Engaging with an Industrial Pandemic: Drivers of and Responses to the Expansion of Ultra-Processed Foods in East and Southern Africa

Intensified marketing and expanding consumption of ultra-processed foods (UPFs) that contain high sugar, salt, trans-fats and other additives and sugar sweetened beverages in Sub-Saharan Africa (SSA) are associated with rising obesogenic environments and non-communicable diseases, termed by some an ‘industrial pandemic’ due to its commercial drivers and cross border nature. This review paper addresses the question of how far SSA, positioned at an early point of a rising wave, is controlling this growing health challenge. The paper explores the public health responses to this expansion of UPFs in SSA, together with the issues and challenges faced. Drawing on existing analytic frameworks, the paper presents available evidence from 86 papers accessed from online searches and pertinent evidence from four United Nations databases. These sources are used to provide information on responses underway in SSA on (i) generating and sharing evidence and information as a form of discursive power; and on engaging (ii) on policy, regulation and other institutional measures; and (iii) at structural level, on taxes on UPFs and sugar sweetened beverages (SSBs) and investment measures, including to promote healthy food system alternatives, particularly in urban areas. While there is clear policy recognition of the need to respond effectively, widely, and more rapidly across SSA, and while a range of responses are underway, the findings suggest that the response is not yet matching the scale or pace of the challenge. The paper examines the challenges in implementing regulatory, policy, tax, and institutional interventions to prevent the health harms of UPFs and SSBs. It further examines the underlying political economy and power imbalances between powerful transnationals and SSA states that weaken health action. The paper argues that the learning raised on the assets for public health measures and opportunities for intervention in SSA, together with the health and wider costs of inaction, call for a strengthened African response to this industrial pandemic.