The ATNI Socials Blog is a series of personal commentaries to stimulate discussion on how to transform markets so that they provide more nutritious, affordable and sustainable foods. Our hope is to trigger understanding around the causes and the cures for access to nutrition.

How bad is obesity in low- and middle-income countries? Is it not still a problem monopolized by wealthy countries like the US and the UK? And wherever it does exist, is the overconsumption of unhealthy foods not simply a problem for the rich? Is it not a problem only found in cities where convenience and fast-food chains dominate? In short, should the development sector not focus its scarce resources on people who are really starving, people in rural areas and in war zones? The answer to these questions is a hard no.

After spending a week in Uganda, talking about the need to start investing in companies that produce healthy food to fight all aspects of malnutrition, my conclusion however is that the urgency needed to fight diet related diseases for all consumers, rich and poor, is not yet widely felt in this country. This is despite the risks being clearly flagged in the Global Nutrition Report of 2017 and despite UNICEF’s State of the World’s Children Report, published in 2019, that rang the alarm bells, highlighting the very high number of children who are suffering from the consequences of poor diets and are fed on fast food high in sugar, fat and calories (Independent, 2019).

Is there also some good news? Yes, there is. In the development cooperation sector the tables are slowly turning. One week after visiting Uganda, I was invited to speak at the GiZ Development Cooperation Talks about ‘Fighting hunger in an obese world’ in Berlin, where development workers from all continents were present. Although a consensus on who should take responsibly appeared lacking in the room. Consumers? Companies? Regulators? Fortunately, the audience did agree that non-communicable diseases caused by unhealthy diets, need our urgent attention.

And rightly so. Obesity and overweigh rates are perhaps still relatively low in a country like Uganda:  only 10% of women above 18 years are now obese (Global Nutrition Report, 2022). Looking at the figures for the whole African continent, however, obesity and overweight figures and type 2 diabetes, are quickly going up. Obesity in the whole of Africa, among women is 18% now. It is, however, expected to grow to 31% in 2035 (World Obesity Atlas 2023). This means that it will almost double!

In fact, according to WHO, Africa is already facing a growing problem of overweight in children: in 2019, the continent was home to 25% of the worlds’ overweight children under 5 years old (WHO, 2022) ). This is not only affecting wealthy people. On the contrary, obesity in African’s urban cities is especially growing among the low and middle-classes (Deutsche Welle, 2019). This often concerns people migrating from rural areas to urban areas where they have less time and space to grow food.

Even more striking is that in absolute figures growth in obesity is going much faster. This is because not only the piece of the pie grows (obesity rates), but also the pie itself: the total population is growing.  Africa is home to 1.3 billion people today, 17% of the world population, but it will be home to 2.4 billion in 2050 and, a staggering, 4.2 billion by the end of this century (John Hopkins University).

Because of this, much business attention is now on Africa. Consider that retail growth, supermarkets, hypermarkets, convenient stores, already grew 41% over the last five years (Euromonitor) and is expected to grow further in the decennia to come.

Packaged food, including ready to eat food, contains higher levels of salt, sugar and fats than fresh produce. Too much of this kind of food, eventually leads to higher risks of non-communicable diseases, such as diabetes, cardiovascular disease and certain types of cancer, and to morbidity and ultimately death. On an individual level this causes personal pain, discrimination, lower wages and a lower quality of life. On a society level this has an impact on the entire economic growth of a country, due to lower productivity of labor and increasing health care costs.

It’s clear that more needs to be done to help people to eat healthy. Considering the private sector’s increasing influence on consumers’ choice, particularly in fast growing urban areas, the sector needs to be kept accountable and furthermore needs to be productive in its engagement with the development sector, with governments and with the finance community that funds its growth. This is ATNI: we develop data and knowledge on how food companies are doing and where they can do better and by sharing this knowledge with the stakeholders best placed to help pull and push the food industry to produce more healthy, affordable and sustainable foods.

In the coming years, ATNI intends to intensify its role in a growing number of African markets. Are you working in market systems transformation and living in Africa? Then you should help! Obesity and overweight is surely not only a problem of the West, nor a problem for just the rich. It concerns us all.

Marije Boomsma is Strategic Alliances Director at the Access To Nutrition Initiative. ATNI is an independent not-for-profit foundation, based in the Netherlands. Our aim is to transform markets to deliver healthy sustainable diets for all, preventing deaths and illness from diet related diseases. ATNI develops and delivers accountability tools and strategies to engage the private sector and transform markets for nutrition.