title: Regional trade and the nutrition transition: opportunities to strengthen NCD prevention policy in the Southern African Development Community.
abstract: BACKGROUND
  Addressing diet-related non-communicable diseases (NCDs) will require a multisectoral policy approach that includes the food supply and trade, but implementing effective policies has proved challenging. The Southern African Development Community (SADC) has experienced significant trade and economic liberalization over the past decade; at the same time, the nutrition transition has progressed rapidly in the region. This analysis considers the relationship between regional trade liberalization and changes in the food environment associated with poor diets and NCDs, with the aim of identifying feasible and proactive policy responses to support healthy diets.
  
  
  METHODS
  Changes in trade and investment policy for the SADC were documented and compared with time-series graphs of import data for soft drinks and snack foods to assess changes in imports and source country in relation to trade and investment liberalization. Our analysis focuses on regional trade flows.
  
  
  RESULTS
  Diets and the burden of disease in the SADC have changed since the 1990s in parallel with trade and investment liberalization. Imports of soft drinks increased by 76% into SADC countries between 1995 and 2010, and processed snack foods by 83%. South Africa acts as a regional trade and investment hub; it is the major source of imports and investment related to these products into other SADC countries. At the same time, imports of processed foods and soft drinks from outside the region - largely from Asia and the Middle East - are increasing at a dramatic rate with soft drink imports growing by almost 1,200% and processed snack foods by 750%.
  
  
  CONCLUSIONS
  There is significant intra-regional trade in products associated with the nutrition transition; however, growing extra-regional trade means that countries face new pressures in implementing strong policies to prevent the increasing burden of diet-related NCDs. Implementation of a regional nutrition policy framework could complement the SADC's ongoing commitment to regional trade policy.
authors.affiliation: Menzies Centre for Health Policy, University of Sydney, Sydney, Australia; annemarie.thow@sydney.edu.au.
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Thow
authors.affiliation: School of Public Health, University of the Western Cape, Cape Town, South Africa.
authors.forename: David
authors.initials: D
authors.lastname: Sanders
authors.affiliation: Menzies Centre for Health Policy, University of Sydney, Sydney, Australia.
authors.forename: Eliza
authors.initials: E
authors.lastname: Drury
authors.affiliation: School of Public Health, University of the Western Cape, Cape Town, South Africa.
authors.forename: Thandi
authors.initials: T
authors.lastname: Puoane
authors.affiliation: Menzies Centre for Health Policy, University of Sydney, Sydney, Australia.
authors.forename: Syeda N
authors.initials: SN
authors.lastname: Chowdhury
authors.affiliation: School of Public Health, University of the Western Cape, Cape Town, South Africa.
authors.forename: Lungiswa
authors.initials: L
authors.lastname: Tsolekile
authors.affiliation: School of Public Health, University of Sydney, Sydney, Australia.
authors.forename: Joel
authors.initials: J
authors.lastname: Negin
mesh_terms: D017954:Africa South of the Sahara; D002253:Carbonated Beverages; D002908:Chronic Disease / Q000517:prevention & control*; D003906:Developing Countries; D004032:Diet; D005523:Food Supply; D006291:Health Policy; D006801:Humans; D009752:Nutritional Status; D011634:Public Health; D062410:Snacks
keywords: Southern Africa; food; health; nutrition; trade