The deaths of 70 Eastern Cape children in the first six months of this year have been linked to severe acute malnutrition, which the Human Rights Commission has described as “a shameful symbol of a national disaster”.
Daily Dispatch reports that Premier Oscar Mabuyane is now expected to appear before the HRC after being subpoenaed to detail the progress – or lack thereof – that his office has made in addressing the issue, which has long been a crisis not just in this province but countrywide.
Almost three years ago, a report was released by the human rights watchdog detailing steps various government departments should take to address malnutrition.
After the tabling of the report, titled Right to Food and Child Malnutrition, in Parliament in 2023, recommendations for the Office of the Premier included that he consider declaring a state of disaster so that immediate interventions could be introduced across the province
The report also recommended establishing a dedicated war room, accountable to the Premier’s office, with decentralised district command centres involving state agencies, including the Departments of Home Affairs, Health, Basic Education, SA Social Security Agency and Social Development, to co-ordinate efforts to address child malnutrition, including data analysis and predictive modelling.
Between April 2021 and March 2022, a total of 1 087 children in the Eastern Cape presented with severe acute malnutrition.
The Commission has also subpoenaed the national Directors-General and provincial HoDs of Social Development, Treasury, Basic Education and Health, saying that that despite the report’s clear recommendations, implementation has been “slow, fragmented and inadequate”.
Reality of poverty
Last Thursday, during a Health Department presentation, it was revealed that 70 children had died from reasons associated with severe acute malnutrition since the start of 2025.
This accounted only for deaths in public health facilities, with officials indicating the number could be higher.
In 2024, the province lost 107 children to malnutrition, the third highest in the country after KwaZulu-Natal and Limpopo.
Health Director-General Dr Sandile Buthelezi said child deaths linked to malnutrition were deeply rooted in socioeconomic inequalities that persisted across communities, particularly in rural and township areas.
“Many households face chronic food insecurity, lacking regular access to safe, sufficient and nutritious meals. This is compounded by high poverty and unemployment rates.
“Children in low-income households are more likely to be stunted, underweight, or overweight due to disrupted eating patterns and poor dietary diversity.”
Buthelezi said the economic situation, with job losses and reduced household income, intensified these challenges, forcing families to choose between nutritious food and other essential expenses like rent or electricity.
Combined with inadequate childcare support and limited multisectoral co-ordination, this contributed significantly to high rates of malnutrition-related child mortality in the country.
In 2025, the Alfred Nzo district leads with 17 deaths, followed by the OR Tambo district with 14 and Amathole district with 12 deaths.
Buffalo City Metro recorded seven deaths. Only the Joe Gqabi district municipality did not record a death.
Buthelezi said the numbers were under-reported.
Hunger takes its toll
Provincial Health HoD Dr Rolene Wagner said: “We want to identify children before they become at risk of severe acute malnutrition.
“We have invested in community-based outreach teams, and increased the number of community development workers to about 4 050 this year, who go out to communities and find children who could be at risk.
“We also work with NPOs to assist us in reaching rural households. Once we find the cases, we link them to care.
“We find children who present to our facilities do so too late. It’s really important to educate the communities and mothers.”
Among its interventions, Social Development’s Xola Ntshona said that since 2023, the department, working with Health, Education, Sassa, Home Affairs and the National Development Agency, had been implementing a mother-child development and support programme..
This was one of the interventions presented to the Commission before the department was subpoenaed, which the Commission found to be “not enough”.
“As part of this plan, we have since incorporated the Agriculture department and developed a rapid response plan for the province …to ensure that it’s not business as usual,” Ntshona added.
“Resources that were spread across the province had to be targeted to hotspots as guided by administrative data we were getting from the Department of Health …
“Part of the intervention… was to acknowledge that we are not doing enough in promoting communities and households to produce their own vegetables.
“And so there’s a commitment to ensure that we promote school gardening interventions, ensuring the school feeding scheme also benefits from those gardens, as well as communities and households near facilities.”
It was also revealed that the province had nearly 2m beneficiaries of social grants, with more than R1bn paid monthly.
HRC Commissioner Philile Ntuli said it was not enough to “talk the talk”. The departments needed to up the ante in addressing malnutrition.
“Despite clear recommendations, implementation has been inadequate. In some instances, there has been no response at all.
“That constitutes rights violations. The purpose of this sitting is not symbolic, but to demand clear answers and time frames.
“Since the release (of the report) … children are still dying of hunger. It’s a profound indictment.
“The Eastern Cape stands as a shameful symbol of a national disaster. We expect commitment.”
See more from MedicalBrief archives:
SAHRC gives government deadline to address Eastern Cape malnutrition crisis
Don’t tell anyone that children are dying
Call for action after 155 children die of malnutrition this year
Nelson Mandela Bay: Acute malnutrition cases increase while R67m distress grant remains unspent