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Author: Zukiswa Zimela

Media release: Call to the Minister of Finance to increase the sugary drinks tax to 20%

Posted on by Zukiswa Zimela

18 February 2021

Healthy Living Alliance (HEALA), Centre for Communication Impact (CCI) and other partners are launching a Mass Media Campaign on the 18th of February 2021 to organise support and raise the public’s awareness about the harms of excessive consumption of unhealthy foods and the most effective policy-related solutions to the problem.

The partnership, whose mission is to improve the health of an increasingly obese South Africa and to empower the nation to make healthy food and lifestyle choices to prevent Non-Communicable Diseases (NCDs), is calling on the Minister of Finance, Honourable Tito Mboweni, ahead of his budget speech on the 24th of February 2021 to raise the Health Promotion Levy (HPL) from the current 11% on sugary beverages to 20%.

An estimated 4.5 million South Africans will have Type 2 diabetes by 2030. The burden of Type 2 diabetes is projected to cost the South African public healthcare system over R35.1Billion by 2030. At least 27% of children under 5 years old experience stunting (impaired growth and development), which contributes to diet related Non-Communicable Diseases (NCDs). Excessive consumption of sugary beverages has been linked to obesity and diseases such as diabetes and hypertension which are the leading causes of early mortality in South Africa. These diseases are rapidly increasing and impacting lower income households and rural communities and already placing a huge burden on the South African Government and society.

A Health Promotion Levy (HPL) of 20% in the long-term can reduce sugar consumption, saving lives from Non-Communicable Diseases but also COVID-19 as many scientists don’t expect the pandemic to end any time soon, despite the availability of the vaccine.

“South Africa’s constitution is based on fundamental principles amongst them, to improve the quality of life of all citizens and free the potential of each person, recognise the injustices of our past and lay the foundations for a democratic and open society in which government is based on the will of the people and every citizen is equally protected by law. If National Treasury doubled the Health Promotion Levy (HPL) now, it could bring an extra R2 billion in government coffers to help fund the fight against COVID-19 in the short term and towards social and economic programs to advance the lives of ordinary citizens”says Lawrence Mbalati, Programme Manager at HEALA.

According to HEALA, CCI and their partners, over the years consumers have increasingly purchased ultra- processed foods and beverages, a trend in both urban and rural areas, therefore Sugar-Sweetened Beverage (SSB) taxes are an effective public health strategy to reduce the burden of health conditions linked to over consumption of sugar. Up to 76% of South Africans support government’s efforts to cut down on excessive sugar consumption now more than ever and it’s time to take bold steps to respond to COVID-19 and diet-related NCDs.

“Policymakers now have the opportunity to increase the Health Promotion Levy (HPL) to 20% to raise additional revenue in the short-term. In the long-term, we know that a Health Promotion Levy (HPL) of 20% will reduce the amount of sugar people consume, decreasing their chance of developing conditions such as diabetes, obesity and high blood pressure that also put people at a higher risk of dying from COVID-19” adds Mbalati.

South Africa introduced a Health Promotion Levy (HPL) on sugary beverages in 2018 to help curb the country’s sugar consumption. Within its first two years, the Health Promotion Levy (HPL) generated R5.4 Billion for Government. The government currently projects a R300 billion shortfall in revenue in this year’s budget due to the coronavirus pandemic. It has lost millions on sin tax collections due to the ban on alcohol and cigarette sales during the 2020 nationwide lockdown. An increase on the sugar tax from its current 11% to 20% is needed in order to improve health outcomes and support increased revenue collection. A further increase in sugary beverages will not only result in a reduction in Non-Communicable Diseases like diabetes, it will also help support the country’s growing tax collection shortfall.

“HEALA, CCI and its partners are therefore calling on the National Treasury to act now. Raising the Health Promotion Levy (HPL) to 20% is absolutely critical to not only funding the COVID-19 fight but also to saving lives now and in the future”, concludes Mbalati.

/ENDS

To read more about HEALA and the campaign, visit the website at: https://heala.org/

https://whatsinmyfood.org.za

Media Release: Doubling the sugary beverage levy could raise billions for Covid-19 fight

Posted on by Zukiswa Zimela

If South Africa doubled its sugary beverage levy, it could raise billions to help fund the fight against Covid-19.

In 2018, South Africa introduced a health promotion levy of about 11% on sugary beverages to help curb the country’s sugar consumption, which is fuelling a rise in non-communicable diseases, such as diabetes, high blood pressure and obesity. 

Currently, beverages are taxed about 2.21 cents per gram of sugar for anything over a 4-gram threshold. The current levy adds about 46 cents to the price of an average can of original taste Coca-Cola, for instance. The levy does not apply to natural fruit juices or sweetened dairy products.  

Within its first two years, the health promotion levy has generated R5.4 billion for government. This would have been enough to finance South Africa’s down payment for Covid-19 vaccines from the Covax facility almost 20 times over despite the health promotion levy’s relatively small contribution to government’s overall budget. 

If the National Treasury doubled the health promotion levy now, it could net the government around R2 billion to help fund the fight against Covid-19 in the short term, head of the Healthy Living Alliance (HEALA) Lawrence Mbalati says. This estimate is based on current consumption levels and the revenue raised by the levy already.

If Treasury doubled the levy and raised R2 billion, that would be enough to pay for several thousand new nurses and doctors, as well as tens of thousands of community healthcare workers based on average salary ranges. 

“This is a watershed moment for the country,” Mbalati explains. “Government revenues are under immense pressure and funding the fight against Covid-19, including vaccines, remains critical.”

“Policymakers, and in particular the National Treasury, have an opportunity now to decide to increase the health promotion levy to 20% to raise additional revenue in the short-term,” he says. “In the long-term, we know that a health promotion levy of 20% will reduce the amount of sugar people eat, decreasing their chance of developing conditions such as diabetes, obesity and high blood pressure that also put people at a higher risk of dying from Covid-19.”

Globally, being obese has been shown to increase a person’s risk of dying from Covid-19 by almost 50% and more than doubles the risk of being hospitalised, according to a recent analysis published in the journal Obesity Reviews.  

South Africa’s health promotion levy has already led some beverage makers to reduce the amount of sugar in their drinks. One study by PRICELESS SA found that the levy also reduced sugary beverage consumption by 60% among people in Soweto who consumed a lot of sugar.

Meanwhile, there is no evidence to date that the levy has led to job losses in the sugar or beverage industry, contrary to industry claims. 

A health promotion levy of 20% in the long-term could reduce sugar consumption, saving lives both from non-communicable diseases but also Covid-19 as many scientists expect the virus to remain with us in the foreseeable future. 

HEALA is therefore calling on the National Treasury to act now.

“Raising the health promotion levy to 20% is absolutely critical to not only funding the Covid-19 fight but also to saving lives now and in the future.”

For interviews, contact:
Lawrence Mbalati, head of the Healthy Living Alliance (HEALA)
082 734 5414
lawrence@heala.org 

Click here to download and read the pdf

Read more:
What you need to know about South Africa’s health promotion levy

Watch:
Healthy Living Alliance Media Briefing: Increase the HPL to 20%

Fact Sheet: Evidence to support increasing South Africa’s Health Promotion Levy (HPL) to 20% in 2021

Posted on by Zukiswa Zimela

South Africa implemented its Health Promotion Levy, or HPL, in April of 2018. The HPL is a sugar-sweetened beverage (SSB) tax of approximately 11%, based on sugar content. Initial research on the price impact of the HPL has shown prices increased commensurate with the tax for taxed beverages but did not change for non-taxable beverages and reduced consumption.

Click here to download and read the pdf

Embargoed For Release

Posted on by Zukiswa Zimela

Big Food Used Global Pandemic to Aggressively Promote Unhealthy, Ultra-Processed Food & Sugary Drinks

A new report finds that the food and beverage industry giants directly and indirectly blocked. Healthy food policies while putting vulnerable consumers at even greater risk.

WASHINGTON, D.C. – A new report released by the Global Health Advocacy Incubator [GHAI] details how food and beverage corporations – such as Coca-Cola, McDonald’s, Nestlé, and PepsiCo – seized the coronavirus pandemic as a unique opportunity to promote their ultra-processed foods to especially vulnerable populations around the world.

Facing Two Pandemics: How Big Food Undermined Public Health in the Era of COVID-19


Reveals how the lack of healthy food regulations worldwide enabled “Big Food” to use the global COVID-19 crisis, publicly portraying themselves as do-gooders while directly and indirectly influencing policy and putting disadvantaged people at even greater risk. These same corporations – whose ultra-processed food and sugary drinks were already contributing to rising rates of obesity, malnutrition, and diet-related diseases – used the pandemic to position themselves and their unhealthy products as essential and safe, putting those compromised populations at even higher risk of coronavirus complications and mortality. GHAI collected more than 280 examples from 18 countries between March and July 2020.

“Based on the examples we gathered, it quickly became clear that Big Food was working hard to position themselves as a crucial part of the pandemic solution,” said Holly Wong, GHAI Vice President, “while furthering their own gains by hindering the advancement of public health policies.”

The GHAI report outlines key ways “Big Food” exploited the coronavirus pandemic to their advantage:

  • They polished their public images with pandemic “solidarity actions,” while aggressively promoting their junk food and sugary drink brands. They donated ultra-processed products to children in school programs and low-income populations when these people needed nutritious foods. They also donated and promoted baby formula, breaching the International Code of Marketing of Breastmilk Substitutes. In South Africa, Coca-Cola collaborated with a nonprofit to donate “cooldrinks” – soft drinks – to local healthcare centers, including an obesity care center.
  • They touted unhealthy ultra-processed food and drinks as essential, safe products, equating food safety with healthy food. In Brazil, the industry group ILSI (International Life Science Institute) highlights that processed foods are allies in the fight against COVID-19 touting their high safety levels that reduce the risk of chemical and physical contamination.
  • They funded online educational platforms aimed at helping children learn during quarantine, dangerously blending marketing with educational information, and positioning these corporations as reliable sources of health-related information. An online learning platform used by schoolchildren in the US featured junk food advertising.
  • They spun a health and wellbeing narrative publicly while leveraging the pandemic as a way to delay healthy food policy. In México, they attempted to use COVID-19 as an excuse to postpone implementing a new front-of-package warning label law.
  • They promoted junk food as a tonic for tough times, linking unhealthy food with appealing sentiments such as comfort, nostalgia, and family togetherness. In Brazil, Burger King promoted its fast-food delivery service under the guise of helping people to stay safe at home.
  • They linked their ultra-processed food and drinks with charitable causes, helping consumers feel good about unhealthy purchases. In the US, Coca-Cola partnered with Uber Eats to donate one meal to Feeding America for every order placed.

These corporate interventions enabled Big Food to improve their image, strengthen their brands, ally with decisionmakers to gain political influence, and position their businesses as public-health partners during an emergency – even as they used these opportunities to advance their own unhealthy products.

Ultimately, the GHAI report underscores the urgent need for evidence-based healthy food policies and regulations, as well as stronger conflict-of-interest protocols, worldwide.

“This is a wake-up call for governments to implement evidence-based public policies designed to create healthier food environments and to protect the right to adequate food,” said Lawrence Mbalati, Programmes Manager of South Africa’s Healthy Living Alliance.

“Such policies will help consumers make healthier nutritional choices during vulnerable times like these. The bottom line is, governments must prioritize public health above private interests and profits.”

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Click here for the report: https://bit.ly/two-pandemics

For media interviews, please contact Lawrence Mbalati, HEALA Programmes Manager,
082 734 5414; lawrence@heala.org. Please note, in addition to English, Lawrence speaks Xitsonga (first language), Tshivenda, Sepedi, Sesotho/Setswana and can also speak isiZulu and isiXhosa.

About the Healthy Living Alliance (HEALA)

HEALA is a  leading alliance of civil society and academic organisations fighting for every person’s right to healthy food in South Africa. Launched in 2016 by the civil society organisations and academic institutions, HEALA successfully campaigned for the Sugary Drinks Tax implemented by South African Government in April 2018.

HEALA’s current campaigns include advocating for clear warning labels on ultra-processed foods, healthy food environment, marketing restrictions of junk food and sugary drinks to under-age children in South Africa.

Calls for Finance Minister to increase health promotion levy (HPL) and include fruit juices

Posted on by Zukiswa Zimela

The Healthy Living Alliance (HEALA) and Rural Health Advocacy Project (RHAP) call for an increase in the so-called sugar sweetened beverage tax and inclusion of fruit juices to reduce diet-related disease and death, and raise much-needed revenue amidst COVID-19 health demands and budget deficits.

Johannesburg, 4 November: Advocacy groups for healthy food in South Africa have made a strong call backed by scientific evidence for an increase from 11% to 20% of the Health Promotion Levy (HPL), and to include fruit juices in the levy.

Responding to Finance Minister Tito Mboweni’s 2020 Medium Term Budget Policy Statement last week, the Healthy Living Alliance and Rural Health Advocacy Project highlight how South Africa is grappling with both a COVID-19 epidemic and an obesity epidemic.

Nearly 70% of South African women, 31% of men and 13% of children under five are considered overweight. This is fuelling noncommunicable diseases (NCDs) such as type 2 diabetes and heart disease which put people at greater risk of severe COVID-19 illness and death. South Africa has the highest recorded number of cases and deaths in Africa. The collision of the COVID-19 and the NCD epidemics has significantly increased demands on the country’s health system.

“Sugar sweetened beverages (SSBs) such as sodas and fruit juices, as well as ultra-processed foods (industrially made ‘ready to eat and heat’ foods such as cereals and processed meats) contribute to obesity, a key risk factor for type 2 diabetes,” said Mr Lawrence Mbalati, HEALA’s programmes manager.

In 2018, South Africa was the first country in the African Region to introduce a tax on sugary beverages, a strategy which the World Health Organization (WHO) recommends as an effective way to reduce sugar consumption and address NCDs. South Africa’s HPL aimed to address rising rates of overweight, obesity and diet-related NCDs, and raise much needed revenue for health promotion.

According to National Treasury data, the HPL raised R3.195 billion in the first fiscal year (April 2018 – October 2019). While the tax is currently set at 11%, HEALA and RHAP have urged the Finance Minister to increase this to WHO’s recommended rate of 20%, which could drop demand by 24%.

“We don’t know the impact of the HPL because NEDLAC’s study on this has still not been completed. We are repeating our call for fruit juices to be included. Excluding them leads people to believe that juices are healthier, when in fact the sugar content is similarly high to soft drinks. Marketing fruit juice as a ‘healthy alternative’ to children and parents puts them at risk of consuming excessive amounts of sugar. Fresh fruits are fine on their own, but when turned into fruit juice, much more fruit is needed to make up the volume. Our bodies process these additional sugars in the same way as SSBs,” he said.

“Now more than ever, South Africa will benefit from an increased HPL tax for additional revenue and help to reduce risks related to obesity,” concluded Mr Mbalati.

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Issued by Healthy Living Alliance (HEALA) and Rural Health Advocacy Project (RHAP)
For media interviews, please contact Lawrence Mbalati, HEALA Programmes Manager, 082 734 5414

New study exposes political practices of food and beverage industry in South Africa

Posted on by Zukiswa Zimela

First evidence of food and beverage industry tactics to counter public health policies in South Africa indicates partnerships with government and calls for greater transparency to stop undue influence

Johannesburg –29 July In the first study of its kind, researchers have uncovered the variety of strategies used by the food and beverage industry in South Africa to negatively influence policies aimed at promoting health, including building relationships with South African government departments.

The article by lead author Dr Mélissa Mialon of the University of Sao Paulo in the International Journal of Public Health (29 July 2020),  maps additional major industry interference techniques which include lobbying government officials, influencing scientific research, and attempting to refocus policy issues by diverting attention away from the role of unhealthy products which contribute to ill health.

“Industry’s corporate political activity influences public opinion and potentially hinders proven health policies to reduce diet-related conditions such as obesity and diabetes which are so prevalent in South Africa,” said Dr Mialon.

Over four million people in South Africa live with diabetes, which is emerging as a major risk factor for severe COVID-19 disease and death, and nearly 70% of women and 40% of men in the country are either overweight or obese.

The researchers found a total of 107 examples of political practices from publicly available documents from January 2018 to April 2019 from ten major food and beverage entities (Tiger Brands, Pioneer Foods, Clover, Parmalat, Nestlé, Coca-Cola South Africa, the South African Sugar Association (SASA), the Consumer Goods Council of South Africa (CGCSA), the Beverage Association of South Africa (BEVSA) and the International Life Science Institute (ILSA)).

These practices included partnerships between industry and government departments such as the Department of Basic Education, the Department of Sport & Recreation, and the Department of Health on company-branded school breakfast programmes, the donation of sugar to food security efforts, and educational funding for students. Industry was found to engage directly in policy processes, including heavy lobbying against the sugar-sweetened beverage tax. A total of 51 examples revealed how industry reframed arguments to divert attention away from the role of unhealthy products in health, and 49 cases of industry building partnerships with third parties to influence health policy efforts.

The authors could find no details about conflicts of interest of government officials or information on interactions and correspondence between industry and government officials.

At the World Health Assembly in 2019, the South African delegation called for urgent action to respond to what it called the ‘commercial determinants of health’ – corporate activities that affect health – which includes corporate political activity of the food and beverage industry.

“It is critical that there is greater knowledge, transparency and monitoring of industry strategies and practices,” the researchers conclude.

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“This study reveals the range of tactics that South Africa’s food and beverage industry deploys, putting profits before people and undercutting critical public health initiatives. To have over 100 examples, and only those publicly available, means this is likely just the tip of the iceberg. It highlights the urgent need for transparency to expose undue influence on public health policy,” said Mr Lawrence Mbalati of the Healthy Living Alliance.

“South Africa needs transparency mechanisms to restrict the food and beverage industry’s influence on policy issues, including policies to ensure interactions between industry and government officials are transparent, and in certain cases prohibited, particularly during the policy decision stage. The health of South Africans cannot be put further at risk,” he said.

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Issued by Health Living Alliance (HEALA)

Endorsing Organisations to Press Statement

  • Right to Know
  • Section27
  • Peoples Health Movement (PHM)
  • Amandla.Mobi
  • Rural Health Advocacy Project (RHAP)
  • Health-e News
  • Southern African Faith Communities’ Environment Institute (SAFCEI)

The article is available at: https://link.springer.com/article/10.1007/s00038-020-01407-1.

For media interviews, please contact: Gugulethu Myeza

Contact Number : 0837934783

The evolution to healthy eating

Posted on by Zukiswa Zimela

Food is fuel, but this concept is relatively new to me. I wasn’t always conscious of what I ate and I would often wolf down food because I was either hungry, bored, or emotional. That was me in 2017, writes Reesha Chibba.

My life changed in December 2017 when I decided to investigate my tiredness and inability to lose weight. I didn’t have any of the usual signs of pre-diabetes like thirstiness, excessive urination in the middle of the night, weight gain, or lethargy. I was just tired and I unknowingly blamed it on my early morning shifts at work which I have been working on and off for more than a decade at that time.    

A rude awakening  

My alarm would scream every week-day at 2:45am, violently interrupting my body’s cortisol function, and killing any chance it ever had of recovering and operating normally throughout the day. I would get dressed and collapse into the routine of my duties and execute them to the best of my ability until my shift was over. Then I would get into the car and drive home with a lump in my throat, analysing and re-analysing everything I did and said, and beat myself for anything I failed at. I was exhausted, every day,   

I would go to the gym run for as long as I could and switch off mentally on the treadmill. That was my routine. My life played out like a CD on repeat, from Monday to Friday. Occasionally I would enter the odd endurance event and train for it like an athlete in an effort to excite and re-invigorate myself. But my body was crumbling, much like a Tennis biscuit dipped in tea. My pancreas was malfunctioning and producing insulin three times more than the average human, my hair was falling by the handful, and my mental health was deteriorating. On the outside I looked and acted fine, but on the inside, I was gasping for air.    

Time of reckoning  

In March 2018 after numerous visits to my GP I sat across from a specialist who told me I needed to change my lifestyle, or else live with diabetes for the rest of my life. And he wasn’t whimsical about his recommendations, he was firm. He gave me a choice and the thought of popping tablets for the rest of my life with shocked me. I had to change, and I knew it.  

I started taking Metformin to help regulate and control my body’s insulin production, vitamin D to kickstart my sleep hormone, cortisol, and Burnout by Solal because well, I was pretty burnt out. He also recommended I see a dietician and his exact words were, “She’ll guide you on what you to eat.“ I wasn’t disheartened, but I was scared, and instantly I knew that my sweet tooth and raging love affair with carbs was going to have to come to an end.   

My dietician didn’t give me an eating plan or strip me of junk food like most diets out there. For a year, she coaxed me into gentle eating patterns by reducing my intake of carbs and increasing the amount of vegetables in my diet. She educated me about various food groups, the properties, nutritional content and its functions. She entertained emails from me requesting more snacks and peanuts because I initially starved and felt hungry all the time, but I actually wasn’t. This happened during winter when the dip in temperatures make you want to nibble everything in the house, including the cat.  

She nudged me to make better choices by eating timeously and not binge eat and starve my body of carbs early in the day. She also provided me with skills to indulge in a donut, practically, without shocking my body. So instead of treating myself willy-nilly to junk food, I’ve gradually learnt how to manipulate myself mentally and give it treats twice a week without hurting myself. And I eat everything, donuts, chocolate, bread (Rye), biscuits, chips, popcorn … the list is epic. But like everything in life, moderation is key. And if mistakes happen and I accidentally decide to eat a slab of chocolate because I’m having a bad day, I rectify the situation by trying again and being kind to myself. No one is perfect. Food is not a reward and restricting yourself shouldn’t ever be a punishment. Food is my only fuel and I’ve learnt what makes me function and function well.    

Learning what my body needs has been a game-changer these past two years. I scrutinise everything in stores and think twice about condiments and sauces. I try to steer clear of using stock cubes and instead of using store-bought dressing and mayo, I make my own because I know what’s in it.   

Every little change  

I’m also not the best person to shop with because I’m a linger-longer – every time I come across new products I tend to linger in the aisles, for longer. My eyes dart straight to the back of the packet to check the sodium, sugar, fat and carb content. And you’ll often see me doing the math or talking to myself about whether or not to buy what I’m holding. I’ve become that girl.   

I’ve learnt now that without being cognisant of what is in different products, you will never truly be able to gain control of your diet. Because there is so much variety on the shelves and most of them these days are touted as healthy – and they probably are healthier than other products –  but they are actually full of carbs, sodium or fat. Being skilled, finally, on how to identify and interpret the nutritional values has opened my eyes to a new world of possibilities.   

Fulfillment and knowledge 

My weight gradually peeled away over the months I was with my dietician and I started getting very creative in the kitchen. I was encouraged by the results and my smaller pants to be honest and would tweak all my favourite foods to make it less carb-rich or fatty. Instead of buying coconut milk, I started making my own and adding it to Thai-infused dishes because real coconut milk is very high in fat. I also started making quinoa roti instead of using refined flours and I gradually started ghosting foods that made me feel tired or heavy. My sweet tooth has never relaxed so I’ve learnt to bake with dark chocolate and Xylitol instead.  

And as the time progressed my energy levels started to increase as well. I’ve always been a runner, and an avid swimmer, but last year I challenged myself to taking part in the 94.7 Cycle Challenge and doing a triathlon. I did my first Ironman sprint towards the end of the year, just weeks after my first cycle race. And I felt awesome. This year I cycled the Cape Cycle Challenge, previously known as the Argus with water as a supplement and my very own date, coconut, and peanut butter concoction.    

I have trained myself to run a 10km with only having had water, honey, and coffee and I because I feel so in tune with my body, I push it to see how far I can go with various homemade power treats. My point is; over time I’ve rediscovered my body and discovered all its kinks, loves and hates. My palette loves chocolate but my body doesn’t. When I eat chocolate, I feel tired almost immediately. But when it is that time of the month, chocolate makes me feel euphoric. My endorphins kick in and my body collapses into its happy self. I’ve also noticed that my body metabolises caffeine differently on days when I sleep well and am rested and on days when I don’t.   

I’m learning every day, about myself and my body. I noticed the subtle changes and I am loving my food evolution.    

I’ve also started a blog to share some of my recipes and experiences with people. I don’t think I am different or better than anybody, but I do think it’s important to share knowledge and tales of fascination and flops from the warmth of one’s kitchen. My website, On the Board, features only what I eat and what I like to eat. When I tried to lose weight before, I would motivate myself by reading stories of people who dropped excessive amounts of weight by exercising and dieting along with supplements. I tried everything but nothing really worked for me until I started understanding what I was feeding myself.  

I have stopped seeing my dietician for over a year and my weight has never returned. I am not razor thin, nor toned to perfection; but I am happier and healthier than I’ve ever been in my life. I no longer take Metformin, and all my levels are the lowest it’s ever been. My story is not extraordinary, but it’s one of balance. I balance protein, carbohydrates, fats and treats, daily. – Health-e News  

Reesha Chibba is an output editor at eNCA and an online food blogger. Visit  her blog at www.ontheboard.co.za 

#LockdownSA: Looming food emergency due to structural inequalities

Posted on by Zukiswa Zimela

The nutrition challenges facing South Africa are complex and underpinned by historical and current inequalities, while undernutrition coexists with the rising incidence of obesity and non-communicable diseases, say experts.

Associations and experts working in nutrition and food systems say that the coronavirus pandemic and subsequent national lockdown has emphasised the importance of food security and nutritional wellbeing for all in the country.  

They also say that it has exposed the vulnerabilities and weaknesses of the country’s current food systems. In view of this, the Association for Dietetics in South Africa (ADSA), the Nutrition Society of South Africa (NSSA) and Dietetics-Nutrition is a Profession (DIP) penned an open letter that calls on the government to address malnutrition in all its forms.   

The health bodies say that, nationally, efforts to contain the spread of Covid-19 have resulted in increased food shortages, nutrition deficits, and an interruption of social and other nutrition support services that the most marginalised groups in the country rely on. 

Diet affected by lockdown  

According to Dr Christine Taljaar-Krugell, ADSA President, more than a quarter of the South African female adult population is overweight and more than a third obese, with the highest prevalence (42%) among urban women.  

Moreover, it is estimated that 269 000 non-communicable disease (NCD) related deaths occur in the country annually.  

Speaking to Health-e News Maria van der Merwe, ADSA spokesperson says the initial hard lockdown response had an immediate and acute impact on households and communities in a multitude of ways.  

“With regards to food and nutrition [there was] interrupted access to food due to restrictions on travelling and informal trading, and discontinuation of food and nutrition social programmes such as the National School Nutrition Programme and feeding at Early Childhood Development programmes,” she explains. 

She continues: “Although the nutrition situation in the country has been of concern prior to the pandemic, the acute nature and vast extent of the lockdown brought the plight of individuals and communities to the forefront.” 

Prof Corinna Walsh, NSSA President, explains that food relief and social relief interventions, such as food parcels and social grants, could address more immediate nutritional needs, but broader actions are required to address the underlying causes of malnutrition.  

Transforming food systems 

DIP notes that the pandemic has come at a time when global food security and food systems are already under strain due to natural disasters, climate change and other challenges.  

This has exacerbated the need to transform food systems to become sustainable and resilient, DIP says. 

“In a way, the Covid-19 pandemic has highlighted the challenges of food insecurity, hunger and malnutrition which existed prior to the outbreak but are now affecting more individuals and households,” says Phunyuka Ngwenya, of DIP. 

She further says that, “the Covid-19 pandemic is unlike anything we have faced in our generation and requires a huge coordinated response from the public and private sector as well as efforts by each individual to curb the spread.”  

Ngwenya adds that the anticipated number of Covid-19 cases will increase rapidly over the next few weeks and months, straining an already burdened economy and health system.  

“Over the long term, the threat of Covid-19 to food security and nutrition is a global concern, with a looming food emergency. It, therefore, requires immediate coordinated action to limit the long-term adverse effects.” 

UN global warning 

The open letter arrives at a time when the United Nations has recognised the threat of the coronavirus pandemic to food security and warns of a dire food emergency if immediate coordinated action isn’t taken.  

While hunger has been reduced and food access in South Africa has improved over the past 15 years, research shows that 1.7–million households still experienced hunger in 2017, and the pace of addressing inadequate food access has been too slow to achieve the goal of zero hunger by 2030. 

According to ADSA, NSSA and DIP, early indications suggest a rapid rise in hunger prevalence since the lockdown was imposed, with up to 24% of residents not having money to buy food.  

In addition, in this context, food prices have increased by as much as 30% over the past two months, further adding to the financial strain on households. It is also anticipated that maternal and child mortality is likely to increase directly and indirectly as a result of the Covid-19 outbreak. 

Coordinated efforts needed  

The health bodies say an important first step will be to recognise the severity of the situation and the need for coordinated strategic efforts to address the underlying factors that contribute to malnutrition, such as insufficient access to food, affordability of fresh foods, poor health services and a lack of quality water and sanitation.  

In a collective response sent to Health-e News by ADSA, NSSA and DIP, they mention that food security and nutritional needs have to be addressed collectively with interventions aimed at tackling these factors.  

“It will require concerted efforts from government, the private sector and civil society to address the immediate, underlying and structural causes of undernutrition,” say the associations. 

They propose that the government must: 

  • Prioritise nutrition on policy agendas related to health and social security, including a regulatory framework to support access to healthy and affordable foods.  
  • Provide strategic direction and ensure coordinated and aligned programming to address food and nutrition security, in collaboration with other sectors including civil society organisations.  
  • Coordinate an adequate and targeted food and social relief approach, prioritising the most vulnerable and needy for short term mitigation. Food relief should be standardised and tailored to the nutritional needs of targeted beneficiaries, especially children.  
  • Progress towards universal health coverage, to ensure access to quality, essential health care.  
  • Prioritise the challenges faced by specific populations, including the elderly, women (especially women of childbearing age), children and those with pre-existing medical conditions (most notably HIV/AIDS, TB and NCDs).  
  • Implement well-funded coordinated strategies to actively address the main drivers of malnutrition; paying attention to food, nutrition and health, backed up by responsive social protection mechanisms. 
  • Improve access to quality nutrition care through investment in human resources to increase the number of qualified nutrition professionals as well as education opportunities for other cadres of workers that provide nutrition services in primary care settings. 
  • Promote nutrition education of the public through targeted and relevant nutrition messaging and communication campaigns. – Health-e News 

#Helpafriendout: Community-led project centres nutrition needs

Posted on by Zukiswa Zimela

“Growing up, I used to help my grandparents with their small garden where we grew flowers, cabbage and spinach. That’s where I developed an interest in farming,” says Amogelang Moroba, chairperson of the Soshanguve-based organisation #Helpafriendout.

Food security and hunger has come to the fore in South Africa, as the Covid-19 pandemic and national lockdown has exacerbated pre-existing food system inequalities, and increased food prices. The United Nations has also recently warned governments that the world faces a food crisis that has been unseen for at least 50 years.  

Youth farmers  

But, three young adults from Soshanguve’s Block H have first-hand experience with the effects of food instability, hunger and gender-based violence in their community, and wanted to do something about it. 

Amogelang Moroba, #Helpafriendout chairperson, Oreneile Matjene, secretary, and Aubrey Nkuna started #Helpafriendout in February 2019. The organisation broadly focusses on farming, tackling gender-based violence and youth development and upskilling.  

“As an organisation we do social and economic development. Covid-19 affected our community badly. People have lost their jobs and it has increased gender-based violence through decreasing incomes,” Moroba tells Health-e News.  

He adds that access to healthy food remains unattainable for most because of unemployment issues, therefore, #Helpafriendout fulfils an important service in the Soshanguve community. 

Last month the organisation launched a new project called #Makemyhoodclean. The project attracted the attention of the Gauteng Department of Agriculture and Rural Development, who backs the initiative.  

There are two project sites where the #Healpafriendout team plants vegetables which are then sold. Youth in the area are hired to help farm, based on their interest and passion for farming. 

Food supply futures 

The trio see themselves and the organisation growing into the food produce supply sphere. In the future, they want to supply the likes of Spar and the 70-80 Street food and vegetable vendors in their neighbourhood. 

“Growing up, I used to help my grandparents with their small garden where we grew flowers, cabbage and spinach. That’s where I developed an interest in farming,” explains Moroba. 

He went on to say that he sees himself being successful in farming, but also making others fall in love with farming.  

Matjene’s interest in agriculture started in primary school when he entered a competition for best school garden, and Nkuna’s foray into farming was borne from necessity – seeing the lack of food and malnutrition issues in his neighbourhood spurred him into action. 

Moroba, Matjene and Nkuna all say they have much to learn about the art of farming, but they believe their passion drives them. – Health-e News 

#LockdownSA: Emotions influence eating habits

Posted on by Zukiswa Zimela

With the general stress of coronavirus and with more people living alone, or in tense family situations – overeating, bulimia and other disordered eating may be triggered due to these risk factors.

Managing an eating disorder can be particularly difficult under lockdown and experts say that severe cases of disordered eating have generally been on the increase. They recommend adapting treatments and becoming more aware of destructive habits.   

“There’s a lot of emotions that we bring to eating, regardless of whether someone has an actual eating disorder or not,” says registered dietician Lila Bruk. 

She goes on to explain that there is a range of behaviours in the category of disordered eating, some of which may be condoned as socially acceptable. She says, “if we look at disordered eating, the spectrum runs very far – from someone who might feel like occasionally they overeat or eat past the point of feeling comfortable to someone with a full-blown eating disorder.” 

Dynamics of lockdown  

According to the South African Depression and Anxiety Group the most common eating disorders include anorexia nervosa, bulimia nervosa, and binge eating disorder. While anyone can develop these disorders, they are often seen as developmental illnesses presenting in adolescence or as a response to trauma.  

Linde Viviers is the consultant clinical psychologist at Akeso Crescent Clinic’ s Eating Disorder Unit in Johannesburg. The unit offers multidisciplinary treatment, and according to Viviers, they have observed higher levels of requests for treatment of severe cases.  

She says, “the dynamics and the impact of the lockdown may bring existing vulnerabilities to the surface.”  

Eating disorders develop over time and may only be presenting fully now, or lockdown may mean that family members are noticing behaviours and seeking help for a person who has previously kept these secret.  

Viviers explains that people with active eating disorders or those in recovery may be more vulnerable now, because lockdown can amplify feelings of anxiety and loss of control that are commonly at the root of these disorders. Being in close quarters with family members could increase destructive behaviours if they are coping mechanisms for interpersonal tension.  

She adds, “daily routines and structures around working, eating, sleeping, and exercise may have changed which may also lead to a relapse.” 

Bruk says that she also expects that eating disorder behaviours would intensify, particularly where people spend more time alone or caught up in overthinking. She says, “especially for bulimia very often feelings of loneliness and abandonment tend to exacerbate symptoms.”  

Healthy eating made more difficult 

Bruk says she is seeing an increase in people eating for comfort or reasons other than hunger, and that the lockdown has made healthy eating more challenging across the board. Food insecurity, which has been exacerbated by income loss attributed to the national lockdown, has also made it infinitely more difficult to eat a balanced and healthy diet. 

Amanda* in Johannesburg, has been hospitalised for anorexia before. She says that she was “originally anxious about the lockdown and eating habits” because of the fluctuation in her diet.  

“I went from not eating at all to eating pretty much anything nice I can find,” she says. 

Akisha* from Pietermaritzburg, says that the lockdown has meant a decrease in her eating disorder behaviours, for instance, because cooking at home makes her more aware of what she is eating.  

“There are always people at home watching my behaviours and for the first half of the lockdown I had a three-week streak of no purging.”  

While treatment for disordered eating and diagnosed eating disorders varies from person to person, Bruk advises that “there needs to be someone they can connect with” during the lockdown period. Viviers says that professional support should be continued, including virtual or in-person therapy as well as nutrition and weight monitoring with a dietician 

While Akisha has found support with friends and online communities, she feels issues like eating disorders are ignored or not dealt with in her Indian South African households.  

She says, “unfortunately given the dynamics at home it is impossible to go to a psychologist and seek professional help because of the stigma attached and the fact that it would mean I was not a perfect child.” 

Balance and routine key 

On a practical level, Viviers says “one of the most important treatment strategies is to keep to a daily structure or meal plan.” This includes eating at regular times, ideally spaced 2,5 to 4 hours apart and together with people if possible. Balanced and appropriate exercise and positive affirmations can help create a healthier connection between the mind and body.  

Amanda affirms that she has had to adjust her methods of staying balanced, by meal planning, forcing herself to eat and “motivate myself every single day that even though we are in lockdown, I need to keep healthy so that I can make it through.” 

Bruk says, “it is important to try as much as possible to link the outcome of the food with the food itself.”  

She advises that despite lockdown, one should create an environment that encourages good food choices, and awareness is key. Keeping a food diary about the content, timing and associated mood of meals is an important tool to pick up destructive patterns and be able to make better decisions instead of falling into automatic decision making patterns.  

In anorexia cases, for instance, says Bruk, “they’ll keep choosing the same foods because that’s what they feel safe with even though maybe it isn’t the best option for them.”  

While lockdown conditions can put more pressure on those recovering from or dealing with an eating disorder, the management can be adapted. If you are struggling with disordered eating or think you may have an eating disorder, please reach out to a doctor or a mental health support structure. – Health-e News