SA faces a worsening health crisis linked to ultra-processed foods and the aggressive marketing tactics used to sell these products to children.

Nearly half of adults are overweight or obese, while childhood obesity has risen from one in 20 to one in eight over the past decade. If left unchecked, more than four million children aged five to 19 could be living with obesity by 2031, placing SA among the top 10 worst-affected countries globally.

Poor diets are driving the rising rates of Type 2 diabetes, hypertension and heart disease, placing strain on families and the health system.

Experts argue that mandatory front-of-package warning labels (FoPWL) are a simple, evidence-based measure to help families identify unhealthy products at a glance and curb deceptive marketing practices.

SA’s Department of Health published a draft regulation in April 2023, which would introduce FoPWL to help consumers make informed decisions and restrict misleading food marketing to children. However, more than two years later, the draft regulation remains unimplemented, despite strong public support and clear scientific evidence.

“Protecting children means standing up to corporate power and putting health before profits,” said Nzama Mbalati, the CEO of the SA advocacy organisation, the Healthy Living Alliance (Heala).

“Warning labels work. They’ve reduced sugary drink consumption and cut children’s exposure to junk food advertising in Chile and Mexico. We have the evidence. What we don’t have is the political will to act.”

Research highlights the problem

• Misleading marketing: Studies show that the packaging for unhealthy foods often carries health claims such as “good for growth” or “high in vitamins,” even when the products are high in sugar, salt or fat. These tactics shape children’s preferences and mislead parents;

• Non-compliance with proposed rules: An audit of more than 6 700 packaged foods in SA supermarkets found that 80% would require a FoPWL under draft Regulation R3337. Over half used child-directed marketing, such as cartoons, and 83% of health claims appeared on products that would carry a warning;

• A right to health issue: FoPWLs are a human rights obligation. International and SA law recognise the State’s duty to regulate the food environment and protect children from harmful commercial practices.

An SA randomised controlled trial also found that FoPWLs outperformed other formats, such as traffic-light and guideline daily amount labels. Participants who saw warning labels were more likely to correctly identify unhealthy products and less likely to want to buy them.

Public discussion highlights urgency

The urgency of these findings was at the centre of Chew on This: Big Food Is Not Telling Us the Whole Truth, a public discussion held in Johannesburg at The Wits Origins Centre on September 4.

The event included public health experts, legal professionals and industry insiders. Journalist Crystal Orderson, known for her reporting on health and social justice issues, moderated the event.

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The panel included:

• Dr Tamryn Frank: Researcher at the University of the Western Cape, specialising in obesity and non-communicable disease prevention;
• Zukiswa Zimela: Heala communications manager experienced in community mobilisation, health systems strengthening, policy advocacy and lobbying;
• Yolanda Radu: Senior researcher at the South African Medical Research Council for health economics and decision science, PRICELESS SA;
• Alice Khan: Researcher at the School of Public Health, University of the Western Cape, focusing on food and beverage marketing to children.
The discussion featured clips from the BBC documentary titled Irresistible: Why We Can’t Stop Eating by Dr Chris van Tulleken, highlighting deliberate strategies companies use, from the addictive balance of salt, sugar and fat to the lure of free toys and cartoon characters, all designed to drive sales.

Experts call for action

Frank emphasised that FoPWL is a human rights issue: “Every child has the right to grow up in an environment that supports their health, not one that exploits them for profit.

“FoPWLs cut through marketing spin by putting the facts where consumers can’t miss them – on the front of the product. The State has a duty to step in and regulate where industry will not.”

Khan highlighted that ultra-processed foods have steadily displaced fresh fruit, vegetables and traditional diets in SA.

“Reversing this trend is critical. We must create conditions where healthier, more affordable foods are widely available so that families can return to eating in ways that support their wellbeing.”

Radu added, “In SA, ultra-processed foods dominate supermarket shelves, while fresh fruit and vegetables are often too expensive or hard to find. Unless we make healthier options accessible to everyone, diet-related diseases will continue to rise.”

Zimela pointed out that Big Food’s marketing is relentless, with children as a prime target, “Packaging, advertising and product design are carefully engineered to bypass parents and appeal directly to children.

“Divulging these tactics equips families with the knowledge they need to make healthier choices and builds pressure for stronger protections and accountability.”

Heala’s call to action

Heala is leading the national call for FoPWLs in SA. Through public campaigns and community roadshows, it engages parents, young people and health workers on the dangers of ultra-processed foods and the need for clear, visible labelling.

Heala urges the Department of Health to immediately finalise and implement mandatory FoPWLs, warning that every delay leaves children exposed to aggressive and misleading food marketing.

“This is a low-cost, high-impact intervention that government can put in place right now. Parents are trying to make healthy choices, but without clear and visible warnings, they’re set up to fail,” said Mbalati.

“Voluntary labelling schemes have failed here and elsewhere. What SA needs are warning labels that are mandatory, simple to understand and impossible to ignore. Anything less is a victory for the food industry at the expense of children’s health.”

For more on Heala’s campaign, visit heala.org