Regional trade and the nutrition transition: opportunities to strengthen NCD prevention policy in the Southern African Development Community

Abstract

Background: Addressing diet-related non-communicable diseases (NCDs) will require a multisectoral policy approach that includes the food supply and trade, but implementing effective policies has proved challenging. The Southern African Development Community (SADC) has experienced significant trade and economic liberalization over the past decade; at the same time, the nutrition transition has progressed rapidly in the region. This analysis considers the relationship between regional trade liberalization and changes in the food environment associated with poor diets and NCDs, with the aim of identifying feasible and proactive policy responses to support healthy diets.

Design: Changes in trade and investment policy for the SADC were documented and compared with time-series graphs of import data for soft drinks and snack foods to assess changes in imports and source country in relation to trade and investment liberalization. Our analysis focuses on regional trade flows.

Results: Diets and the burden of disease in the SADC have changed since the 1990s in parallel with trade and investment liberalization. Imports of soft drinks increased by 76% into SADC countries between 1995 and 2010, and processed snack foods by 83%. South Africa acts as a regional trade and investment hub; it is the major source of imports and investment related to these products into other SADC countries. At the same time, imports of processed foods and soft drinks from outside the region - largely from Asia and the Middle East - are increasing at a dramatic rate with soft drink imports growing by almost 1,200% and processed snack foods by 750%.

Conclusions: There is significant intra-regional trade in products associated with the nutrition transition; however, growing extra-regional trade means that countries face new pressures in implementing strong policies to prevent the increasing burden of diet-related NCDs. Implementation of a regional nutrition policy framework could complement the SADC's ongoing commitment to regional trade policy.

Keywords: Southern Africa; food; health; nutrition; trade.

Fig. 1

Nutrition related risk factors in the SADC countries and their contribution to the total burden of disability adjusted life years. Global Burden of Disease Project 2010, available at: www.healthmetricsandevaluation.org/gbd/visualizations/gbd-cause-patterns Note: ‘Dietary risk factors’ includes: diet low in nuts and seeds, diet low in fruits, diet low in seafood omega-3 fatty acids, diet low in whole grains, diet high in sodium, diet high in processed meat, diet low in vegetables, diet low in fiber, diet low in polyunsaturated fatty acids, diet high in trans fatty acids, and diet high in sugar-sweetened beverages.

Fig. 2

Total imports of soft drinks and processed snack foods into South Africa and other SADC countries. FAOSTAT detailed trade data (16). Notes: ‘Soft drinks’ refers to non-alcoholic beverages excluding fruit juice. Snack food categories: ice cream, sugar confectionery, wafers, pastry (this includes all baked products other than bread – i.e. cakes, biscuits etc.), chocolate products, and popcorn.

Fig. 3

Growth of imports of soft drinks into SADC countries other than South Africa (indexed so that 1996–1998=100), by source. FAOSTAT detailed trade matrix (16). Notes: Data missing for Angola, Lesotho, and Mozambique; 2004–2006 data for Botswana, Namibia, Malawi, DRC missing; 2006–2007 data for Zimbabwe missing. ‘Soft drinks’ refers to non-alcoholic beverages excluding fruit juice.

Fig. 4

Growth of imports of processed snack foods into SADC countries other than South Africa (indexed so that 1996–1998=100), by source. FAOSTAT detailed trade matrix (16). Notes: Data missing for Angola, Lesotho, and Mozambique. Snack food categories: ice cream, sugar confectionery, wafers, pastry (this includes all baked products other than bread – i.e. cakes, biscuits), and chocolate products (popcorn data not available in detailed trade matrix).