BHEKISISA OP-ED | How to know if your party is taking hunger seriously

In Latin America access to food is a hot issue in politics. Living in one of the most fertile and biodiverse regions on earth, millions of people still go hungry — and hungry people are also voters.  

So if you want to be the next president of a Latin American country, food security must be near the top of your agenda. 

In theory this shouldn’t be different in South Africa. One in five people in our country don’t have enough food to eat. Ten-thousand children die from the effects of severe underfeeding each year and a quarter of children under five years are stunted because of malnutrition.

Food is different from other commodities which are simply a means to make money. Adequate nutrition is a basic condition for life, human development and social stability. And it must be a priority on the agenda of every political party.

But will South Africa’s politicians take the feeding of our nation seriously in the upcoming elections? 

How food security became an election issue in Latin America 

In the 1980s and 1990s many Latin American countries were unable to pay their debts to foreign commercial banks. So the World Bank and the International Monetary Fund bailed them out on strict conditions that included gearing agricultural production to the export market.

This brought much-needed foreign currency into the region’s economies, but it came at the expense of the poor — because small-scale farming gave way to large corporatised single-crop farming and food companies chased profits beyond country borders. 

Today, Latin America exports one quarter of its locally produced food compared to Asia, which exports only 6%. 

Because of exports, food became more expensive in Latin America and poorer people struggled to afford food at prices set by global markets in the 1980s and 1990s. Riots broke out and  looting of food was widely viewed as a right — a form of restorative justice with community leaders and academics leading activist coalitions that forced food security to the top of the political agenda. 

More food: more degrees, better jobs

Not that food insecurity and hunger have been done away with in Latin America. Given the cash generated by food exports, governments had little appetite to prioritise domestic consumption. 

But one aspect of food security which was within their power and appealed to voters was to improve the nutrition of children. 

National programmes were designed to ensure mothers, babies and young children had enough nutritious food to eat. Many countries — Chile, Peru, Mexico, Columbia, Argentina and Brazil — made great gains over 10 to 20 years, despite governing parties changing.

More children did better at school and went on to study for university degrees.

Today, one in six adults in Brazil and Mexico has a bachelor’s degree, compared with one in 12 in South Africa. Consequently, those countries’ labour markets became more skilled as human capital pipelines began to flow. 

Back home: SA grows enough crops but exports result in local hunger 

South Africa, on the other hand, is stuck.

Jobs, housing and food are pressing issues for young voters in South Africa and provoke grassroots movements and political protests. A review by one of our projects reveals political parties have latched onto jobs and housing, but none has yet placed food security at the centre of their 2024 election manifestos. 

Yet hungry people have the vote. 

About one in five people in South Africa — 22% — had too little access to food in 2022 and 12.9% reported going hungry. That is a large constituency — 13,005,000 (22%) of the country’s estimated 61,384,000 people. 

When it comes to who has access to how much food, South Africa and Latin American countries are in the same boat. 

Our country produces enough food to feed everyone if it wanted to, but 29% of our food output is exported because consumers in other countries can pay more for those products than most South Africans can. 

What political parties can do to fight to end hunger 

There isn’t much leeway to change the extent of international trade as the government wants to increase exports, not decrease them. But we can learn from Latin America: there is still a lot of room to improve food security — starting with children.

Imagine if every political party committed to section 28(1)(c) of the constitution which gives every child the right to basic nutrition, shelter, healthcare and social services. If they made adequate child nutrition a cornerstone of their election promises — and delivered on them — over the next five years it would be possible to:

• stop the 10,000 child deaths a year caused by severe acute malnutrition;

• reduce the rate of low birth weight from 14% to below 10% (this is aligned with World Health Organisation targets); 

• halve the rate of stunting among children under two from 30% to 15%; and 

• reduce the levels of child obesity from 13.5% to below 10%.

The five best — and most urgent — ways to do this, are: 

1. Close the gap between the child support grant of R510 and the food poverty line of R760, starting with children younger than three.

A food poverty line of R760 means someone in South Africa needs at least R760 per month to buy enough food for a healthy diet (according to the UN Food and Agricultural Organisation, this translates to an intake of 2,100 kilocalories per adult per day). 

Ideally, the child support grant should be increased from R510 to R760 for eligible children, but our fiscus can’t afford this. However, the National Treasury should set aside an extra R6bn for under three-year-olds, which would protect children during the most important stage of their development. 

2. Ensure pregnant women have enough nutritious food to eat 

Policies such as iron and folate supplementation (too little iron and folic acid during pregnancy can make a pregnant woman sick and her unborn baby develop inadequately) must remain in place, but we need to do more than this to keep moms-to-be healthy.

The child support grant should be extended backwards, so expecting women receive grants from 12 weeks of pregnancy instead of from birth.

Mothers who are underweight should receive cellphone food vouchers to buy milk powder and eggs at spaza shops or supermarkets. These foods are high in proteins and other vitamins and minerals essential for helping their unborn babies to grow at the right pace.

3. Spot and treat children under three who fail to thrive 

We should train and equip community health workers to identify and refer children who fail to thrive. Failing to thrive means their development falls more and more behind the normal growth of children.

Each community healthworker should have a scale to weigh children and track their progress, and they should all be allowed to dispense vitamin A and deworming medication. In most provinces, these field workers are not allowed to do so because it is believed handing out medicines is outside their scope of work. Yet anyone can buy these medicines over the counter and their dispensing requires minimal training.

Vitamin A protects children from falling seriously ill by boosting their immune systems and deworming medication helps children to get the right amount of nutrients (chemical compounds such as proteins and fats contained in food); worms lower someone’s ability to absorb nutrients, which leads to children growing at a slower pace than they need to. 

Once malnourished children are identified, they should be treated, as we do any other health condition. The right treatment for malnutrition is providing such children with the right food. Caregivers should get vouchers to buy powdered milk and eggs (which are important for child growth) for malnourished children they take care of.

4. Link organisations who help people to grow food with government training programmes 

Supporting smallholder farmers financially is not enough to ensure they succeed — that’s a lesson learnt from broad-based black economic empowerment (BBBEE) and Covid-19 relief. In addition to money, small-scale farmers need training and mentoring, as well as interaction with their peers, to become players in local food supply chains.

For example, Thanda in southern KwaZulu-Natal supports more than 400 farmers with seedlings, training and access to school feeding schemes and spaza shops to which they sell their products. Linking the resources of government extension services (government-operated programmes that provide educational learning experiences to farmers) and NPOs would boost local markets.

5. Make 10 nutritious foods cheaper 

About 2.5-million children in South Africa who qualify for child support grants can’t access the payments because they don’t have the required documents (identity documents) or their parents are foreigners. That’s why we need plans which will also help such groups. These include the food industry’s agreement to forego profits on selected items, matched by a publicly funded retail subsidy, so all children can benefit from lower prices. Malaysia has done this to great effect, making food more accessible while also capping food inflation.

David Harrison is a medical doctor and CEO of the DG Murray Trust, a public innovation fund based in Cape Town.

This story was produced by the Bhekisisa Centre for Health Journalism. Sign up for the newsletter.