News Archives

Press Statement: HEALA CALLS ON THE FINANCE MINISTER TO TAKE THE HEALTH OF SOUTH AFICANS SERIOUSLY AHEAD OF HIS 2023 BUDGET SPEECH

Posted on February 22, 2023June 4, 2024 by Zukiswa Zimela

Healthy Living Alliance (HEALA) is calling on the Finance Minister to put people’s health ahead of industry interests when he delivers his 2023 budget speech on 22nd of February. South Africans are facing a deluge of non-communicable diseases which could be prevented if the government institutes research based fiscal and legislative policies. Our health system is significantly challenged. The South African health system faces a range of systemic and structural challenges to deliver quality and affordable health care.

It is important to clarify that many of the issues plaguing the sugar sector have little to do with the Health Promotion Levy (HPL). The challenges plaguing the sugar industries are well documented and date back to over two decades prior to the implementation of the HPL in 2018, the sugar industry was already highlighting issues of a lack of economies of scale and scope, high inputs costs (Chemicals and seeds), lack of access to markets, farming marginal and communal lands and serious governance challenges, especially in cooperatives. These were highlighted by the South African Farmers Development Association (SAFDA) to the Trade Industry and Competition Committee in 2017.

“The main issues are cheap sugar imports, climate change, floods, loadshedding and the sugar industry’s own inefficiencies, corporate governance and corruption, high labour outputs, outdated technology. The HPL cannot be the main reason for the sugar industry’s problem. It is important for Industry to begin addressing its own inefficiencies that affect jobs and stop scapegoating the HPL” says Nzama Mbalati, Programme Director at Healthy Living Alliance (HEALA).

South Africa suffers from a considerable health burden including communicable disease, violence, and injury as well as non-communicable diseases. Reducing morbidity and mortality for all South Africans requires an approach that transcends health services, where public policy addresses the broader social and economic determinants of health by designing and implementing interventions that improve people’s health more effectively than individual interventions within the health sector.

Legislative, regulatory, and fiscal policies could substantially and cost-effectively reduce the burden of nutrition-related non-communicable diseases. South Africa has successfully reduced the salt content of foods through mandatory regulation and there is evidence demonstrating that a 20 per cent tax on sugary beverages will reduce obesity.

What the sugar industry fails to mention is how much the illnesses caused by their products are costing taxpayers. Diet-related diseases are killing us. In 2017, about 47000 people died from diabetes and cardiovascular diseases. Currently, an estimated twelve million South Africans suffer from diet-related diseases. It costs ZAR62 billion to treat annually, and about ZAR33 billion of that expenditure can be avoided if SA takes measures to prevent diet-related diseases.

SA cannot sit for her people to suffer from industry profit activities. Industry must accept responsibility of loss of life, rising NCD management cost, and the pain our people suffer through no

fault of theirs. The history of the South African sugar industry cast light upon deeply rooted obstacles for sugar reduction anti-obesity interventions.

This is money that could be used to fund much-needed social programmes. Let us remember that this financial burden falls on the very people whose jobs they claim have been shed by the tax, the money used to treat people with non-communicable diseases is taken from the taxpayers, many of whom are struggling to make ends meet.

Research exists to show that the sugar tax has worked in reducing obesity, particularly in young people. Experts from the Epidemiology Unit at the University of Cambridge reported that the introduction of the sugar tax was associated with an 8% relative reduction in obesity levels.

The local sugar industry has been and continues to be in steady decline. It is important for the industry to pivot and find relevance in diversifying crops and look at other uses of sugar through biofuel market.

ENDS
For more information and interviews, please contact:

Nzama Mbalati on 082 734 5414
Zukiswa Zimela on 074 521 0652

PRESS STATEMENT: HEALA Calls For Accountability and Transparency From Finance Minister Godongwana

Posted on October 24, 2022June 4, 2024 by Zukiswa Zimela

Press Release

21 October 2022

For Immediate Release

HEALA CALLS FOR ACCOUNTABILITY AND PUBLIC TRANSPARENCY FROM FINANCE MINISTER GODONGWANA…

During the 2022 Budget Speech, the Minister of Finance announced a planned increase to the HPL of 4.5% – raising the levy from 2.21 cents to 2.31 cents per gram of sugar for sugar-sweetened beverages (SSBs). HEALA welcomed this announcement as it would be the first increase since the HPL was enacted in 2018.

To HEALA’s disappointment, the National Treasury postponed the increase to April 2023. We believe that the decision to postpone the health promotion levy (HPL) was a result of the sugar industry interference and lobbying.

“There are deep historical roots of the South African sugar industry and its influence on dietary sugar consumption at the population level. The sugar industry is a prime example of a colonial activity shaping the economy, polity, penetration of sugar content into food products, and blocking proven public health policies for an extended period. With the soaring health conditions linked to unhealthy food, the reliance on sugar and energy dense diet for industry profiteering is no longer sustainable,” explains HEALA Programmes Head Nzama Mbalati.

The National Treasury has not given the reason for this postponement or how the decision was made. This lack of transparency and accountability is worrying especially regarding a food policy that helps prevent unhealthy consumption of SSBs and protects the public against obesity and other life-threatening non-communicable diseases (NCDs).

“We have been trying to have productive engagement to get answers from the National Treasury about the meetings that led to the decision to postpone the increase; however, these requests have been ignored. We submitted a Public Access to Information Act (PAIA) application to the National Treasury, this application has also been ignored. We believe National Treasury has failed to follow the Promotion of Access to Information ACT (PAIA) by not responding to our request to access this information, says Mbalati.

HEALA believes in food justice and for all South Africans to have equitable access to affordable and nutritious food. We know that this can be achieved through strengthening food policies that protect the public against unhealthy food environments and those that promote good health.

The economic, household, and individual costs of not realising the Right to Food are placing our people at a disadvantage to develop into a flourishing nation. HEALA calls on the government to wholeheartedly commit to strengthening the health promotion levy, an existing and successful health policy, that benefits both the public’s health and government fiscals. The National Treasury must increase its efforts to raise the HPL to the intended 20% and begin the process of expansion to fruit juices and lowering the 4g threshold.

ENDS

NOTES TO THE EDITOR:

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 civil society organisations and academic institutions, HEALA successfully campaigned for the Sugary Drinks Tax implemented by the 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.

For more information, please visit https://heala.org/

Issued on behalf of HEALA by Maverick Communications

Neo Merafi +27 71 359 9738

Crosby Amos +27 82 561 3544

For more information and interview opportunities, please contact:

Nzama Mbalati

082 7345414 nzama@heala.org

STATEMENT: Parents want to make healthy food choices for their children

Posted on September 7, 2022June 4, 2024 by Zukiswa Zimela

Making healthy food choices is almost impossible when you do not know what is in the food you are eating.

When shown images of foods with warning labels, parents indicated that they would buy less foods high in nutrients of concern that were labelled as “high in sugar, sodium, saturated fat” and switch to non-labelled, healthier, foods.

This is according to an investigation [1] by researchers from the University of Limpopo, the University of Western Cape, and the University of North Carolina on parents’ food purchasing decisions and perceptions of unhealthy food.

Following global trends, South Africans are consuming increasing amount of ultra-processed foods. A quick trip to the grocery store shows that shelves are increasingly filled with pre-packaged foods which are often high in nutrients of concern such as in salt, sugar, and fat.

Nutrients of concern contribute to non-communicable diseases such as diabetes, heart disease and some cancers. Worryingly South Africans have a 51.9 per cent chance of dying from an NCD – diabetes, heart diseases and stroke being the most likely culprits – according to the NCD Countdown 2030. [2] South Africa has one of the highest prevalence rates of diabetes in sub-Saharan Africa. [3]

Parents looking to make better health choices for their families are bombarded by confusing and overly technical nutritional information buried at the back of the tins, boxes, and bottles at the store. Easy to read front-of-package labelling would translate the information consumers need to know into simple language.

The researchers noted that poor nutrition knowledge and affordability surfaced as one of the leading influencers of parental food selection. This study illustrated parents’ misconception about ultra-processed/unhealthy foods, where for the first time, they realized that these products were high in sugar. 

“HIGH IN” front-of-pack warning labels, which clearly identify products that are high in things like sugar, salt, saturated fat, would help consumers easily spot unhealthy foods.

The Healthy Living Alliance (HEALA) believes that consumers have a right to know what is in the food they are eating. Easy to read front-of-pack warning labels could help consumers make better health choices.

We are asking concerned parents, caregivers, and ordinary citizens to join our call to The National Department of Health (NDoH) to release [for commentary] by signing this petition.

“Addressing non-communicable diseases needs legislative, regulatory and other measures agency to help save lives now. South Africa needs front-of-package labelling on its toolbox to help consumers make better choices and live healthier lives,” says HEALA Programmes Head, Nzama Mbalati.

For more information, visit www.whatsinmyfood.org.za to get more information on how you can be a part of the cause or add your voice by sending a WhatsApp to 079 751 9751.

Ends –

[1] Bopape M, Taillie LS, Swart R (2022). Perceived effect of warning label on parental food purchasing and drivers of food selection among South African parents – an exploratory study. Frontiers in Nutrition, 10.3389/fpubh.2022.939937

[2] https://defeat-ncd.org/new-reports-south-africans-now-most-likely-to-die-from-ncds/

[3] https://www.tandfonline.com/doi/full/10.1080/16089677.2021.1897227

The Healthy Living Alliance (HEALA) is a coalition advancing food justice in South Africa. 

For interviews contact

Zukiswa Zimela

Communications Manager: HEALA

zzimela@heala.org

0745210652

Treasury chooses special interests over people

Posted on June 2, 2022June 4, 2024 by Zukiswa Zimela

16 May 2022

For interviews, contact:
Nzama Mbalati, HEALA
082 734 5414
Nzama@heala.org

16 May 2022

Treasury’s postponement of a planned 4.5% increase to the health promotion levy, announced in the 2022 Budget, raises concerns about who calls the shots on the country’s national economic and health policy. The increase, initially announced to go into effect 01 April 2022, was a long overdue but welcomed action to curb the high consumption of unhealthy sugary drinks, reducing the risk of health conditions such as diabetes, high blood pressure and obesity. The levy has the additional benefit of generating revenue to support the Budget Review’s stated intent “to extend support to poor and vulnerable South Africans”.

“This delay calls into question the government’s appreciation of our current economic and health crises and looks like an attempt to appease short-term interests at the expense of the long-term health of our nation, says Nzama Mbalati, head of health advocacy organisation HEALA.

South Africa introduced a health promotion levy of 11% on sugary beverages to help curb the country’s sugar consumption fuelling a rise in noncommunicable diseases. The increase would raise the levy from 2.21 cents to 2.31 cents per gram of sugar for sugar-sweetened beverages above the threshold of 4 grams of sugar per 100 ml.

“We know that by reducing the amount of sugar people consume, the levy creates a healthier South Africa, reducing the cost of treating noncommunicable diseases and creating a healthier and more productive workforce, Mbalati explains. But the levy’s benefits are only possible if it keeps pace with inflation, and Treasury hasn’t meaningfully increased the levy since it was introduced in 2018. This delay shows that Treasury has chosen special interests over the health of our country.”

Treasury’s announcement did not explain how or why the government decided to postpone the increase to the current levy, only stating that the 12-month postponement of the increase is proposed to allow consultation on the expansion of the HPL to include fruit juices and lower the 4g threshold of the levy.

“An increase to the existing levy is unrelated to whether the government decides to expand the levy to include fruit juices or lower the sugar threshold. Treasury is deliberately mixing these two issues to appease special interests while at the same time slashing health, education and social support budgets and eroding our socio-economic rights. How long until our government realises that our nation will never meet its economic potential without investment in health and social protection programmes?” says Mbalati.

HEALA is calling for National Treasury to immediately:

Stop budget cuts that impactsocioeconomic rights provisions such as health and education;
Overturn the proposed postponement and implement the 4.5% increase to the HPL immediately, alongside consultations for expanding the HPL.
Indicate whether public commentary on the Revised Draft Rates and Monetary Amounts and Amendment of Revenue Laws Bill can be made and provide a deadline for comments.
Explain why a postponement of the increase is now considered an essentialrequirement to enable consultations to expand the levy and reduce the threshold, especially when the announcements made in the 2022 Budget indicated no conflict between the two processes.
Release the intended process for consultations, including timeframes andstakeholders, as soon as possible to ensure transparencyand help build public confidence and participation.

HEALA wrote an official letter to National Treasury dated 04 April 2022 to engage on this issue and made several attempts to follow up and secure a meeting with the Department to no avail.

For media enquiries, contact:
Nzama Mbalati, HEALA
082 734 5414
nzama@heala.org

Vacancy: Communications manager

Posted on March 7, 2022June 4, 2024 by earth

Are you an exceptional communicator with at least five years’ experience in journalism or communications? Are you committed to social justice and health equality?

We are looking for a communications manager to implementation of HEALA’s communication strategy and to develop, implement, monitor and evaluate communications to support HEALA’s primary policy advocacy campaigns.

This person must have the ability to think strategically, handle ambiguity, and problem solve in a fast-paced, limited-structure, multicultural environment.

HEALA is a coalition of civil society organisations advocating for equitable access to affordable, nutritious food in South Africa by building a more just food system.
HEALA’s mission is to create a platform for communities to organise and mobilise around policy and the realisation of the right to affordable, nutritious food.
Find out more on our website.

Role specifics

Fixed term position – 1 year contract.
Location – Rural Health Advocacy Project – Rosebank Johannesburg.
Closing date 25 April 2022.

What we’re looking for

This work is all about conveying information to various audiences, including a range of cultures and international partners, donors and NGOs. The skills we’re looking for include:

Fluent written and spoken English as well as one other South Africa language.
Sound knowledge of the South African media sector, including news production cycles and outlets.
Basic knowledge of social media and website metrics, including Twitter and Facebook.
Experience with web content management systems and newsletter delivery systems such as Mailchimp is a plus.
Proven ability to translate health and/or scientific research jargon into easy-to-understand language; experience in helping researchers and experts do the same is an added advantage.
Excellent oral and written communications skills, including the ability to communicate about complex issues in sensitive and compelling ways.
Willingness to travel nationally or internationally as required.

What the role looks like

Key performance areas include:

Designing, writing and editing advocacy communications materials for the HEALA coalition and specific policy advocacy campaigns
Managing the content and co-ordination the reporting for all of HEALA’s digital platforms including the WordPress website, MailChimp and social media channels (Facebook, Twitter and LinkedIn)
Facilitating effective communication within the HEALA coalition and with external stakeholders
Building and maintain relationships with the media
Overseeing event management
Effective self-management and performance ownership

Find out more

You can find further information at the full job spec.

How to apply

Accepted applications will comprise of two parts:

Your CV detailing all relevant experience and education
A cover letter answering these three questions:
- Please describe a piece of communications work that you are proud of and provide links where possible. What was your role in creating this work?
- What are three important values you would embody as the communications manager for HEALA, and can you give examples of how you embody them already?
- What are two concrete learnings from your experience working in communications sector that you would bring to HEALA?

Please email your CV and cover letter to nboomgaard@witshealth.co.za with the subject line: RHAP-Comms Manager before 15 March 2022.

Open letter: Conflict of Interest at the Third Biennial Conference of the African Research University Alliance

Posted on November 22, 2021June 4, 2024 by Zukiswa Zimela

Open letter to: Member Universities and Centres of Excellence within ARUA

23 November 2021

RE: CONFLICT OF INTEREST AT THE THIRD BIENNIAL CONFERENCE OF THE AFRICAN RESEARCH UNIVERSITY ALLIANCE (ARUA), GLOBAL PUBLIC HEALTH CHALLENGES: FACING THEM IN AFRICA (17 – 19 NOVEMBER 2021)

We are a group of concerned public health practitioners and academics working in the fields of child health, nutrition, non-communicable diseases (NCD’s) and health promotion.

We are pleased that the Third Biennial Conference of the African Research University Alliance (ARUA) on Global Public Health Challenges: Facing them in Africa to be held from the 17th to the 19th of November will include topics relating to food governance, systems, and access to nutritious food as well as discussions on the role of NCDs in global health.

We understand access to nutritious food to be a key driver of global public health.i We also note the role of diet-related non-communicable diseases in exacerbating the Covid-19 pandemic worldwide, and in Africa. ii Finally, the role of the private sector in influencing food environments in Africa cannot be overstated, iii with corporate political activity and progressive health policies relating to the diets frequently at odds.iv

We note that Professor Lindiwe Sibanda (UP) as one of the main conference speakers will be providing opening remarks. We also note from the biography connected to this conference that Professor Sibanda is a serving member of the Nestlé International Board of Directors. We are concerned that URUA does not recognize this as a conflict of interest.

Nestlé is an international company with a product portfolio that includes infant feeding products, soft drinks, coffee and tea products. Nestlé is a behemoth in the food and beverage industry, reporting CHF 7.3 billion profit for the first half of 2021 (ZAR 122.9 billion/ NGN 3293.4 billion/ 4530 CFA billion). Nestlé controls the world’s most valuable food and drinks portfolio.v Per its own admission, more than 60% of Nestlé’s food and beverage portfolio are deemed unhealthy products.vi Nestlé has also been accused of engaging in harmful corporate practices including the use of child slave labour, vii illegally promoting- breastmilk substitutes, viii unfair labour practices, ix and massive water usage sourced from water-scarce areas.x We only list allegations levelled against Nestlé in 2021. We do not purport to take a position on these allegations, but we are concerned by the gravity and scope of these allegations.

Specifically, in South Africa, we have documented repeated violations by Nestle of the R991xi xii regulations related to infant formula marketing and recently academics and civil society voiced opposition to a recent Nestle sponsored event for mothers which was subsequently cancelled.xiii

We note the Carnegie Corporation which is funding this conference is committed to avoiding conflicts of interest as per its 2009 Code of Ethics.xiv We believe the member universities of ARUA share in this commitment. Public Health England defines conflict of interest as an inability to contribute impartially to a programme of work, research, governance or oversight functions.xv The WHO described a conflict of interest as a set of circumstances where there is a potential for a secondary interest to unduly influence or be reasonably perceived to unduly influence the independence or objectivity of the primary interest. xvi The World Public Health Nutrition Association classifies possible conflicts of interest as any engagement with commercial producers of unhealthy foods, and specific industry involved in infant feeding products, ultra-processed foods and sugar-sweetened beverages (all part of Nestlé’s product portfolio).

As academics and professionals, we may think we are immune to conflicts of interest, yet a Cochrane review found that industry funding leads researchers to favour corporations either consciously or unconsciously. xvii While a conflict of interest does not necessarily equate to collusion or corruption it is often “difficult to distinguish subtle, unconscious bias from deliberately concealed impropriety”. xviii It is also important to recognise that perceived conflicts of interest may be as damaging as actual conflicts as they may “tarnish the reputation of scientists, organisations or corporations”. As such governments, universities and international organisations such as the WHO, have put measures in place to prevent and mitigate conflicts of interest.

The first step in managing conflicts of interest is disclosure and transparency at the individual and institutional level in order to screen and identify individuals/institutions with conflicting interests. xix While this is indeed a necessary first step, it is not sufficient to eliminate the COI, and where serious conflicts of interest arise between an individual’s private interests and public duties, it may become necessary to prohibit that individual from taking on positions of influence, and/or participating in key decision-making processes. Alternatively, the individual or institution should be asked to divest and rid itself of any interest that may undermine its integrity and independent judgement.

We are therefore concerned that Professor Sibanda’s leadership role in the conference, including hosting a workshop in her role as Director of the ARUA Centre of Excellence in sustainable food systems, while simultaneously holding a remunerated xx board of directors position with Nestlé constitutes a conflict of interest which may further compromise food and nutrition security on the African continent

Please clarify how this conflict has been investigated and how the conflict of interest will be managed.

Yours Sincerely,

List of Signatories:

Name	Institutional affiliation
Dr Chantell Witten	South African Civil Society for Women’s Adolescent’s and Children’s Health – SACSoWACH
Prof Tanya Doherty	Health Systems Research Unit, South African Medical Research Council
Prof Karen Hofman	SAMRC Centre for Health Economics and Decision Science, PRICELESS SA, Wits School of Public Health
Prof Susan Goldstein	SAMRC Centre for Health Economics and Decision Science, PRICELESS SA, Wits School of Public Health
Lori Lake	Children’s Institute, University of Cape Town.
Dr Sara Jewett Nieuwoudt	School of Public Health, University of the Witwatersrand
Prof Ameena Goga	HIV Prevention Research Unit, South African Medical Research Council
Prof Maylene Shung-King	School of Public Health and Family Medicine, UCT
Dr Catherine Mathews	Health Systems Research Unit, South African Medical Research Council
Prof Rina Swart	Dietetics and Nutrition, University of the Western Cape
Prof Mark Tomlinson	Institute for Life Course Health Research, Dept Global Health, Stellenbosch University
Catherine Pereira-Kotze	School of Public Health, University of the Western Cape
Prof Chris Scott	Paediatrics and Child Health, UCT
Dr Louis Reynolds	Paediatrics and Child Health, UCT; People’s Health Movement
Prof Arvin Bhana	Health Systems Research Unit, South African Medical Research Council, Centre for Rural Health, College of Health Sciences, UKZN
Dr Gillian Schermbrucker	Paediatrics and Child Health, UCT
Dr Zoe Duby	Health Systems Research Unit, South African Medical Research Council; School of Public Health & Family Medicine, University of Cape Town
Dr Wiedaad Slemming	Division of Community Paediatrics, University of the Witwatersrand; SACSoWACH
Ms. Pumla Dlamini	SACSoWACH Co-Chair
Ms Emmanuelle Daviaud	Health System Research Unit, South African Medical Research Council
Raul Mercer MD MSc	Working group on Commercial Determinants of Child Health / CAP 2030
Precious Robinson	SACSoWACH Chairperson
Dr Elizabeth Goddard	Paediatrics and Child Health, UCT
Mary Kinney	School of Public Health, University of the Western Cape
Prof. Ingunn Marie Stadskleiv Engebretsen	Centre for International Health, University of Bergen, Norway
Jane Badham	Global Nutrition Consultant
Simela Petridou	La Leche League South Africa
Tamryn Frank	School of Public Health, University of the Western Cape, South Africa
Stefan Peterson	Karolinska Institutet
Leslie London	School of Public Health, University of the Cape Town
Dr Annibale Cois	Division of Health Systems and Public Health, Department of Global Health, Stellenbosch University
Prof Amy Slogrove	Paediatrics and Child Health, Stellenbosch University
Dr Rahmat Bagus	General Practitioner, IBCLC, La Leche League Leader South Africa
Dr Gabriel Urgoiti	RX Radio SA
Dr Elmarie Malek	Paediatrics and Child Health University of Stellenbosch
Joan Truby	La Leche League South Africa
Prof Desiree Lewis	Women’s and Gender Studies Department, University of the Western Cape

Vicky Reynell	La Leche League South Africa
Prof Mignon McCulloch
Dr Wanga Zembe
Maryse Arendt	BFHI coordinator Luxembourg
Nzama Mbalati	Healthy Living Alliance (HEALA)
Elisabeth Sterken, MSc Dt.	Director INFACT Canada/IBFAN North America
Tony Waterston, MD FRCPCH	International Society for Social Pediatrics and Child Health
Dr Christine Magendie	PCP
Dr Dr Seth Christopher Yaw Appiah	Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Jeffrey Goldhagen	International Society for Social Pediatrics and Child Health
Dr Lucy Reynolds	International Society for Social Paediatrics and Child Health
Suné Greeff	Eastern Cape Department of Health
Jenny Wright	Milk Matters
Lebogang Ramafoko	Tekano Atlantic Fellows for Health Equity
Scott Drimie	Department of Global Health, Stellenbosch University
Delena Strydom	IBCLC – Panorama Breastfeeding Clinic
Koketso Moeti	amandla.mobi
Judy Kirkwood	IBCLC and Midwife, Developer of the The Best Start Feeding Initiative. Shark Latch – breastfeeding technique (patent and TM)
Nicolette Henney	Dietitian
Tobie Muller	IBCLC, La Leche League Leader South Africa
Hettie Grove	SACLC
Julia Gane	La Leche League Leader South Africa, Physiotherapist
Prof Neil McKerrow	Paediatrics & Child Health, KZN
Carol Browne	Independent nutrition consultant
Anna Shevel	Good Food Network
Aadielah Maker Diedericks	Southern African Alcohol Policy Alliance
Prof Uta Lehmann	Director, School of Public Health, University of the Western Cape
Prof Nicola Christofides	School of Public Health, University of the Witwatersrand
Dr Tanya Ruder	Division of Community Paediatrics, University of the Witwatersrand
Dr Anri Manderson	The Hoedspruit Hub, Limpopo
Alison Baker	South African Certified Lactation Consultant
Dr Nandi Siegfried	Chief Specialist Scientist, SA Medical Research Council
Tanya Thomas	LLL Leader South Africa
Leana Habeck IBCLC	The Breastfeeding Clinic
Brenda Pierce	IBCLC
Dr Nanette Jolly	Medical Doctor, IBCLC, La Leche League Leader South Africa
Ana Frawley	Lactation Consultant
Barbara Chambers	IBCLC, CFT
Lynn Shier	IBCLC, LACSA, Midwife
Pauleen Nelson	IBCLC, LACSA, Midwife
Dr Nadine Harker	Specialist Scientist, SAMRC
Mervyn Abrahams	National Department of Health, SA

Alan Rosenberg	South African Organic Sector Organization
Dr Christiane Horwood	Centre for Rural Health, UKZN
Lynette Smit	SACLC, IBCLC, CFT
Liezel Engelbrecht	Dietitian
Melissa Zwart	SACLC
Kari Oosthuizen	SLT & LLL representative
Nicole Meyer	La Leche League Leader South Africa
Lenore Spies	Public Health Nutrition Consultant
Maya Bhardwaj	University of Pretoria
Zani Smith	Dietitian & SACLC
Dr Michelle De Jong	University of the Western Cape
Ulla Walmisley	University of the Western Cape
Claire Moffatt	SACLC
Dorle Verrinder	RD IBCLC
Lindie Pitt	Doula
Katinka Fourie	IBCLC
Carey Haupt	RD SACLC MSc(Med)
Dr Khaleed Sayed	MBChB, Dip of Obs
Dr Natasha Ramjee	MO in Paediatrics, Mowbray Maternity Hospital
Ceferino Cenizo	Earth And Man Foundation
Claire Bracher	M.Sc nursing RN. RM. IBCLC
Luyanda Majija	Communication Manager, Vital Strategies
Anna Coutsoudis	Professor Emeritus, School of Clinical Medicine, University of KwaZulu-Natal, Durban
Ann Behr	National Department of Health
Melissa Whitson
Simone fink	Doula, Yoga Teachers trainer, Bcom
Cristel Cloete	Birth & Bereavement Doula
Jean Ridler	IBCLC, RM, RN
Dr Surya Ebrahim	Mowbray Maternity Hospital
Sandy Bayman	WOMBS Doula
Irene Bourquin	WOMBS Doula Trainer, Registered Nurse/Midwife
Amanda Neito	La Leche League Leader, South Africa, WOMBS Birth and Postpartum Doula
Lizl Dunn	WOMBS Doula, Breastfeeding Counselor
Pamela Wilment	La Leche League Leader, South Africa, WOMBS Doula
Dr Vanessa Farr	Environmental Humanities South, University of Cape Town
Laura Sayce IBCLC	IBCLC
Dr Sharon Nyatsanza	National Council Against Smoking
Sithabile Shobowale	WOMBS DOULA
Jane Pitt	IBCLC – SOUTH AFRICA
Samantha Crompton	RN, SACLC – The Baby Lady SA
Adriano Cattaneo	Epidemiologist (retired), Trieste, Italy
Bronwyn Balcomb, RD (SA), IBCLC	Registered Dietitian, South Africa

Anneleen De Keukelaere	People’s Health Movement South Africa
David Pienaar
Dr Max Kroon	Paediatrician, UCT
Ronel Sorgenfrei	Registered Dietitian, South Africa
Vongani Mkhabele	Registered Nutritionist, South Africa
Michael Hendricks	Paediatrician, UCT
Vanessa Black	Biowatch South Africa
Marion Stevens
Nikki Schaay	School of Public Health, University of the Western Cape
Anton Delport	School of Public Health, University of the Western Cape
Brittany Kesselman	Society, Work & Politics Institute (SWOP), WIts University
Prof Susan Fawcus	Department Obsterics and Gynaecology, University Cape Town
Manya van Ryneveld	School of Public Health, University of the Western Cape
Estelle Wasserfall	ADSA, WOMBS doula
Prof Minette Coetzee	Children’s Nursing Development Unit, UCT Department of Paediatrics and Child Health
Dr Hazel Bradley	School of Public Health, University of the Western Cape
Andrea Amos	Children’s Nursing Development Unit – Department of paeds and child health, UCT
Prof Rachel Wynberg	Department of Environmental and Geographical Science, UCT
Angela Leonard	Children’s Nursing Development Unit, UCT Department of Paediatrics and Child Health
Angelika Peczak	HEALA
Prof Nick Spencer	International Society for Social Pediatrics and Child Health (ISSOP)
Florian Kroll	DSI-NRF Centre of Excellence in Food Security; UWC Institute for Poverty, Land and Agrarian Studies
Russell Rensburg	Rural Health Advocacy (RHAP)
Zolile Mlisana	Retired paediatrician
Emeritus Professor Marian Jacobs	UCT Department of Paediatrics and Child Health
Katinka Musavaya – IBCLC	IBCLC – Maternal and Childhealth Zimbabwe
Prof Ashraf Hassen Coovadia	Academic Head of Paeds Wits University
Dr Nomlindo Makubalo	DCST Paediatrician Eastern Cape
Beatrix Callard	APN, RN, Windhoek Namibia
Thandi Puoane	Emeritus Professor
Prof Bruno Losch	Institute for Social Development, University of the Western Cape / DSI-NRF Centre of Excellence in Food Security / Cirad, France
Prof Diane Cooper	Extraordinary Professor, School of Public Health, University of the Western Cape
Prof Stephen Devereux	Institute for Social Development, University of the Western Cape / DSI-NRF Centre of Excellence in Food Security / IDS Sussex, UK
Dr Simon Lewin	South African Medical Research Council and Norwegian Institute of Public Health
Lisanne du Plessis	Division of Human Nutrition, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University
Marcus Solomon	National Coordinator Children’s Resource Centre

Rifqah Roomaney	PhD intern, SAMRC
Richard Matzopoulos	Burden of Disease Research Unit, South African Medical Research Council
Maurice Smithers	Southern African Alcohol Policy Alliance in SA (SAAPA SA)
Dr Edward Nicol	Burden of Disease Research Unit, South African Medical Research Council
Carole Dobrich	RN, IBCLC, International Institute of Human Lactation Inc.
Jennifer Welch	IBCLC International Board Certified Lactation Consultant
Dale Hansson, RN, CFHN	BFHI Lead Assessor, Lactation Consultant
Janelle Maree	Director, Breastfeeding Advocacy Australia
Dr Magdalena Whoolery	MCH-IYCF Consultant and IBFAN Member
Prof Sharon Fonn	Wits School of Public Health
Ateca Kama	Chief Dietitian & Nutritionist, Ministry of Health and Medical Services, FIJI
Prof Alice Nte	Department of Paediatrics, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
Milton Semenekane	South African Medical Research Council
Noloyiso Matiwane	North-West University
Hassan Mahomed	Division of Health Systems and Public Health, Dept of Global Health, Stellenbosch University
Jane Simmonds	South African Medical Research Council
Dikoloti Morewane	Botswana Breastfeeding Association
Jane Joubert	South African Medical Research Council
Dr Jane Battersby	UCT
Mr. Phillip Mokoena	Global Health Advocacy Incubator
Makoma Bopape	University of Limpopo
Maria van der Merwe	Independent public health and nutrition consultant
Bill Jeffery	Centre for Health Science and Law

Dr Anam Nyembezi	Senior Lecturer, School of Public Health, University of the Western Cape
Tara Callow	Pediatric Nurse Practitioner, MSN, CRNP USA
Prof Di Gray	UCT Department of Paediatrics and Child Health
Ravi Ram	Madhira Institute & PHM Kenya
Sarah Motha	Umphakatsi Peace Ecovillage
Ronel Beukes	Division of Human Nutrition, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University
Petronell Kruger	Public health lawyer and researcher at PRICELESS
Denis Joseph Bukenya	Human Rights Research Documentation Center (HURIC)
Jamiru Mugalu	People’s Health Movement Uganda
Dr Phumza Nongena	UCT Department of Paediatrics
Prof Yousuf Vawda	UKZN School of Law
Dr Natisha Dukhi	Human Sciences Research Council (HSRC)
Ms Bongekile P. Mabaso	Registered Nutritionist, PhD Candidate at UCT, School of Management Studies
Prof Salim S. Abdool Karim	Director: CAPRISA
Laurie Schowalter	HEALA
Patti Rundall	Baby Milk Action, IBFAN Global Council
Sam Waterhouse	Womxn and Democracy Initiative
Dr Gwen Norton	La Leche League Leader
Nadine Nannan	Specialist scientist, SAMRC
Duduzile Mkhize
Nomajoni Ntombela	IBFAN Africa
Dr Irena Zakarija-Grković	Croatian Association of Lactation Consultants; University of Split School of Medicine, Croatia
Nomajoni Ntombela
Nophiwe Job	Registered Nutritionist
Sasha Stephenson	Section27
Sally Raine	La Leche League Leader South Africa
Prof Julia Goedecke	Non-Communicable Diseases Research Unit, South African Medical Research Council

	Public Health Association of South Africa
	Rural Health Advocacy Project
	HEALA
Stuart Gillespie	Non-resident senior fellow, IFPRI
Rene Williams	Retreat Feeding Initiative feeding community and serving to uplift those in need. Independent non Gov
Shireen Marks	Retreat Feeding Community Worker exposed daily to mothers and children dealing with affordability issues regarding feeding
Colleen Brickles	Retreat Feeding Assistant working with kids feeding daily
Dr Anna Herforth	Independent researcher
Ralph Hamann	University of Cape Town

Aviva Tugendhaft	SAMRC Centre for Health Economics and Decision Science, PRICELESS SA, Wits School of Public Health
Dr Thandi Wessels	District Paediatrician, Western Cape Dept Health, Department of Paediatrics and Child Health, Stellenbosch University
Prof Linda Richter	Distinguished Professor, DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand

NEDLAC-commissioned report backs South Africa’s “sugar tax”

Posted on September 14, 2021June 4, 2024 by earth

A recently leaked report on the health promotion levy’s economic impacts affirms that the levy can play an important role in financing healthcare in South Africa. However, the Healthy Living Alliance (HEALA) disputes the report’s claims — based on flawed methodology — that the levy will lead to job losses.

In 2018, South Africa introduced a health promotion levy of 11% on sugary drinks with more than 4 grams of sugar per 100 ml to help curb skyrocketing rates of noncommunicable diseases — such as diabetes, high blood pressure and heart disease — linked with increased sugar consumption. Many of these conditions are now among the leading causes of natural death, according to Statistics South Africa.

Practically, the levy — also sometimes called a “sugar tax” — adds about 46 cents to the price of an average can of original Coca-Cola, for instance. The levy does not apply to natural fruit juices or sweetened dairy products.

No, the Nedlac report did not argue the sugar tax should be cut

In 2018, the Portfolio Committee on Trade and Industry directed the National Economic Development and Labour Council (Nedlac) to commission a study to assess the levy’s impact on South Africa’s economy.

Although the official report has not yet been released, a leaked copy circulated in June recommended that the levy should continue and that the tax funds be earmarked to support public healthcare. Currently, these funds are not specifically designated for the health budget.

Yet, the research also used what HEALA believes is a flawed methodology to argue that more than 16,000 jobs and an estimated R 653-million in economic investment were lost due to the sugar tax. These calculations fail to account for other forces such as EXAMPLE that are affecting the sugar industry.

The NEDLAC document fails to consider the levy’s proven health benefits

But more glaring is the Nedlac report’s failure to account for the health promotion levy’s economic benefits.

By reducing the amount of sugar people consume, the levy creates a healthier South Africa, reducing the cost of treating noncommunicable diseases and creating a healthier and more productive workforce.

The South African government spent R2.7 billion treating people living with diabetes in 2018, and the costs for 2030 are projected to be R35.1 billion. A 2016 modelling study estimated that an increased health promotion levy of 20% would save R5 billion in healthcare costs in the next two decades.

According to the 2016 research, a health promotion levy of 20% could save 72,000 lives in the next 20 years.

The NEDLAC report lacks transparency

The sugar industry has had a history of misrepresenting the economic impact of a tax on sugar-sweetened beverages. The industry has repeatedly made unproven claims about alleged job losses connected to the sugar tax without backing these up with data, as AfricaCheck found in 2016. The fact-checking organisation also revealed that industry claims downplayed sugary beverage consumption among South Africans and masked inequalities within consumption levels.

Today, there is no publicly available information on how the NEDLAC report authors, Wesbound (PTY) Ltd, were appointed, the timeframe for the research or their terms of reference.

The evaluation appointment process and terms of reference must be made freely available to ensure public confidence in the report. Transparency is crucial for ensuring that the work was independently conducted and free of influence from industry, the Portfolio Committee on Trade and Industry or NEDLAC.

Here’s what we do know about the health promotion levy’s impacts

Since the Portfolio Committee on Trade and Industry’s request for an economic impact evaluation, two local, peer-reviewed published studies assessing the HPL’s impact have found that levy works to reduce harmful sugar consumption.

University of Witwatersrand researchers found that the levy led to a 60% reduction in sugary beverage consumption among people who consumed a lot of sugar in Soweto. In the Langa outside Cape Town,

University of the Western Cape scientists found that adults between 18 and 39 years old slashed their overall sugar intake by almost a third after the levy was introduced.

In short, the levy is working just as intended to — incentivising people to change the way they consume sugar.

The sugar tax also generated an extra R5.4 billion for the country in its two years.

The Nedlac report is a wasted opportunity

HEALA believes in food justice, or the right of all communities to access nutritious, affordable, and culturally appropriate food. Because of shortcomings in both methodology and transparency, HEALA believes that the NEDLAC report represents a missed opportunity to evaluate a transformative and innovative policy to improve the lives of all South Africans.

HEALA also continues to demand that the National Treasury Department increase the health promotion levy to 20% to ensure the tax keeps pace with inflation and remains effective.

HEALA is sympathetic to the sugar industry’s concerns regarding job loss and fully supports the implementation of the Department of Trade, Industry and Competition’s Sugar Master Plan.

However, South Africa simply cannot afford to rely on sugar consumption at the expense of our current and future health and productivity – nor do we need to. The industry can and should transform to build more diversified revenue streams for sugar producers, including capitalising on global demand for biofuels.

Noncommunicable diseases fuelled in part by dangerous sugar consumption remain a significant risk factor for developing severe COVID-19. Today, COVID-19 has cost more than 200 000 people in South Africa their lives and pushed another two million into poverty.

Government can and should use all the tools at its disposal to help enable and grow a healthy population that can fully realise their potential and contribute to our shared future.

Joint sign-on letter: Nestlé’s violation of SA Regulation R991 (on foodstuffs for infants and young children)

Posted on August 12, 2021June 4, 2024 by Zukiswa Zimela

12.08.21

Dear National Department of Health

RE: Nestlé’s violation of SA Regulation R991 (on foodstuffs for infants and young children)

It has come to our attention that Nestlé has sponsored a (now cancelled) free event that was planned for the 14 August 2021 that violates South African law. The event was advertised together with You, Drum and TrueLove magazines and shared on the News 24 platform. The advert referred to in this letter (which at the time of writing was still displayed online) prominently features Nestlé, as well as three Nestlé products (Cerelac, Nestum and Nido3+). The planned event was a one-hour online ‘Free Stokvel Mom and Child Forum’, where various panellists (including health professionals and Nestlé brand ambassadors) would share information with attendees. The event targeted “all moms, grandmas, aunties and guardians of little ones”. The virtual advert refers to “fab freebies” and “winning some epic prizes”. The emotive language in the advert creates the impression that this event supports and protects the audience: “Drum and the Nestlé INFANT NUTRITION team have our back!” We explain below why this planned event undermines attempts to improve short and long-term health in South Africa (SA) and violates SA Regulation R991 (on foodstuffs for infants and young children).

The nutritional status of children in South Africa has been a cause for concern for many years and is set to worsen due to the impacts of the COVID-19 pandemic. Chronic malnutrition, manifested as stunting (or low height-for-age) affects more than a quarter (27%) of children in South Africa as reported in the 2016 South African Demographic and Health Survey. Pre-COVID-19, 11% of children (2.1 million) lived in households that reported child hunger. In the context of COVID-19, child hunger has increased with 1 in 7 (i.e. 14%) households reporting a child went hungry in April 2021. While undernutrition is still a major problem in South Africa, rates of overweight and obesity in children are also increasing with 13% of children under five being overweight for their height. A recent report by the World Obesity Federation anticipates that SA is likely to have the 10^th highest level of childhood obesity in the world by 2030. These rising rates of obesity are linked to increased ultra-processed food consumption.

The products advertised in this ‘Stokvel Mom and Child Forum’ are ‘baby cereals’ marketed for children from six months of age and a ‘fortified milk powder’ marketed for children over three years of age. All three products are ultra-processed, contain added sugars and are costly. In a country like South Africa, these products are unaffordable for most households. In 2018, 59% of children (close to 2 in 3) lived below the poverty line, 30% were without water on site, and 21% without adequate sanitation. If mothers or caregivers purchase these products, they may over-dilute them to make the product last longer. Additionally, there are challenges with keeping bottles clean in the absence of adequate water and sanitation, and the results are potentially life-threatening. These advertised products often interfere with optimal infant and young child feeding practices. The World Health Organization (WHO) and UNICEF, together with the National Department of Health (NDoH) recommend exclusive breastfeeding for the first six months of life and continued breastfeeding up until two years and beyond together with the addition of safe, affordable and nutritious complementary foods from six months. Unfortunately, in South Africa, breastfeeding under the age of six months remains low, at 32%, below the WHO target of 50%. South Africa also has high rates of the early introduction of complementary foods. It is particularly pressing that South Africa promotes infant and young child practices that are healthy, affordable and sustainable both for children and the planet.

Furthermore, the marketing strategies used in the advert for this event contain emotive, persuasive language that could mislead the undiscerning public. The use of the word ‘stokvel’ in the name of the ‘Mom and Child Forum’ is problematic as a ‘stokvel’ refers to a community-based savings scheme that has traditionally been used in South Africa for essential items. A stokvel would not traditionally be used to purchase or access the types of products being advertised in these events. In South Africa, stokvels form part of many vulnerable people’s social protection net, allowing households to build resilience, particularly at a time when COVID has intensified poverty and hunger. However, the event organisers are instead using this event as an opportunity to promote their products, that are not essential for health or wellbeing, and can be viewed as harmful to health due to their ultra-processed ingredients. Furthermore, the organisers of this event, sponsored by Nestlé, have used emotive words in the advert, such as – “get ready to be empowered“; “you’ll learn valuable information“; “It’s all about learning together and building a community of like-minded caregivers who want to grow with their little ones” to persuade mothers that these products are necessary. The use of a health professional (a nurse with a PhD) on the panel is another marketing strategy used in this advert, intended to convince mothers or caregivers that these products are endorsed by health professionals. Not only are Nestlé promoting their ultra-processed products as suitable for feeding young children, but they are also in violation of South Africa’s R991 Regulations relating to foodstuffs for infants and young children.

Given the importance of exclusive breastfeeding and efforts by formula producers and related companies to undermine exclusive breastfeeding, the South African government implemented Regulation R991 to limit the promotion and marketing of an array of products including infant formula, complementary foods and powdered milks presented as suitable for infants and young children under the age of three years old.

Regulation 2(14) of R991 provides that “no incentives, enticements or invitations of any nature, which might encourage consumers to make contact with the manufacturer or distributor of a designated product which might result in the sale or promotion of a designated product for infants or young children shall be used on the label or in the marketing of a designated product(s) for infants and young children”. Not only are Nestlé incentivising consumers to make contact with Nestlé through this free event, but they are also providing those who attend the opportunity to win R500 Shoprite vouchers and for those who attend to receive information about the use of their products in childhood and infant feeding. This is a clear violation of the R991 regulations.

Regulation 7(5) of R991 states “No manufacturer, distributor, retailer, importer or person on behalf of the aforementioned shall produce, distribute and present education information relating to infant and young child nutrition“. In violation of this regulation, the webinar invite indicates that Nestlé (a manufacturer of infant formula) will be involved in providing infant and young child feeding advice. The invite states: “Feeding your littles one can be challenging, but it doesn’t need to be. We’ve got you covered! Join the FREE Stokvel Mom and Child Forum event on 14 August 2021 – brought to you by NESTLÉ CERELAC, NESTLÉ NESTUM and NESTLÉ NIDO +3 – to learn everything you need to know about feeding your little one.“

Though the event is billed as educational, three of the speakers are described as Nestlé brand ambassadors representing or well-trained in infant (referring to a child younger than 12 months of age) nutrition. Regulation 7(5) of R991 prohibits the provision of education information related to infant and young child nutrition by a manufacturer. The event is billed as being about nutrition for infants and young children and nowhere does it specify that they will be speaking about nutrition of children over the age of 3 years.

Furthermore, the products being advertised are known to be subject to this prohibition and despite this, Nestlé intends to promote these products as an integral part of childhood nutrition. This is evidenced by the notices at the bottom of the advertisement which illustrate further violations of R991:

“1.1. Important Notice for all in-scope products from 0-36 months (IF, FUF, GUM, all complementary foods)

IMPORTANT NOTICE. A well-balanced diet, both during pregnancy and after delivery, helps sustain an adequate supply of breastmilk. Exclusive breastfeeding is recommended during the first 6 months of life followed by the introduction of adequate nutritious complementary foods, along with sustained breastfeeding up to two years of age and beyond. As babies grow at different rates, seek advice with your health professionals on the appropriate time when your baby should start receiving complementary foods.

1.2 Important notice for IFSMPs

1.3 IMPORTANT NOTICE. NESTLE NIDO 3+ is not a breastfeeding substitute and is formulated to meet the changing nutrition needs of healthy children older than 3 years.”

Point 1.1 above clearly contains education information relating to infant and young child nutrition, which is prohibited by provision 7(5) of R991.

Point 1.3 above indicates ‘that NESTLE NIDO 3+ is not a breastfeeding substitute’. However, simply labelling a product as for children above 3 does not exclude it from the ambit of R991. Specifically, a designated product includes ‘liquid milks, powdered milks, modified powdered milks, or powdered drinks marketed or otherwise represented as suitable for infants or young children.’ Placing a disclaimer that the NIDO is not suitable for children under 3 does not then allow Nestle to market the milk powder at an event on infant nutrition or engage in marketing activities about infant or childhood nutrition. If Nestle engages in activities, such as the ‘mum and child’ stokvel event where Nido is presented as suitable for infant feeding, it can be considered a designated product under R991. It also worth noting that public health recommendations are that breastfeeding should continue up until two years and beyond. Therefore, if a product like NIDO 3+ is marketed to the mother of a 3-year-old who is breastfeeding, it could be a breastfeeding substitute.

This event was only cancelled due to pressure placed on Nestle. This is clear by their initial response to an interview by the Daily Maverick, where they indicated that they would be proceeding with the event. Only after publication of the article, and pressure placed by various public health activists, did they cancel the event, which was not a once off event. Although this has come to our attention now, there have been past events. There are a series of “mum and child” stokvel events targeting followers of You, Drum and TrueLove magazines that fall within the News24 stable that have occurred in April 2021 and May 2021. Whilst we appreciate the attempt by these magazines to support families around infant feeding, partnering with infant milk companies is not recommended. We urge You, Drum and TrueLove Magazines to take the necessary action to re-imagine any similar events in the future. Future events need to be free from the influence of infant milk companies, or the ultra-processed food and beverage industry. Academic and non-governmental experts not aligned to or influenced by the food and beverage industry are a good unbiased source of information on infant and young child feeding.

We thank you for the leadership you showed as the National Department of Health, placing pressure on Nestle, and the role it has played in this event being cancelled. We urge you to consider taking legal action against Nestle for violating Regulation R991, to prevent this from ever happening again.

#NotTodayNestle

Regards,

A collective group of concerned individuals and organisations

Catherine Pereira-Kotze Dietitian, PhD Candidate, School of Public Health, University of the Western Cape	Safura Abdool Karim Public Health Lawyer SAMRC Centre for Health Economics and Decision Science/ PRICELESS, University of Witwatersrand School of Public Health	Tamryn Frank Dietitian, Researcher, School of Public Health, University of the Western Cape
Chantell Witten Lecturer, Division Health Sciences Education, Faculty of Health Sciences, University of the Free State	Lori Lake Communication and Education Specialist, Children’s Institute, University of Cape Town	Lisanne du Plessis Associate Professor, Division of Human Nutrition, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University
Rina Swart Professor, Department of Dietetics and Nutrition, and DSI/NRF Centre of Excellence in Food Security, University of the Western Cape	Karen Hofman Director, SAMRC Centre for Health Economics and Decision Science/ PRICELESS, University of Witwatersrand School of Public Health	HEALA Healthy Living Alliance
Uta Lehmann Director, School of Public Health, University of the Western Cape	RHAP Rural Health Advocacy Project	Linda Richter Distinguished Professor, University of the Witwatersrand
Lenore Spies Chairperson Professional Board for Dietetics and Nutrition	Carlos Monteiro Professor, Department of Nutrition, School of Public Health, University of Sao Paulo, Brazil	Luyanda Majija Communication Manager South Africa, Vital Strategies
Shu Wen Ng Associate Professor, Department of Nutrition, Gillings School of Global Public Health and the Carolina Population Center, The University of North Carolina	Barry Popkin Kenan Distinguished Professor, Department of Nutrition, Gillings School of Global Public Health and the Carolina Population Center, The University of North Carolina	Haroon Saloojee Professor, Division of Community Paediatrics, University of the Witwatersrand
Marita Hennessy Postdoctoral Researcher, College of Medicine and Health, University College Cork, Ireland	Inês Rugani Ribeiro de Castro Associate Professor, Department of Social Nutrition, Institute of Nutrition, State University of Rio de Janeiro, Brazil	Mélissa Mialon Research Fellow – Trinity College Dublin, Ireland & University of Sao Paulo, Brazil
Kimiellle Silva Researcher, State University of Rio de Janeiro, Brazil	Kate Sievert PhD Candidate, School of Exercise and Nutrition Sciences, Deakin University	Cecília Tomori Associate Professor, Director of Global Public Health and Community Health, Johns Hopkins School of Nursing
Healthy Food Systems Australia	Phillip Baker Research fellow, Institute for Physical Activity and Nutrition, Deakin University	Alexey Kotov Director, Vital Strategies, USA
Alexandra Jones Research Fellow (Food Policy and Law), The George Institute for Global Health, UNSW, Sydney, Australia	Makoma Bopape Lecturer, Department of Human Nutrition and Dietetics, University of Limpopo, South Africa	Rob Moodie Professor of Public Health and Deputy Head Melbourne School of Population and Global Health, Australia
Thandi Wessels District Paediatrician and Lecturer, Department of Paediatrics and Child health, Tygerberg hospital, Stellenbosch University	Julika Falconer CEO Zero2Five Trust, Durban, South Africa	Claudio Schuftan Member of WPHNA and PHM
Kim Jonas Specialists Scientist, Health Systems Research Unit, SAMRC	Zoe Duby Specialist Scientist, South African Medical Research Council	Namukolo Covic Senior Research Coordinator, International Food Policy Research Institute, Ethiopia, Member of the Nutrition Society of South Africa
Lynette Daniels Senior Lecturer, Division of Human Nutrition, Department of Global Health, Faculty Medicine and Health Sciences, Stellenbosch University	Britta Boutry-Stadelmann Consultant for IBFAN-GIFA, Geneva, Switzerland	Karessa Govender Rural Health Advocacy Project
Jaco Murray Head of Clinical Unit Department of Paediatrics, Paarl Hospital.	Catherine Mathews Chief Specialist Scientist, South African Medical Research Council	Ruth Hall Professor, SA Research Chair in Poverty, Land and Agrarian Studies, University of the Western Cape
Megan Marais Registered Dietitian, Khayelitsha Eastern Substructure, MDHS, Cape Town	Nomajoni Ntombela Chairperson.Technical Advisor IBFAN Africa	Wanga Zembe-Mkabile Specialist Scientist, South African Medical Research Council
Prof Susan Goldstein Public Health Medicine Specialist	Dr J Dippenaar Specialist midwife and technical advisor Health Systems Trust	Dr Louis Reynolds Paediatrician, People’s Health Movement.
Dr Jane Battersby Senior Lecturer, Department of Environmental and Geographical Science, UCT	Prof Robert Pattinson Emeritus Professor, UP Research Centre for Maternal, Fetal, Newborn & Child Health Care Strategies	Prof Ute Feucht Director, Research Centre for Maternal, Fetal, Newborn & Child Health Care Strategies, University of Pretoria
Dr Christiane Horwood Senior researcher, Centre for Rural Health, University of KwaZulu-Natal	Dr Valerie Vannevel Researcher, Centre for Maternal, Fetal, Newborn & Child Health Care Strategies, University of Pretoria	Dr Tsakane Hlongwane Researcher, Centre for Maternal, Fetal, Newborn & Child Health Care Strategies, University of Pretoria
Prof Jannie Hugo Director, Research COPC Research Unit, University of Pretoria	Sylvia Kimmie Program Associate IBFAN Africa	Dr Max Kroon Paediatrician, Mowbray Maternity Hospital, University of Cape Town
Dr Ben van Stormbroek Paediatrician, Victoria Hospital and University of Cape Town	Nazeeia Sayed Post-doc Reserach fellow, Dieititian. University of the Western Cape.	Aiesha Mohamed Dietitian Retreat CHC, Southern Western SS MDHS, DOH
Ass.Prof Diane Gray Department of Paediatrics and Child Health, University of Cape Town	Michael Hendricks Department of Paediatrics and Child Health, University of Cape Town	Fiona Duby Director, Babymilk Action, UK
Jane Badham Independent global nutrition consultant, Managing Director of JB Consultancy	Dr Adelaide Masu Paediatrician, Senior lecture University of Cape town	Shihaam Cader Chief and HOD Dietitian RCWMCH
Dr. Claire Procter Paediatric Intensivist, Red Cross Children’s Hospital	Inger Hendry Lecturer, Post Grad Child Nursing, University of Cape Town	Prof Brenda Morrow Professor, Department of Paediatrics and Child Health, University of Cape Town
Maylene Shung King Associate Professor, School of Public Health and Family Medicine, UCT	Aesha Arnold Isaacs Dietitian, Lady Michaelis CDC, Southern western Substructure MDHS DOH-western cape	Jane Vos Programme Coordinator, Children’s Nursing Development Unit, University of Cape Town
Assoc Prof Minette Coetzee Director, Children’s Nursing Development Unit, University of Cape Town	Mary Kinney Researcher, School of Public Health, University of the Western Cape	Scott Drimie Extraordinary Professor, Division of Human Nutrition, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University
Emmanuelle Daviaud Senior Specialist Scientist, South African Medical Research Council	Tanja Venter Dietitian, Delft CHC, Northern Tygerberg Substructure MDHS DOH – Western Cape	Dr Phumza Nongena Paediatrician, New Somerset Hospital, University of Cape Town
Tanya Doherty Chief Specialist Scientist, SAMRC	Diane Cooper Extraordinary Professor, School of Public Health, University of the Western Cape	Julian May Professor, Centre of Excellence in Food Security, University of the Western Cape
Sue-Ann Fortuin Registered Dietititan, MPICF, Klipfontein Mitchells Plain Substructure, Cape Town	Maryse Arendt Lactation consultant IBCLC, BFHI coordinator Luxembourg	Sara Nieuwoudt Senior Lecturer, School of Public Health, University of the Witwatersrand
Olinda Mugabe Member of IBFAN Mozambique and Reencontro Assotiation	Mark Richards Paediatrician, Red Cross Children’s Hospital	Christiaan Scott Paediatrician, Red Cross Children’s Hospital
Mphasha Pitso Parttime lecturer and PHD Candidate at University of Limpopo, South Africa	Anton Delport Social scientist, PhD candidate	Ditope Rabodiba Head of Department, University of Limpopo, Department of Human Nutrition and Dietetics
Yousouf Jhugroo Chairmain and Co-Founder of MAPBIN	Geeta Tekchandani Operations Director MAPBIN	David Clark Independent Consultant, Public Health and Human Rights Law
Leslie London Chair of Public Health Medicine, University of Cape Town	Constance Ching Technical Consultant (Code Implementation and Advocacy), Alive & Thrive	Hussein H.T.Tarimo WABA Steering Council member
Naefa Kahn Advocate and member of the Cape Bar	Leah Margulies, Esq. Founder, Infact, IBFAN and Nestle Boycott – Senior Staff Attorney, CAMBA Legal Services	Kent Buse Director, Healthier Societies Program, The George Institute
Yogan Pillay Affiliate, Center for Innovation for Global Health

New Health Minister Dr. Joe Phaahla has a once-in-a-generation opportunity to reform South Africa’s food policies

Posted on August 6, 2021June 4, 2024 by Zukiswa Zimela

New Health Minister Dr. Joe Phaahla has a once-in-a-generation opportunity to reform South Africa’s food policies

06 August 2021

The Healthy Living Alliance (HEALA) welcomes the appointments of Health Minister Dr. Joe Phaahla and Deputy Health Minister Dr Sibongiseni Dhlomo. HEALA urges the ministers to prioritise reforms for equitable access to healthy food.

These appointments come when South Africa is experiencing unprecedented levels of hunger amid a COVID-19 epidemic. About 10-million people and 3-million children live in households affected by hunger, according to the most recent National Income Dynamics Study – Coronavirus Rapid Mobile Survey (NIDS-CRAM).

Many families experience “perpetual” hunger, with 1.8 million households and 400,000 children experiencing food shortages for more than a year.

Women, who were significantly more likely to shield children from hunger, may be worst hit by food insecurity.

South Africans strongly support better food policies

South Africa also has a growing burden of obesity and related non-communicable diseases (NCDs) such as diabetes, stroke and heart diseases that are driven — in part — by unequal access to healthy food. Many of these NCDs are now among the leading causes of death in South Africa and have been shown to be strong risk factors for severe COVID-19 disease.

“The lack of access to affordable and nutritious food in South Africa is a health crisis,” warns the head of HEALA, Nzama Mbalati.

“Over the last 16 months, we have seen how poverty and inequality impact health outcomes,” Mbalati says. “Today, our new ministers have a once-in-a-generation opportunity to prioritise reforms to ensure equitable access to food and nutrition, such a 20% health promotion levy and better food warning labels.”

South Africans strongly support government action to reduce diet-related NCDs through policies such as taxes on sugary drinks and front-of-package warning labels for products high in fats, salt and sugar, found a 2020 study published in the scientific journal Nutrients.

Introduced in 2018, South Africa’s health promotion levy added a tax of 11% on sugary drinks with more than 4 grams of sugar per 100 ml. The levy is aimed at curbing sugar consumption that is fueling a rise in NCDs. The tax generated R5.4 billion for the nation in its first two years.

Still, three years into the levy’s implementation there is no clear understanding of how the levy revenue is allocated to “promote health,” as its title might imply.

The country’s 11% health promotion levy remains also remains far short of the World Health Organisation-recommended benchmark 20%, which would be more effective and raise much-needed revenue for important national priorities such as the National Health Insurance and a Basic Income Grant.

HEALA calls on Health Minister Dr Joe Phaahla and Deputy Health Minister Dr Sibongiseni Dhlomo to intensify efforts that accelerate access to equitable health and food for all.

“Disease in South Africa is fueled by poverty and inequality,” Mbalati says. “Without a concerted intervention to address food and nutrition insecurity, we exact a high cost to our future potential.”

The Healthy Living Alliance is a civil society coalition working to advance food justice in South Africa to ensure that communities can exercise their right to affordable, nutritious food.

For interviews, contact:

Nzama Mbalati, head of the Healthy Living Alliance (HEALA)

082 734 5414

nzama@heala.org

What is front-of-package labelling, and why does South Africa need it?

Posted on June 6, 2021June 12, 2024 by Zukiswa Zimela

Easy-to-understand labels could save your time in the shop — and your health.

Let’s face it: Nutrition labels are hard to read.

In South Africa, confusing and overly technical nutritional information is buried at the back of the tins, boxes and bottles we buy at the store. But front-of-package labelling translates the information consumers need to know into simple language and puts it right on the front of foodstuffs.

At least 10 countries, including Brazil, Mexico and Chile, have already switched to front-of-package labelling or will in coming years. Now, South Africa looks set to join them.

Globally, front-of-package labelling can take different forms.

In some countries, front-of-package labelling looks like a traffic robot, colour-coding the levels of nutrients of concern like salt or sugar based on whether they are low or high. However, research from Australia and the United Kingdom has found this form of front-of-label packaging may be ineffective.

In other places, food may carry a badge that says that it’s a healthy option overall. Lastly, some countries may choose to use front-of-package labels that simply say how many servings, for instance of fruits or vegetables, are in a given food.

But “high in” front-of-pack warning labels, which clearly identify products that are high in things like sugar, salt, saturated fat or trans fat — what experts call “nutrients of concern” — are the most effective at helping consumers spot unhealthy foods.

1. Why does South Africa need a front-of-package label?

South Africa needs front-of-package labelling to help consumers make better choices and live healthier lives.

Globally, ultra-processed foods often high in salt, sugar and fat are more available than ever before in low and middle-income countries, including South Africa. A diet high in sugar, salt and fat can put you at risk of developing a range of conditions such as obesity, high blood pressure, type 2 diabetes and heart disease — or what are often called non-communicable diseases (NCDs).

More than six out of 10 women above the age of 15 in South Africa are overweight or obese, putting them at risk of developing life-threatening illnesses, shows data from the most recent South African Demographic and Household in 2016. Overall, the World Health Organisation estimates that almost one in three South Africans were obese in 2016. About 13% of children in South Africa are also over weight – more than twice the global average.

As a result of trends like this, more people in South Africa are dying from NCDs than ever before, according to Statistics South Africa. Diabetes, hypertension and heart disease are all among the top 10 leading causes of natural death in the country, according to the latest figures from 2017.

In a 2012 national survey, about one in five people surveyed either had high blood pressure or were on track to develop the condition unless they changed their diets. About a quarter of adults had high cholesterol levels, which can increase your risk of heart disease and stroke.

2. Do front-of-package labels really work to change the way people shop and eat?

Yes. Front of package labels that state a food is “high in” or has “excessive” amounts of nutrients of concern – think sugar, salt and trans fat, for instance – are proven to help consumers tell if a food is healthy or not.

For instance, in one study shoppers who were presented with sugary fruit juices bearing these warning labels were less likely to view the beverages as healthy, according to a 2020 study published in the journal Preventive Medicine. Fruit juices are often a hidden source of sugar in many people’s diets who may mistakenly believe them to be healthy.

Consumers were similarly better able to identify unhealthy yogurts, juice, crackers and bread when these products came with front of package warning labels, another 2020 study in the journal Food Quality and Preference found.

But these food warning labels don’t just help consumers make better choices at the till. Several studies, including one conducted among more than 600 young people, found that front of package labels can also make people less likely to buy unhealthy food in the future.

And front of package labels can save lives and money. In Mexico, front of package labels warning of excess nutrients of concern like sugar and salt are expected to avert more than a million cases of obesity in Mexico and save the country more than R25 billion in healthcare costs over five years, researchers found in another 2020 study also featured in PLOS Medicine.

3. But South Africa already includes nutritional labels on food, aren’t these good enough?

No. Several studies have shown that people globally and in South Africa have trouble reading traditional nutritional labels — even if they might not know it. Researchers in India, Mexico and South Africa have all found that many people actually understand nutritional labels less well than they think, found a 2015 article published in the Global Health Action journal.

For instance, most people in a 2011 study in the North West reported regularly reading nutritional labels. But when scientists quizzed study participants on how well they understood these labels, test scores revealed that even frequent readers did not always understand how to use labels to make better food choices.

A third of participants didn’t even read labels.

4. When will South Africa introduce front-of-package labels?

It’s not clear when South Africa’s national health department will release new draft guidance on front-of-package label requirements. It will be the first step in a long road to consumer-friendly policies that will help counter big corporation’s influence on what we eat for a more food-just South Africa.

Until then, scientists across the country are working on new research that will help guide the country’s rollout of new, easier-to-use labels that will save consumers’ time — and health.

The Healthy Living Alliance (HEALA) is a coalition advancing food justice in South Africa. For updates, follow us on Twitter or subscribe to our newsletter.

Category: News