Successful sodium regulation in South Africa
Hypertension is neither unique nor novel to South Africa (SA), but the legislative actions undertaken by the South African government reflect a new approach to addressing this growing burden. Current levels of hypertension in SA affect a significant proportion of the population, in which some districts show a prevalence rate of over 40% in both men and women. Hypertension also adds a tremendous strain to the national health budget, as over South Africa Rand (ZAR) eight billion is spent on treating hypertension and other noncommunicable diseases on an annual basis. Research has shown that a significant portion of hypertension is linked to sodium consumption, and a major proportion of sodium consumption in SA comes from bread--part of the staple diet. Aware of the burden of hypertension and the high levels of sodium in processed foods, Minister of Health Aaron Motsoaledi and the National Department of Health (NDOH) spearheaded legislative action to regulate sodium in food products at the manufacturing level. Based on the mixed results of voluntary regulation in other countries, the NDOH decided to initiate mandatory regulation to effectively curb sodium consumption.
Answers to a questionnaire distributed to food industry members showed that about half of the groups who answered preferred to have regulated rather than voluntary sodium, because they believed this could even the playing field. The government devoted a significant amount of time and effort to understanding the industry's concerns, many of which were considered in negotiations. Years of South African research and intersectoral interactions between government, academia, and industry culminated in successfully signed regulations.
Even with this first successful step, the hypertension problem is far from solved. This report concludes with a discussion on plausible recommendations that calls for international collaboration across the African continent, in order to further address the growing prevalence of hypertension.