non-competitive space that can run throughout the food sector.
WWF South Africa and the Food Lab have together convened a number of systems-wide initiatives over the past 10 years.
Underpinning the methodology is the use of systems learning and iteration, taking into account the complex inter-relationships and different perspectives of everyone who has a stake in the problem and the solution.
View the report, An Appetite for Collaboration, at: www.southernafricafoodlab.org/an-appetite-for-collaboration.