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

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

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

Diet affected by lockdown  

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

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

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

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

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

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

Transforming food systems 

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

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

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

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

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

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

UN global warning 

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

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

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

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

Coordinated efforts needed  

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

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

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

They propose that the government must: 

• Prioritise nutrition on policy agendas related to health and social security, including a regulatory framework to support access to healthy and affordable foods.  
• Provide strategic direction and ensure coordinated and aligned programming to address food and nutrition security, in collaboration with other sectors including civil society organisations.  
• Coordinate an adequate and targeted food and social relief approach, prioritising the most vulnerable and needy for short term mitigation. Food relief should be standardised and tailored to the nutritional needs of targeted beneficiaries, especially children.  

• Progress towards universal health coverage, to ensure access to quality, essential health care.  
• Prioritise the challenges faced by specific populations, including the elderly, women (especially women of childbearing age), children and those with pre-existing medical conditions (most notably HIV/AIDS, TB and NCDs).  
• Implement well-funded coordinated strategies to actively address the main drivers of malnutrition; paying attention to food, nutrition and health, backed up by responsive social protection mechanisms. 
• Improve access to quality nutrition care through investment in human resources to increase the number of qualified nutrition professionals as well as education opportunities for other cadres of workers that provide nutrition services in primary care settings. 
• Promote nutrition education of the public through targeted and relevant nutrition messaging and communication campaigns. – Health-e News