OPINION | The decisive role nutrition should play in building the economy

South African rand 10, 20, 50 and 100 banknotes in South Africa. Photographer: Waldo Swiegers/Bloomberg
South African rand 10, 20, 50 and 100 banknotes in South Africa. Photographer: Waldo Swiegers/Bloomberg
Getty Images
  • The coronavirus has underscored the value of good nutrition 
  • The lockdown, together with the economic blow, has severely compromised food and nutrition security in SA
  • This doesn't bode well for the future as a good nutrition status in children is needed for economic development

Our collective memories of 2020 have been marked by people queueing for food parcels and once-in-a-lifetime statistics of a shrinking economy and job losses. However, the link between economics and nutrition is often completely overlooked, undervalued and misinterpreted.

Nutrition challenges in South Africa are known to be complex, with historical and current inequalities underpinning them. The theme of this year's National Nutrition and Obesity Week (NNOW) emphasises how disrupting the pandemic has been to food systems, leading to poorer food choices and compromising food and nutrition security for many South African families. 

When the pandemic broke out, it quickly became clear that the coronavirus presents an increased risk for people suffering from overweight and obesity and/or diet-related non-communicable diseases such as type 2 diabetes. The term “co-morbidity” was now being used beyond medical circles as it focused people’s minds on the importance of a healthy balanced diet and active lifestyle. The coronavirus did what patient education could never do – it made the risk tangible and underscored the value of good nutrition.  

An unequal blow

But the lockdown also severely affected those who were not afflicted by the virus. Prior to lockdown, South Africa already carried the burden of a high unemployment rate, but restricting people to their houses and locking down the economy have meant a further loss of income and of jobs. The second-quarter GDP statistics show that the economy contracted by 16,4% and that between 2.2 million (QLFS data) and 2.8 million (NIDS-CRAM data) jobs have been lost. Of those that were able to work, one in five received a reduced wage.

This blow struck unequally with poor households, manual labourers, people without formal qualifications and contracts, and people in rural areas hit much harder. The initial lockdown had already restricted food accessibility and affordability, and together with the economic blow, severely compromised food and nutrition security. Poor households were spending proportionally more on food – children who had meals at school now did not, and migrant workers also returned home.

In addition, households could no longer shop around for the lowest prices as they did before the lockdown, and prices of essential food items increased. The result was news images of people queueing for food parcels provided by farmers, community groups and NGOs. Government’s Covid-19 relief package also provided for food parcels.

The first wave of the NIDS-CRAM data quantified this increase in need. In Wave 1, 47% of respondents indicated that their household had run out of money to buy food in April. Approximately 22% of households indicated that an adult went hungry during the week and 15% indicated that a child went hungry. Red-tape and corruption were blamed, as well as the suspension of the National School Nutrition Programme.

Children particularly vulnerable

As the restrictions eased and the government relief package was rolled out, the situation improved somewhat. The second wave of the NIDS-CRAM data shows that hunger for “anyone in the household” declined from 22% to 16% and for children from 15% to 11%. Around 20% fewer households ran out of money to buy food in June compared to April. Yet, the researchers caution that we need to guard against representing this progress as more than it is, as the impact of the pandemic is still unfolding. It risks removing the urgency from what is still a crisis afflicting many people.

On the one hand, there is a geographical aspect as certain places are lagging in recovery, on the other hand, children are particularly vulnerable. The country’s stunting rate of 27% means that more than one in four children are chronically undernourished.

The crisis has become more nuanced and localised. The long-term interaction of nutrition and economic outcomes should be given attention. Improving nutrition status in children leads to better economic development. Healthy, well-nourished children get sick less often, have better school attendance, learn better when they are attending school, are more likely to be employed as grown-ups and are more likely to earn higher wages.

The children of today will be the grownups of tomorrow, and by neglecting their wellbeing we are negatively impacting our own economic growth of the future. The 2020 Global Nutrition Report emphasises that “nutrition must be understood and recognised as an indispensable part of health, food, education and economic development. Particular attention must be paid to equity, the theme of this year’s report, ensuring that all forms of policy, action and systemic change support the poorest and most vulnerable, leaving no one behind”. 

Nutritious, safe, affordable and sustainable diets

In South Africa, this means more engagement by a wide range of role players: farming and land reform are linked to food security, but so is competition in retail markets. Nutrition is about more than just the supply of food and is linked to social welfare and education. Health outcomes matter for economic outcomes and the other way around.

We need to strengthen our collaborative efforts; we need to overcome the hurdles that keep well-written policies from being implemented to achieve the desired health outcomes. A pro-equity policy agenda requires programme-level collaboration. We need food systems and food environment that deliver nutritious, safe, affordable and sustainable diets.

*Prof Waldo Krugell (Professor in Economics, North-West University) and Dr Christine Taljaard-Krugell (PhD Nutrition, President of the Association for Dietetics in South Africa)

Image credit: Getty Images

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