REPORTAGE // SA Retail 2026

REPORTAGE

What South Africa’s retail power means for public health

Highlights from the 2026 South African Retail Assessment

South Africa grows enough food to feed its people but hunger and poor nutrition remain a challenge for many communities. As prices rise and household budgets tighten, the cost-of-living crisis is making it harder for families to eat well. For many households, especially those dependent on social grants, supermarkets are central to monthly bulk shopping. Trolleys are filled at the start of the month, often timed with grant payments, while informal outlets like spaza shops, street traders, and small independent stores, remain important for weekly top-ups of basics.

Findings from the South Africa Retail Assessment 2026, developed by the Access to Nutrition initiative (ATNi), look beyond profits and market share to how leading retailers shape the nation’s health. The report reviewed market leaders, including Shoprite, Pick n Pay, and Spar, which account for about 80% of national food sales. The report analyses nutrition policies, product promotion, pricing strategies, the relative cost of healthy diets, and relevant government policies as well as how leading retailers shape the nation’s health.

We attended the Daily Maverick’s recent webinar unpacking the ATNi report to learn more about the findings, and what they mean for customers and retailers alike. Featuring expert commentary from Yolanda Radu (senior researcher at the Centre for Health Economics and Decision Science at the Wits School of Public Health) and Greg Garrett (Executive Director of the Access to Nutrition Initiative), the discussion brought out some valuable points about how the cost-of-living crisis is affecting food security and access to nutritious affordable food in South Africa. Here are our big takeaways from the assessment:

Healthy vs unhealthy food baskets

Greater physical access to supermarkets has not translated into equal access to healthy food. The ATNi assessment found that a healthier food basket costs about 30% more than a less healthy one.

A healthy basket would include brown rice, plain yoghurt, white meat such as chicken, unsalted beans, unsalted nuts, and basic cooking noodles. Less healthy options include white rice, sweetened yoghurt, processed and red meats, beans in high-sodium sauces, salted nuts, and flavoured instant noodles.

For families struggling financially, prices drive choices. When budgets are tight, cheap, energy-dense foods high in salt, sugar, and fat often replace fresh produce and minimally processed options.

Burden of disease

Ultra-processed foods account for over 60% of packaged food sales in South Africa. About 70% of private-label products sold by major retailers would need warning labels under draft front-of-pack rules for exceeding sugar, salt, or saturated fat limits. Less than a quarter of flyer promotions feature healthier options.

This presents public health consequences with South Africa facing a triple burden of malnutrition. Nearly a third of children are stunted, while 37% of adults live with obesity – the highest rate in Sub-Saharan Africa.

Undernourishment has tripled since the mid-2000s affecting 1 in 10 people, diet-related diseases like diabetes and heart disease are rising across all incomes, and only 1 in 4 adults eats all five recommended food groups. For low-income families, cheap, filling staples dominate. In parts of Cape Town, ultra-processed foods make up nearly 40% of daily calories, while fruit and vegetable intake is just 7%.

Research estimates these conditions cost the economy about R33 billion annually in direct healthcare spending, with hidden costs – lost income, disability, and long-term treatment – likely far higher.

In March, the South African Human Rights Commission (HRC) will hold a national hearing into food systems. Food affordability and the widening gap between healthy and unhealthy foods will be at the centre of the hearing.

Policy

Fiscal measures including sugar taxes and subsidies for healthier ingredients can shift price incentives while proposed front-of-pack labelling could further change behaviour. The Health Promotion Levy prompted reformulation, though inflation reduced its impact.

Fortification – the addition of micronutrients to staple foods – is an effective public health tool, especially where fresh produce is limited. In South Africa, maize meal, flour, and salt are fortified with nutrients such as iron, folic acid, and iodine. Costs rise by about 1%, with significant health benefits.

The role of retailers

Speaking during the webinar, experts say retailers must be far more transparent in their reporting and investors should see not only financial results, but clear nutrition data too. Many retailers still fail to disclose this. They also need meaningful nutrition targets and should link executive pay to nutrition performance. Doubling sales of healthy products may sound impressive but not if unhealthy sales grow even faster. Targets must reflect the full picture.

Currently, the playing field is uneven as few countries have fully integrated nutrition into their market systems. Retailers can play their part, but policymakers must set the rules that make healthier supply and demand viable.