South Africa has a protein security problem and VAT exempting more foods won’t solve malnutrition

At the opening of Parliament, President Cyril Ramaphosa announced the government’s intention to expand the list of food items exempt from value-added tax (VAT) to provide greater protection and support to the most vulnerable in society.

But if that is the aim, then the means of achieving it needs to be reconsidered. What is required is deeper discounting, not wider, to substantially reduce the price of a more limited basket of high-protein staple foods that, with a couple of exceptions, are already VAT exempt.

This conclusion is consistent with the National Treasury’s 2018 report to the minister of finance that, apart from a few additional foodstuffs, it would be better to direct more money to low-income households through expenditure side interventions than through further VAT exemptions.

One of the foodstuffs it did propose for new exemption was individually frozen chicken pieces, which are the main source of meat protein for lower-income households. From a nutritional point of view that makes a lot of sense, and we would add peanut butter to the list because of its high protein content.

Beyond those items, the revenue foregone by the National Treasury would be better directed to steeper price reductions on a subset of highly nutritious basic foods. 

Read more: Ramaphosa government urged to add protein-rich foods like peanut butter and chicken to VAT-free basket

Children need energy, protein and vitamins and minerals to grow. Carbohydrates are the body’s main source of energy, while proteins can also be converted into energy.

Conversely, excess carbohydrates can be converted into some amino acids – the building blocks of proteins – but they cannot be changed into essential amino acids, which can only be obtained from the food we eat.

Vitamins and minerals (also called micronutrients) are present in a wide range of foods, especially those that are unprocessed. It is the relative unavailability of energy, proteins and micronutrients that determines the clinical picture of malnutrition.

Malnutrition in children presents in three ways.

The first is acute, where children are underweight or, in the most serious cases, dangerously ill with severe acute malnutrition. In South Africa, about 15,000 children are hospitalised with severe acute malnutrition each year, and 1,000 die from it. Typically, these children fail to get enough of all forms of food – carbohydrates, oils, proteins and micronutrients.

The second is the opposite side of the spectrum, where children are overweight and obese, sometimes because they are genetically predisposed, but often because they overeat. Children from poorer families may gain excessive weight from eating too much starch and sugars even though they are not getting enough protein. The latest National Food and Nutrition Security Survey found that more than a fifth (22.6%) of young children are overweight.

The third form of malnutrition is chronic, which manifests as stunting (short for age). This means that children are not getting enough protein to grow their bodies and brains, even if they are getting enough energy. Studies show that stunted children have lower levels of circulating essential amino acids.

This is our biggest household food security problem – that families cannot afford enough protein-rich foods. If we must reduce our nation’s nutritional status to just one diagnosis, this is it: South Africa has a protein security problem.

Food insecurity

Severe acute malnutrition