Almost 150 days into a national lockdown, what we feared would happen has happened.
The recently released National Income Dynamics Study (NIDS) Coronavirus Rapid Mobile (Cram) survey has found that South Africans, and worse, children, are hungry, hungrier than they have been in years. This persistent hunger is likely to result in a national malnutrition crisis with such far-reaching consequences that it will make the effects of the coronavirus pale in comparison.
Even before the lockdown, the nutritional status of a large proportion of South African families was very fragile. A quarter of South Africa’s children under five suffer from stunting as a result of chronic malnutrition. Malnutrition is an underlying contributory factor in at least two-thirds of child hospital deaths in South Africa. A quarter of pregnant women in South Africa report going hungry and twenty-five percent of households live below the food poverty line. Quite literally, vast numbers of families have been living on the edge.
Our communities have no reserves and the shock of the Covid-19 pandemic and lockdown is pushing families over the edge. According to the NIDS-Cram survey, conducted between May and June this year, almost half of the surveyed households reported running out of money to buy food that month, and 15% reported that a child went hungry in their household that past week — this even after the child support grant was increased.
These devastating findings suggest nutrition for adults and children is worsening and will deteriorate further over the next months as savings dry up.
This will likely result in an increase in the number of low-birth-weight babies and an increase in susceptibility to infections, firstly to Covid-19 and then to childhood illnesses such as diarrhoea and measles, which can potentially result in secondary epidemics, especially with health services already overwhelmed by Covid-19.
It is crucial that we find ways to mitigate the economic and nutritional impact of the lockdown on all people in South Africa.
Our government has taken the lead by putting additional cash into the hands of vulnerable households. But that cash won’t avert a malnutrition crisis if highly nutritious foods are not made more affordable. Eggs, legumes (beans and lentils), tinned fish, fortified maize meal, peanut butter, amasi, soya mince and full cream milk powder are high in nutritional value and could protect vulnerable individuals from slipping into acute malnutrition, but are becoming increasingly unaffordable for families, as household incomes dwindle and food prices soar.
The Grow Great Campaign is dedicated to ensuring no child is denied the opportunity to reach their full potential as a consequence of the effects of malnutrition. We are calling on food manufacturers, wholesalers and major retailers (excluding, of course, primary producers, who themselves are struggling) to provide a basket of nutritious foods, such as those described above, at cost for the next six months.
We acknowledge that many of these goods are already sold with thin profit margins, but this solution could significantly reduce the cost of these goods — and could be limited to one item per customer to avoid reselling in communities.
It’s not only an issue of social solidarity.
Persistent malnutrition has long-term effects on the growth of economies. Children suffering from chronic malnutrition (stunting) are impacted physically and cognitively. They perform worse at school, are less likely to finish school and are more likely to live in unemployment and poverty as adults than their well-nourished counterparts. In addition, these children are more vulnerable to infectious diseases as children and chronic diseases as adults, meaning their productivity is decreased and costs to the health system are higher.
What’s worse is that stunted mothers are more likely to have stunted children, suggesting that a malnutrition crisis today can rob the next generation of South Africans of full and productive lives.
It’s no surprise, then, that African and Asian countries with high burdens of chronic malnutrition or stunting incur economic losses of 4%-11% of GDP. The looming malnutrition crisis is not just a government problem, it’s an all-of-society problem.
If civil society, government and business, do not address the problem collectively, it will cast a shadow into the futures of not only the current generation of South Africans but generations to come.
We appreciate that many retailers are already involved in their own efforts, such as distributing food parcels to disadvantaged people, but inevitably a piecemeal approach will leave many people unsupported, especially the most vulnerable.
We need a more systematic approach that addresses the fundamental challenge of affordability. The economic impact of the pandemic on South Africa’s families is so large that preventing a secondary malnutrition epidemic will require the food industry to work alongside government to ensure highly nutritious foods are affordable and that the hard-won gains in health and development of the last two decades are fiercely defended during this time.
Dr Kopano Matlwa Mabaso is the executive director of the Grow Great Campaign. A medical doctor with a special interest in public health, she is a Rhodes Scholar and an alumnus of the University of Oxford, and an award-winning novelist.