Sunday Times (Johannesburg) - April 6, 2003

The article "HIV concoction slammed as toxic" (March 30) argues that African potato is not good for people with HIV and Aids, while "Diet makes a difference" brings our attention to a Lesotho study in which a food supplement that includes African potato has rendered positive results in fighting Aids-related infections.

For the record, I told the health portfolio committee that people should, for example, eat garlic because of its antibacterial and anti-fungal properties, lemon because it contains vitamin C and olive oil as a source of vitamins A and E. All these vitamins are antioxidants and therefore protect cells against free radicals.

It is important to outline the government's approach to nutrition's role in fighting HIV/Aids and why we are putting so much emphasis on it as part of our developmental agenda, health promotion and response to diseases in general.

A few months ago the Sunday Times highlighted the plight of children in a part of the Transkei who were dying of malnutrition. These stories confirmed what we had established in various studies about the challenge of poor nutrition in this country.

In 1994, a study carried out among preschool children showed that 33% had vitamin A deficiencies, 21.4% were anaemic and 10% had an iron deficiency. In 1999, a National Food Consumption Survey showed that one in two children aged between one and nine had an intake of less than half of the required levels of energy, vitamins A, C and B6, riboflavin, niacin, folate, calcium, iron and zinc.

Although information on other age groups is limited, we know from this survey that two out of three households in South Africa do not have access to sufficient nutritious foods.

The role of nutrition in the promotion of good health is beyond debate. The question that remains is, how do we as a country respond to our challenges of poor nutrition? How do we incorporate nutrition as part of our strategy to create a healthy nation? How do we ensure that our people do not succumb to diseases much quicker than well-nourished individuals?

The government social cluster is attending first to the issue of food security. This includes emergency food relief, provision of social support, promotion of community-based income-generating activities and food gardens, as well as economic growth leading to the creation of employment.

We view the challenge of poor nutrition as caused not only by the inability to acquire food but also by a lack of information about choices that people have to make about their limited resources. Our main role is to ensure that the food that can be accessed by the poor is nutritious and that people are informed of the health benefits of certain products.

One of the steps we have taken is to launch a food-fortification programme. Through regulations published in the Government Gazette this week, we require millers to add specified amounts of vitamins and minerals to all maize meal and wheat flour .

Bread and maize meal are the foodstuffs consumed most in our society and are therefore the best vehicle to deliver required micronutrients to people who cannot afford a balanced diet. Food fortification is a proven cost- effective strategy which has been used successfully in a number of developed and developing countries.

Our view, shared by the World Health Organisation and other United Nations agencies, is that good nutrition not only promotes good health but is a critical component of a comprehensive response to disease. Of course, good nutrition is not a substitute for appropriate treatment, but it often determines the success of other interventions, including medicinal therapies.

As we give people medicines to be taken before, with or after meals, it is also our duty to ensure that the meal is, in fact, there and is healthy.

We are therefore strengthening our nutritional guidelines for people with HIV and Aids, TB and other diseases.

The first step we have taken is to draft a strategy for the formulation of this nutrition programme. Among other things, the strategy will provide selection criteria for products and substances that may be recommended.

We have invited three UN agencies, UNAids, Unicef and the WHO, as well as local and international specialists to contribute to this work. Because we would like this process to be as inclusive as possible, those who support or argue against a particular product or substance are more than welcome to make their input through the Health Department's nutrition unit.

Our aim is to create a nutrition programme that is informed by both the international experience and local conditions and is based mainly on products that are available and affordable to the majority of South Africans.

Clearly no single intervention can undo the more than 100 years of underdevelopment that undermined the health of our people. But through our collective efforts, our vision of a healthier South Africa can soon be realised.

Tshabalala-Msimang is the Minister of Health

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