Skip to main content

Doubling down on malnutrition


Across Africa, diseases from malnutrition are on the rise, with growing rates of both undernutrition and obesity. By 2030, non-communicable diseases are projected to be the leading cause of death on the continent. Through the Catalyzing Change for Healthy and Sustainable Food Systems (CCHeFS) initiative, IDRC and the Rockefeller Foundation are supporting teams across Africa to strengthen food-system policies and practices to address this emerging public-health problem.

There is no silver bullet to tackle these complex health issues. However, there is an internationally recognized set of food and health policies, known as policy bundles, that tackle multiple forms of malnutrition, from both undernutrition and the overconsumption of unhealthy foods. Effective sets of these policy bundles can change consumer food environments by enabling more nutritious diets and effectively tackling undernutrition, obesity and other diet-related non-communicable diseases.

Policy and nutrition experts are committed to creating health and nutrition-focused policy bundles that:  

  • provide consumers with food labelling 
  • regulate the marketing of unhealthy foods 
  • support public procurement of healthy foods  
  • include fiscal measures, like taxation, that incentivize greater health

These policy bundles consider improved nutrition and health as a piece of the broader food-systems puzzle – including environmental and agricultural aspects. They also play a vital role in facilitating food-systems transformation since they tackle multiple issues simultaneously.

Establishing policy bundles is no easy feat. Yet a major win was achieved by a CCHeFS project in Ghana, when in late 2023, a 20% tax on sugar-sweetened beverages became law. This new law, along with education campaigns to consumers, is expected to reduce health problems, such as type 2 diabetes, hypertension and stroke, in the population.

Despite this significant achievement, numerous barriers are hindering African policymakers and other government officials from adopting such policy bundles.  

Research highlights

  • By 2030, non-communicable diseases like those linked to undernutrition and obesity are projected to be the leading cause of death in Africa. 
  • There is an internationally recognized set of food and health policies, known as policy bundles, that tackle malnutrition from both undernutrition and the overconsumption of unhealthy foods. 
  • Collaboration and knowledge sharing between African researchers and other stakeholders can help advance the development and implementation of food and health policies that can lead to healthier populations across Africa.

Barriers to implementing food and health policy bundles 

In many countries, food and beverage companies attempt to sway governments to not adopt policies that go against their business interests.  

“Child-directed marketing restrictions are often challenged on the false basis that the policy does not have a causal link with improved health outcomes,” explained Sameera Mahomedy, senior researcher at the University of the Witwatersrand in Johannesburg, South Africa, and CCHeFS project lead.

“Policy makers have been known to be swayed by these arguments and demands,” said Gideon Amevinya, coordinator for the CCHeFS  project in Ghana, revealing that industry opposition was a significant hurdle in passing the sugar-sweetened tax.

Another challenge to implementing policy bundles is how long it can take for policymakers to move from evidence to policy action due to various administrative hurdles, shifting political priorities and economic climates.

A CCHeFS project in Kenya that is developing a nutrient threshold profile model, a crucial element of a proposed policy bundle, has relied on a multi-stakeholder technical committee comprised of government and non-government actors. Shukri Mohamed from the African Population and Health Research Center and associate research scientist with the Kenya project, found that the decision-making process from the technical committees was very slow. As a result, the development of the team’s model faced delays.

What are some ingredients for success?  

Despite the challenges to enacting health and nutrition policy bundles, CCHeFS project teams are pioneering solutions towards their greater adoption across Africa. Through collaboration in various countries including Kenya, Ghana, Senegal and South Africa, teams are gathering robust evidence and lessons learned to strengthen food policies across the continent.

A crucial approach to developing these policies involves creating multi-stakeholder platforms, such as those developed by teams in Ghana and Kenya.

A strong coalition was crucial to enact Ghana’s sugar-sweetened beverage tax. “Evidence generated and lessons learned in Ghana can help other countries with implementing similar policy bundles and pre-empting industry arguments," emphasized Amevinya, from the University of Ghana.

The CCHeFS team in Kenya has formed a multi-stakeholder group comprising government officials and food-system leaders. Together, they have diverse expertise from which to create scalable, sustainable policies. Such approaches have inspired other countries, including Senegal, to follow suit with adopting multi-stakeholder platforms to encourage governments to strengthen their food and nutrition policies.

Such knowledge exchange between countries is vital in enhancing policy-bundle development and uptake. This type of sharing would benefit school feeding policies and practices in West Africa, for instance. A CCHeFS project has assessed public policies and found that these types of policies and practices are more robust in some countries than in others. “Countries can learn from each other. We should develop a set of best practices that can be shared between countries,” said Professor Adama Diouf of Cheikh Anta Diop University in Senegal.

Having the right voices included in research may also sway policymakers by ensuring policy recommendations are responsive and context specific. In developing Ghana’s tax policy on sweet drinks, key informant interviews enabled the identification of potential factors facilitating or impeding its implementation. The CCHeFS project on food marketing in South Africa found that it was important to involve children in research to understand their perspectives.

While only a small number of African countries have developed such policy bundles so far, opportunities to implement ambitious health and nutrition policies nationally and across Africa are a key focus of the CCHeFS initiative. Find out more about its work on policy bundles in Africa in a thematic brief