HEALA extends a warm welcome to the newly elected Health and Finance Ministers, Dr Aaron Motsoaledi and Mr Enoch Godongwana. 

In congratulating both Ministers, HEALA also urges them to prioritise the implementation of evidence-based policies that will address the triple burden of hunger, food insecurity, and obesity – and ultimately improve the health of ordinary South Africans. 

To date, South Africa faces alarming levels of hunger, food insecurity, and obesity stemming from a broken food system. Globally, ultra-processed foods high in salt, sugar, and fat are more available than ever before, particularly in low and middle-income countries such as South Africa. Diets high in these components significantly increase the risk of people developing non-communicable diseases (NCDs) such as obesity, high blood pressure, type 2 diabetes, and heart disease. 

According to Statistics South Africa, more and more people are dying from NCDs than ever before. Diabetes, hypertension, and heart disease rank among the top ten leading causes of natural deaths in South Africa, based on the latest figures from 2017.

“HEALA particularly wishes for the Health Minister, Dr Motsoaledi, to speed up regulation on food labelling to assist ordinary South Africans in making informed food choices, to initiate coordinated mechanisms and resource mobilisation towards government and civil society as well as support improvement of the school food environment, champion taxation and regulation of unhealthy products such as sugary drinks, tobacco and alcohol,” says HEALA CEO Nzama Mbalati. 

HEALA believes the government has ample evidence demonstrating the effectiveness of the Health Promotion Levy (HPL) and Front-of-Pack Warning Labels (FOPL) in addressing many of the health issues plaguing ordinary South Africans.

Previous HPL evidence has shown that public health policies, which increase the price of harmful products, can reduce consumption. However, there is potential to do even more. Government can allocate the funds generated from the levy towards addressing issues of hunger and poverty by increasing the Child Grant and subsidising healthier foods.  

HEALA calls on Finance Minister Mr Godongwana to protect the gains made by the levy by increasing it to 20%, and expanding it to include fruit juices. We also urge Health Minister Dr Motsoaledi to fast-track the implementation of easy-to-read warning labels and empower ordinary South Africans to make better food choices.

In South Africa, essential nutritional information is buried at the back of canned products, boxes, and bottles, making it difficult for consumers to read or decipher the food labels. Implementing front-of-package labelling can translate necessary nutritional information into simple language and prominently display it on the front of food products.

The FOPL regulation will also protect children from predatory marketing practices employed by food manufacturers who use fancy marketing strategies to seduce vulnerable children into being addicted to unhealthy food.

The South African health system is buckling under the weight of NCDs. Two years ago, researchers found that “overweight and obesity cost South Africa’s health system R33 billion (US$1.9bn) a year. This represents 15.38% of government health expenditure and is equivalent to 0.67% of GDP. Annual per person cost of overweight and obesity was R2 769”. The cost of inaction in addressing this issue for both the state and the individual is too high. 

 HEALA remains committed to holding government leaders accountable for their responsibility in ensuring that the food environment benefits ordinary people rather than industry profits.

We are calling on the newly elected ministers to put food justice on the political agenda and create a healthier, more equitable future for all South Africans.

“HEALA is confident in Dr Motsoaledi’s expertise, enthusiasm and the political will he demonstrated in his previous tenure as Health Minister,  during which he prioritised pivotal public health policies and initiatives aimed at improving the health of all South Africans,” concludes Mbalati. 

Ends.

About HEALA: 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.

For media interviews contact

Zukiswa Zimela | HEALA Communications Manager

zukiswa[@]heala.org

OPINION: Let’s be upfront on front-of-pack labelling

By Nzama Mbalati and Zukiswa Zimela

It is really difficult to read food labels. What is trans-fat? How is it different from saturated fat? Why is sodium in milligrams instead of grams? Is it good for me?

That is, of course, if you even see the label on the back of the package.

On April 21, 2023, the National Department of Health published R3337, putting forward a draft regulation to introduce front-of-pack labelling in South Africa.

The draft regulation aims to provide easy-to-understand information on the front of packaged food to help consumers make healthy purchasing decisions.

This type of labelling has been incorporated successfully into several other countries and has been shown to help consumers better understand what they are eating.

The draft regulations also propose introducing restrictions on how foods can be marketed when those foods are deemed unhealthy.

The restrictions specifically aim to restrict techniques used to entice children to purchase and eat unhealthy food – an important measure as children are more vulnerable to persuasive marketing practices.

The draft regulation seems to be a no-brainer: more people will understand what is in food, and children will be less likely to be manipulated into making unhealthy eating decisions.

Especially in light of the worrying revelation early last week by Statistics South Africa that non-communicable diseases – diseases often associated with poor diets – have increased by 58 percent in the last two decades.

However, there has been staunch opposition from the food industry, and several red-herring arguments have been advanced.

We provide the following clarification to help the public understand the new proposed draft regulations.

Food producers will have fair use of their trademarks

The food industry argues that the restriction in the regulations aimed to remove misleading product descriptors “arbitrarily” deprive producers of their intellectual property rights.

First, the Trade Mark Act, the law regulating the protection of trademarks in South Africa, already contains a list of criteria limiting the use of trademarks, including allowing other laws to restrict trademarks or prescribing that marks which are confusing or misleading do not attract legal protection.

Second, food producers register multiple variations of their trademarks and will not face significant trade implications should a variation fall foul of the law.

As an example, we searched the Companies and Intellectual Property online database for trademarks affiliated with a popular soda brand in South Africa and found 60 different trademark results.

The regulations are deemed successful internationally The World Health Organization has called for front-of-pack labelling as a key consumer nutrition literacy intervention to promote healthy diets.

While it is very difficult to show how a policy intervention like a front-of-pack label can improve overall dietary choices, preliminary evidence exists (from Chile and more broadly), and strong evidence shows that the information-imparting objective is effective.

Additionally, the importance of the attached marketing restrictions to protect children has been proven, as studies show a strong link between unhealthy food marketing and childhood obesity.

Consumers should know that food contains ‘artificial sweeteners’

Evidence suggests that providing a warning label on excess sugar can lead consumers to unknowingly substitute sugar-sweetened beverages with alternative sweetened beverages (beverages containing artificial sweeteners).

The safety of artificial sweeteners is still debated.

The warning label is intended to be a consumer information intervention and warning consumers, especially parents, allows consumers to make a decision on appropriate artificial sweetener intake given the risk of allergic reaction, impact on diet for patients with diabetes, potential impact on long term food preferences and emerging evidence on the risk of cancer.

The label will not make it more difficult to import or export food

All countries have variations in food safety and labelling standards and require different procedures to meet local laws. There is a definite trend towards introducing front-of-pack labelling, and food producers seek regulatory harmonisation, endorsing FOPL policies to best achieve this goal.

The food industry will unfairly lose profits

Some food producers argue that they will lose profit because consumers will not buy foods with the warning labels – that is the point!

People will always eat – having people eat healthier foods should encourage food producers to make better alternatives available to the public. Corporate profits can never be more important than public health.

* Nzama Mbalati is the programmes manager at the Healthy Living Alliance (Heala).

* Zukiswa Zimela is the communications manager at Heala.

This oped was first published on IOL on the 9th of November 2023

This World Heart Day, the Healthy Living Alliance (HEALA) is calling on the government to take the health of South Africans to heart.

One in 3 South Africans suffer from some form of cardiovascular disease and heart disease and hypertension are in  listed in top ten causes of death in the country. A 2020 study  published in the European Heart Journal – Quality of Care and Clinical Outcomes journal highlighted poor diet as one of the leading contributors to heart disease deaths around the world.

The over consumption of an unhealthy diet is one of the leading causes of death for millions of people around the world.  Now more than ever, South Africa needs strong evidence based regulations to protect us from life threatening noncommunicable diseases such as cardiovascular disease.

Pre-packaged foods and beverages, high in salt, sugar and saturated fat have increasingly become readily available in virtually every community around the world, with South African shops inundated with these pre-packaged foods that are processed with high levels of added sugars, salt, and saturated fats. Research has found these nutrients are connected to increased obesity and chronic nutrition-related diseases.

“More than six million deaths [globally] could be avoided by reducing intake of processed foods, sugary beverages, trans and saturated fats, and added salt and sugar, “researchers found.

Front of pack warning labels are among the tools recommended by the World Health Organisation aimed at reducing the consumption of foods high in salt, sugar and saturated fat. Earlier this year the National Department of Health (NDoH) released for public comment draft regulations on the implementation of mandatory front of pack warning labels. According to the proposed regulations, all foods and beverages that have added salt, sugar or saturated fat and fall within “high in” thresholds or contain any non-sugar sweetener will have a black and white triangle warning on them to alert consumers.

The country cannot afford a delay in the implementation of the mandatory front of pack warning labels regulations. HEALA is calling on key decision makers to prioritise the health of South Africans.

“We calling on the National Department of Health to lead by its own mission “to improve health status through the prevention of illness, disease and the promotion of healthy lifestyles, and to consistently improve the health care delivery system by focusing on access, equity, efficiency, quality and sustainability”,” says Nzama Mbalati, Programmes Manager at HEALA.

The consumption of sugar sweetened beverages has also been linked to an increased risk of heart diseases. In a bold move by the South African government, the country blazed a trail as the first African country to legalise a tax on sugary drinks, in order to reduce the consumption of these products. However, in a series of decisions which favour the sugar industry, including putting a moratorium on an increase of the tax until 2025, National Treasury has threatened the efficacy of the regulation and put people’s health at risk.

“Industry often uses its economic power, lobbying and marketing machinery, and manipulation of the media to discredit scientific research and influence government inaction in order to propagate the sale and distribution of its deadly products. We cannot allow the continuation of putting profits over people,” Mbalati says.

END

About HEALA’s advocacy work in South Africa:

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. Because government policy forms a crucial part of the South Africa’s food system, HEALA believes that hunger, food insecurity and malnutrition are policy choices.

HEALA advances the right to food by advocating for more just food systems in South Africa. We do this by acting as a platform for organisations and communities to organise around the realisation of the right to affordable and nutritious food. Through our campaigns, we help amplify the voices of people on the ground to ensure that they are heard by those in power at a local, provincial and national level.

HEALA’s vision is a South Africa in which all people have equitable access to healthy food to unlock their full potential.

For more information about HEALA’s advocacy work, please visit: www.heala.org

Media Contact
Zukiswa Zimela, Communications Manager
zzimela@heala.org; 0745201652

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

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 dietsAbout 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.