Effectiveness of advertising complaint mechanisms in South Africa: Public health implications and regulatory gaps

The prevalence of overweight and obesity among South African children is increasing. Unhealthy food and beverage marketing is a major contributor to this burden and has been associated with an increased risk of diet-related non-communicable diseases (DR-NCDs), unhealthy food preferences among children, and changes in household purchasing patterns. Despite these risks, South Africa primarily relies on industry self-regulation to govern advertising, raising questions about the effectiveness of existing complaint mechanisms. This study evaluated the procedural and substantive effectiveness of advertising complaint mechanisms for child-directed marketing across South African regulatory bodies. A 'mystery shopper' methodology was used to assess the complaint mechanisms under real-world conditions. Nine adverts were purposively selected from a broader observational sample, resulting in eleven complaints submitted to the relevant regulatory bodies. Complaints related to alcohol adverts, unhealthy food and beverage adverts, and promotional adverts across television, radio, YouTube and outdoor platforms. Complaint mechanisms were evaluated for timeliness, accessibility, jurisdictional clarity, and procedural and substantive adjudication. The current advertising framework is largely self-regulatory through the Advertising Regulatory Board (ARB), limiting the scope of enforceable oversight. Complaint procedures were frequently characterised by delays, incorrect referrals, inconsistent procedural requirements, and fragmented jurisdiction. Procedurally, nine of the eleven complaints were not satisfactorily resolved. Substantively, none were satisfactorily resolved. The ARB applied a narrow "specifically directed to children" test, despite broader evidence that children's exposure to unhealthy product marketing can influence behaviour, particularly among adolescents. Comparison with relevant ARB decisions involving public health messaging further suggested asymmetries in evidentiary standards between commercial advertising and public health communications. These findings highlight important procedural and substantive limitations within South Africa's current advertising complaints framework. They further support consideration of stronger statutory or co-regulatory approaches with independent oversight to better protect children from harmful commercial marketing.