Motsoaledi admits SA’s malnutrition rate has stayed ‘unacceptably high’ for two decades
· Citizen
South Africa’s stunting rate has remained unacceptably high for over 20 years, health minister Aaron Motsoaledi told the South African Human Rights Commission’s inquiry into food systems, confirming that roughly 28.8% of children under five are affected nationally.
The figure climbs to 46.2% in the Northern Cape and 46.4% in the Western Cape, according to provincial data read into the record.
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Acting director-general Nicholas Crisp said the country carries a “triple burden of malnutrition,” with undernutrition, overnutrition, and micronutrient deficiencies occurring simultaneously across the population.
He explained that the drivers were interconnected, citing poverty, rising food prices, aggressive marketing of unhealthy products, low nutrition literacy, and poor access to clean water and sanitation.
A socioeconomic problem, not a clinical one
Evidence leader Dr Eileen Carter pushed Motsoaledi on why the gap has persisted so long. He responded that the problem is fundamentally socioeconomic rather than clinical, saying, “You can’t cure it via the health department only because it’s socioeconomic, it’s a result of gross inequality.”
He pointed to a critical gap between the first thousand days of a child’s life, when health interventions apply, and school-going age, when the Basic Education Department’s nutrition programme takes over.
Damage suffered during that window, he warned, “does not get reversed,” comparing it to neural tube defects that folate supplementation cannot undo once they have occurred.
No formal request to treasury for extra funding
Asked whether the department had formally requested additional treasury funding for preventative nutrition, Motsoaledi conceded it had not.
“The direct answer is we’ve not made a submission to ask for the health budget to be increased to feed children,” he said, arguing instead that the government should tackle alcohol and gambling spending that eats into household food budgets.
He noted South Africa hosts the world’s highest documented rate of fetal alcohol syndrome, centred in the Northern Cape, calling it “the most common preventable cause of intellectual disability.”
Motsoaledi also revealed the department had tried and failed to have revenue from the sugar tax, formally the health promotion levy, ring-fenced for nutrition education after its 2018 introduction.
He said treasury rejected the idea because earmarking funds from one sector would unravel the wider budgeting system, adding that he does not expect government to revisit the decision.
Industry pushback delays food labelling reforms
On regulation, Motsoaledi described years of industry resistance to sodium-reduction rules introduced in 2013, which later won South Africa a United Nations award for best practice.
He said the same resistance was now playing out more than draft front-of-pack labelling regulations, delayed after the industry demanded the matter be tabled at the National Regulator for Compulsory Specifications.
Motsoaledi urged the commission to help fight what he called “commercial determinants of health,” singling out alcohol marketing to young people and pushback from formula manufacturers over proposed growing-up milk regulations.
“If the commission wants to help, they must enter that battle rather than just calling us and asking us questions,” he said.
Progress on pesticide bans and malnutrition screening
On pesticides, Motsoaledi confirmed an inter-ministerial committee, chaired with agriculture, had already secured a ban on the chemical Terbufos after tracing it to child deaths, and said the department would share its full report with the commission.
Crisp added that the department screens roughly 3.5 million children at household level for acute malnutrition, though therapeutic supplementation remains targeted rather than universal, since indiscriminate distribution risked pushing healthy children toward obesity.