The imperative of cross-sector collaboration in addressing SA’s dietary transition

Dietary transition poses a severe threat

Malnutrition including undernutrition, micronutrient deficiencies, and overweight and obesity is severely impeding Africa’s development trajectory. In South Africa, access to adequate nutrition is a constitutional right and yet hunger is rife and food access is a daily struggle with more than 26% of the population experiencing food insecurity. The dietary transition is a compounding factor that is defined as a shift in consumption and energy expenditure, which coincides with economic, demographic, and epidemiological changes.

To look at the available data, there has been a 50% increase in consumption of processed and packaged food since 1994. In a market predominantly shaped by large industrial food companies, obesity and other non-communicable diseases are on the rise and South Africans have become less healthy in the past few decades. There are now more than 70% of women overweight and obese, 27% of children under 5 are considered stunted and 43% of deaths are caused by diet-related non-communicable diseases. In short, the dietary transition has severe implications for the future. Such transitions are impending disasters that few nations have managed to effectively address and South Africa is particularly affected.

As individuals and households increasingly urbanise, consolidating the 67% of the population already living in urban areas, they gain access to better schools and clinics. There is also no shortage of food where they now live, but the food is largely convenience food and highly processed, high in calories and low in nutrients.

Women and children are at the forefront of this disaster, but it permeates across society with far-reaching consequences.

The issue is less about the amount of food we consume as it is about what we are eating and why. Overall, diets in South African cities are high in calories and carbohydrates and lack essential sources of macro and micronutrients provided by vegetables and fruit.

The South African food system, while effective in meeting calorie requirements, has also inflicted more damage to the natural environment than any other human enterprise. According to WWF South Africa’s 2019 report Agri-food Systems: Facts and Figures, it is escalating biodiversity loss, deforestation, desertification and soil degradation, water scarcity and declining water quality.

The role and responsibility of commercial interests

“Until now, under nutrition and obesity have been seen as polar opposites of either too few or too many calories… In reality, they are both driven by the same unhealthy, inequitable food systems, underpinned by the same political economy that is single-focused on economic growth and ignores the negative health and equity outcomes,” argues Prof Boyd Swinburn of the University of Auckland, the co-chair of a commission of experts brought together by the Lancet medical journal to explore the impact of obesity, under nutrition and climate change.

One of the key drivers of the type and quality of food that ends up on our plates is the commercial imperative. Large food companies wield significant power in the system.

Industry activities have often emerged through prompting from government – as a concession to outright regulation – through partnerships with non-profits and other civil-society organisations, or independently in response to regulatory risk through industry alliances or associations. Industry activities for improved food-related public health are still predominantly voluntary or self-regulatory, despite a global trend towards regulation, with regulatory action often following voluntary/self-regulatory industry efforts.

There is broad international recognition that this sector needs to be engaged and have their power and influence moderated (as an example, voluntary codes have proven to be insufficient).

Society needs to work together now

Adapting for the future is not just about localised change; it requires change at an unprecedented scale – multifaceted, multisectoral and multi-impact – and at unprecedented speed. Transformative change hinges on taking a system view, understanding all the possible interconnections and feedback loops so that, in intending to fix one thing, we do not create another unintended consequence.

The scale and urgency of the problem necessitates immediate mobilisation. Many nations have demonstrated strong political will to tackle these issues and the research suggests that multi-sector collaboration along with multi-level stakeholder platforms will provide the most effective means to do so.

It is critical that we break out from our siloed approach to the food system. In South Africa, the National Development Plan explicitly emphasises the value of social dialogue in this regard, but decisive leadership is sorely lacking.

Filling the Gap

It is this challenge which the Southern Africa Food Lab working in close collaboration with WWF-SA seeks to address.

The Southern Africa Food Lab was established in 2009 to promote creative responses to the problem of hunger through multi-stakeholder dialogue and action. The Food Lab has given rise to a number of initiatives not only because it generates new ideas, but because it creates commitments and relationships for “new action.”

The Lab team is one of unprecedented diversity in the region, comprising stakeholders from corporate, grassroots, NGO, academic, and government sectors, all working together to transform the food system from farm to table. Over the past decade the Lab has successfully facilitated collaboration and dialogue, not just raising awareness, but effectively catalysing action to foster innovations and experimental action towards a thriving, just and sustainable food system.

Building on in-depth research resulting in the report An Appetite for Collaboration, a Food System Dialogue took place in Johannesburg yesterday (6 March 2019) as a means of launching a broader platform focusing on the private sector’s role in addressing the challenge of dietary transitions.

Speaking at the Dialogue, Lawrence Haddad, joint winner of the 2018 World Food Prize, called the meeting “an extraordinary initiative”.

“I hadn’t seen an initiative like this emanating from Africa, bringing together all sectors of society to overcome the extraordinary challenges we have. It’s too big a problem for anyone stakeholder to do themselves, we must work individually and together.”

Through ten years of collaborative research in the role of food system transformation, we believe that the Southern Africa Food Lab working in close collaboration with a range of diverse partners is well positioned to convene and guide this process.

The opportunity

There are a number of opportunities for collaboration within the food industry that would serve to promote public health in the nation. Some of these include increasing consumer awareness of and accessibility to healthier eating options, driving the affordability and accessibility of healthier food, driving consumer aspiration for healthier foods and fostering greater accountability in the food sector.

Addressing distrust

An underlying factor which may well undermine the process, if not adequately addressed, is the very low levels of trust between various aspects of the food system (for example, between business and civil society, the public and private sector, and amongst private sector actors themselves). This was exemplified by last year’s listeriosis outbreak and the response of both business and civil society, which was characterised by stark polarisation about where responsibility lay and what action was required.

Collaboration is by no means without its challenges, some of which include:

  • Overcoming the highly competitive nature of the South African food industry;
  • Addressing concerns with collusion;
  • Overcoming polarisation and mistrust between actors in the system;
  • Managing conflicting business imperatives;
  • Securing sufficient and sustainable source of funding; and
  • Having an agreed common understanding of a ‘healthy diet’.

Nevertheless, we believe that by inter alia setting challenging outcomes-driven goals, considering appropriate ways to ensure accountability, backing this up with sufficient funding, sound science and good communications, and agreeing on the principles of engagement and setting clear ground rules, such challenges can be overcome.