Mapping the Evidence on Commercial Determinants of the Dual Burden of Malnutrition in Sub-Saharan Africa

In the SSA region, the CDoH framework is very relevant given several converging trends, including the rapid increase of ultra-processed foods (UPFs) across urban markets, facilitated by trade liberalization under regional and bilateral trade agreements; the aggressive expansion of fast-food chains and informal food retail in secondary cities; the saturation of urban media environments with nutrient-poor food advertising often targeting children and adolescents; the displacement of traditional food systems and indigenous diets by global commodity supply chains; and the disproportionate use of SSA as an emerging market by multinational food corporations seeking growth beyond saturated high-income country markets. These commercial forces simultaneously undermine dietary quality in ways that worsen both ends of the malnutrition spectrum