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Tlaleng Mofokeng

Medical doctor from QwaQwa, South Africa. Graduate of the Nelson R. Mandela School of Medicine at the University of KwaZulu-Natal (MBChB 2007). Clinician in the Gauteng health system, in pediatrics at Charlotte Maxeke Johannesburg Academic Hospital and the West Rand clinics; then in sexual and reproductive health. Chair of the Sexual and Reproductive Justice Coalition of South Africa; country lead for Global Doctors for Choice from 2017; Commissioner of the South African Commission for Gender Equality from 2019.

In July 2020, at the 44th session of the Human Rights Council, appointed Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, the first woman and first African to hold the mandate. Two three-year terms; mandate concluded in June 2026.

The complete series of thematic reports

Two reports per year across the mandate, one to the Human Rights Council in June, one to the General Assembly in October. Cumulatively, a self-contained body of work on the right to health that will remain the primary reference for the mandate for the next decade.

A/78/185, food, nutrition and the right to health

Delivered to the General Assembly on 14 July 2023 and publicly launched on 27 October 2023 by the Aspen Institute, the O’Neill Institute for National and Global Health Law at Georgetown, Vital Strategies and Bloomberg Philanthropies.

The report is the first, in the twenty-two-year history of the mandate, to place food and nutrition at the centre of the right to health rather than at its periphery. Its analytical frame is intersectional, anti-colonial and anti-racist, and its argument runs through the entire food chain, from production and processing to marketing, distribution and consumption.

Its central premise, in the Special Rapporteur’s own words at launch:

Equitable access to food and nutrition is both a necessity for sustainable development and a reflection of the power asymmetries that dictate health outcomes.

At the most basic level, equity in the food and nutrition space is about ensuring everyone in the world has access to healthy, safe, affordable, culturally appropriate foods.

Nothing humanizes all of us and bonds us more than food.

The report notes that more than 2.4 billion people lack regular access to adequate food, and that malnutrition disproportionately falls on Indigenous Peoples, women and children. It treats the global obesity burden (roughly two trillion U.S. dollars in annual economic cost) not as a matter of individual choice but as the product of an ecosystem in which ultra-processed foods dominate the supply, particularly in low-income communities where healthier alternatives are unavailable or unaffordable.

The report reads Article 12 of the International Covenant on Economic, Social and Cultural Rights, and its authoritative interpretation in General Comment 14 of the Committee on Economic, Social and Cultural Rights, as generating positive obligations on states with respect to food environments. Four passages carry the argument.

On the obligation to protect against corporate interference (paragraph 12):

The obligation to protect requires States to take measures that prevent third parties, including corporations, from interfering with the enjoyment of human rights. The “failure to regulate the activities of the food and beverage industry to prevent them from violating the right to health of others and protect consumers from practices detrimental to their health may amount to a violation of the right to health”.

On the minimum core obligation with respect to nutritionally adequate food (paragraph 14):

Under the right to health, States’ core obligations include ensuring “access to the minimum essential food which is nutritionally adequate and safe, to ensure freedom from hunger to everyone”.

On the specific obligation to regulate the childhood food environment (paragraph 15):

States must … address obesity in children by limiting their exposure to fast foods that are energy-dense, micronutrient-poor and high in fat, sugar or sodium; regulate the marketing of such products, especially when focused on children; and ensure that business enterprises identify, prevent and mitigate their negative impact on children’s right to health, including across their business relationships and within any global operations.

On the treatment of state inaction on non-communicable disease risk factors as a rights violation (paragraph 41):

Given that non-communicable diseases lead to preventable morbidity and mortality with tangible human rights implications, international human rights law mandates that States address non-communicable disease risk factors, including unhealthy diets. States’ failure to do so may amount to violations of the right to health and health-related rights.

On the role of multi-stakeholder governance and its erosion of state responsibility (paragraph 61, quoting the Special Rapporteur on the right to food):

“Multi-stakeholder governance also leaves the role of States unclear and does not address their role as the main duty bearers.” … States must refrain from directly or indirectly interfering with the enjoyment of the right to health and health-related rights by refraining from entering into partnerships in policymaking that subordinate health, particularly the health of the most vulnerable. Moreover, by allowing legitimate decision-making processes to be co-opted by private interests that often compete with public health interests, States may become complicit to the point of violating this obligation.

Micronutrients named in the report

The report names specific micronutrients at four distinct points, in each case at the population-aggregate level rather than in reference to individual physiological adequacy.

On the global burden of micronutrient deficiency (paragraph 29):

Micronutrient deficiencies also remain a major global problem, particularly for children, pregnant persons and other groups with higher nutrient requirements.

On the immunological consequences of the same deficiencies (paragraph 33):

Two billion people suffer from micronutrient deficiencies, including vitamins A, C and E and the minerals zinc, iron and iodine, which impair the body’s ability to form antibodies and develop a strong immune system.

On dietary antioxidants in gynecological health (paragraph 46):

Studies have demonstrated that the consumption of dietary antioxidants, such as carotenes, ascorbic acid and vitamin D, might offer a protective role against inflammation and multifactorial disorders affecting uterine and ovarian health in people of reproductive age.

On the specific obstetric consequences of suboptimal diets (paragraph 49):

Suboptimal diets leading to folic acid, vitamin D and iron deficiencies and higher maternal weight during preconception and pregnancy can increase the risk of pregnancy complications and non-communicable diseases in pregnant persons and their children. In crisis situations, the United Nations Population Fund often provides iron folate, vitamin A and other supplements to ensure good nutrition for lactating mothers and their babies.

Named good practices (Section XII)

The report catalogues specific state instruments as commendable practice. This is the operative list against which future compliance can be tested.

The sixteen recommendations to states (Section XIII, paragraph 97)

The report closes with sixteen lettered recommendations directed to member states and other stakeholders. In her own text:

The concluding sentences of the report, in her own voice (paragraph 96):

Food is more than just the nutrition that it provides. Besides being one of the most common sources of pleasure, food is also a social glue. As a concept, food is certainly more than nutrition; it has always been a special and glorious expression of self, culture and societal, economic and political autonomy.

On the epigenetic imprint of hunger

In an interview around the report’s release:

Experiencing famine and starvation can alter the way your DNA, body experiences food. Your body can begin to store fat…

Institutional follow-up

The framework press release from the Special Procedures branch, on the same theme:

Tackling inequities in food, nutrition and health outcomes requires a rights-based approach. (OHCHR, October 2023)

The O’Neill Institute at Georgetown published a brief that reformulates the report as a set of state-level obligations for the noncommunicable disease prevention agenda.

On racism and the right to health (A/77/197)

Her second report to the General Assembly, in 2022, systematized the argument that racism is a determinant of health rather than a modifier of it. From her extended interview with the Stanford Social Innovation Review on the same theme:

Racism is not a factory fault; it was designed to yield these very inequalities we are facing.

The remnants of racism and coloniality and imperialism permeate every sector of our society, economic, political, civil, socioeconomic, cultural.

Their success in life cannot be left to a series of perfectly aligned miracles. We really need to change the systems and the structures.

(SSIR interview)

Other institutional positions and outputs

Why she matters here

Her food and nutrition report is the single most consequential opening, in twenty years of UN thematic work on the right to health, for the argument this resource develops. Three points on the relation.

First, on the door she has already opened. Article 12 of the ICESCR names the right to the highest attainable standard of physical and mental health. General Comment 14 of the Committee on Economic, Social and Cultural Rights, and the mandate of the Special Rapporteur, have historically operationalized that right on the side of health systems and health care access. A/78/185 is the report that pulls food and nutrition into the same framework, treating unhealthy dietary environments as a failure of state obligation rather than as a matter of individual behavior. The physiological rights argument developed in this resource is downstream of that move.

Second, on the gap her report leaves open. She does name specific micronutrients, and she does so more than once: vitamins A, C and E, and the minerals zinc, iron and iodine (paragraph 33); carotenes, ascorbic acid and vitamin D as dietary antioxidants (paragraph 46); folic acid, vitamin D and iron in relation to preconception and pregnancy (paragraph 49). What her frame does not yet do is descend from the aggregate level (two billion people deficient) to the level at which the physiological rights argument operates: individual reference ranges, the failure of serum tests to detect tissue depletion, individual variation in requirement, the twenty-year latency between the science on the physiological requirement of magnesium, of folate, of vitamin D, and its reflection in public guidance. Her frame is regulatory and industry-facing; it stops at food environments, marketing, labeling, fiscal instruments, procurement. The physiological rights framing extends her logic by one order of specificity, from the food environment to the physiological status of the individual within it.

Third, on the strategic import. She is no longer the mandate holder as of June 2026, and her successor has not yet been named. Her period of formal institutional influence has closed. But the body of thematic reports she produced is now the durable reference for her mandate, and A/78/185 is a text on which any subsequent argument on nutritional adequacy at the UN level will be built. To engage her work now, and to bring the physiological rights argument into productive tension with it, is to engage the mandate as she has left it.

She is, additionally, the natural bridge to the O’Neill Institute at Georgetown, where the leadership of English-language scholarship on the right to health resides, and to Alicia Ely Yamin at Harvard’s Petrie-Flom Center. The three institutional addresses (Geneva mandate, Georgetown, Harvard) are the three at which the argument, if it is to be heard at all at the level of international law, will be heard.

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