According to Article 14, the state (governments), as well as broad civil society (‘all sectors of society’) have a social responsibility or duty to promote the best possible health (‘highest attainable standard of health’) of all fellow citizens (‘their people’) (Art. 14.1; Létourneau 2016). Ten Have (2019) offers the following comment: ‘Ethics is not merely an individual affair but asks questions about the good life, as well as the good society.’ Succinctly put, promoting everyone’s health is also everyone’s social responsibility. The reason for calling for action is that the best possible health is the fundamental right of every human being (‘the fundamental rights of every human being’ – Art. 14.2) (Létourneau 2016). A fundamental right is generally regarded as a right that deserves high priority and attention. It is noteworthy that Article 14 regards health as a fundamental right, but not the right to food.

How can health be promoted? According to Article 14, it can be achieved through access to quality health care and essential medicines, improvement of living conditions and the environment, elimination of marginalisation and exclusion of people, reduction of poverty and illiteracy and, lastly, access to adequate nutrition and water (‘access to adequate nutrition’ – Art. 14b) (Ten Have 2019). The broad principle set out in Article 14 is that governments, civil society and the individual have a common ethical duty to help promote the health of their fellow citizens through access to adequate nutrition (Korthals 2016). In this context, this article emphasises the concept of ‘promoting access to adequate nutrition’.

How should the following phrase ‘access to adequate nutrition’ be understood? It would appear that two norms stem from the principle of access to adequate nutrition, namely access to enough food, that is, the quantitative aspect; and food that is safe, that is, the qualitative aspect (Ten Have & Patrão Neves 2021b).

The first norm suggests that adequate nutrition has quantitative significance in the sense of enough food (Létourneau 2016; Macer 2016). Quantitative food security entails a stable supply of food, as well as physical and economic access for all citizens so that they can enjoy a healthy life. The four classic dimensions of quantitative food are availability, access, capacity to prepare food correctly, and stability (Ten Have & Patrão Neves 2021b). It is widely accepted that access to enough food is central to promoting and maintaining good health (WHO 2020a).

Why did the political bioethical world community, through UNESCO, consider it necessary to formulate access to designate sufficient food as a global ethical and human rights principle? There are currently about 8 billion people on earth, and it is expected that humanity will have grown to 9.15 billion in 2050 (Ten Have 2019; United Nations 2022). The Millennium Development Goals indicated that, since 1990, the percentage of hungry people has decreased from 23.3% to about 12.9% (United Nations 2015). Unfortunately, from 2015, the number of people who did not have access to enough food began to increase (FAO 2020) and Ten Have (2019) described this truth as a moral embarrassment.

In 2019, about one in ten adults on earth was hungry (FAO 2020; Ten Have 2019). About 822 million people are hungry daily and do not have enough food to lead an active life; they live mainly in developing countries (Ten Have 2019; Ten Have & Patrão Neves 2021c). In Asia 513 million, in Africa 256 million and in Latin America and the Caribbean about 43 million people do not have enough food on a day to day basis. It has been demonstrated that more women than men do not have access to enough food (IBC 2010; WHO 2019). Low-income countries rely mainly on scarce staple foods with limited access to vegetable, fruit and animal proteins (FAO 2020). One in seven children in the world is malnourished (Ten Have 2019). Between 2018 and 2020, the number of people undernourished in South Africa amounted to 3.8 million, showing an increase compared to previous years (Statista 2022).

One of the major health disadvantages of limited access to enough food is malnutrition. The effects of too little food are serious in most cases (IBC 2010). Malnutrition occurs when hungry children and adults do not get enough essential micronutrients such as vitamins and minerals. Around 340 million children struggle with micronutrient deficiency (FAO 2020; IBC 2010; WHO 2020b). Micronutrients enable the body to produce enzymes, hormones and other substances that are essential for its health. Iodine, vitamin A and iron are among the most important nutrients and, without these, people’s health can be seriously harmed (WHO 2020b). Malnutrition also causes a weakened immune system which, in turn, offers almost no protection for adults and children against curable infectious diseases, diarrhoea, pneumonia, malaria and other diseases (IBC 2010). Malnutrition is the single biggest contributing cause of disease in the world (Ten Have & Patrão Neves 2021c).

What are the reasons for hunger and malnutrition? For a long time, the belief was upheld that population growth was the cause of hunger and famine, because there was too little food. Yet, it would seem that the opposite is true (Ten Have 2019). The contradiction is that the world community produces enough food to feed all the people in the world. As early as 1996, the World Food Summit concluded that the global agricultural community produces enough food for every world citizen (FAO 2020; Ten Have 2019; Ten Have & Patrão Neves 2021c). It observed that, although the world population had doubled in the preceding 30 years, food production had increased even faster. This was confirmed by FAO studies in 2012. Currently, agriculture produces about 2770 calories for every person on earth, while only 2200 calories are needed (Ten Have & Patrão Neves 2021c). In the 1990s it was observed that the majority of malnourished children live in countries where surplus food exists. Despite the fact that the world population is increasing, there is evidence that the production and availability of food is also growing. Countries such as the United States and Australia (and many others) produce more food than is necessary for the nutrition of their citizens, and, in fact, export much of their food (Ten Have 2019; Ten Have & Patrão Neves 2021c).

The general consensus is that hunger and malnutrition are not the result of food shortages, but rather that access to adequate food due to poverty, unequal global distribution of food, incompetent and corrupt governments, and the absence of equity are some of the obstacles in the way of sufficient nutrition (Létourneau 2016; Ten Have & Patrão Neves 2021c). Poor people are hungry and malnourished because they cannot afford to buy it (FAO 2020; Macer 2016; Samuel 1995; Ten Have 2019). Hunger increases in countries where economic growth is low or absent. In most countries, where access to food is a major problem, large income inequality exists (Létourneau 2016). Basic food is not affordable or available.

A good example of this is India, where organised agriculture produces large-scale surplus food, while about 250 million informal farmers go hungry (Ten Have & Patrão Neves 2021c). Research shows that many malnourished children live in developing countries where there is a surplus of food (Ten Have 2019). More than 1.5 billion people cannot afford a diet that contains the essential nutrients and over 3 billion people cannot afford a low-priced healthy diet (FAO 2020).

This reality serves as a background for the ethical and human rights call of the UDBHR that access to enough food is imperative. The global ethical call of the first norm of UDBHR is a move away from a call for more food to be produced, and a healthy step in the direction of the ethical duty to promote access to existing food (Ten Have 2019). Ten Have and Patrão Neves (2021c) succinctly formulate the purpose of this first ethical norm as follows: ‘Therefore ethical debate on hunger means shifting the focus from food production to better access.’

This first norm therefore points to the responsibility of the state to promote social development that will focus on availability, financial ability, knowledge of use and stability around sufficient food (FAO 2020; Ten Have & Patrão Neves 2021b). The declaration’s global aspect moreover indicates that countries and governments should collaborate in solidarity and cooperation (see UDBHR, Art. 13): this should help poorer countries gain access to enough food (Létourneau 2016).

The second norm indicates that adequate nutrition has qualitative significance in the sense that food must also be safe and healthy (Létourneau 2016; Macer 2016). It is a recognised fact that access to safe food plays an extremely important role in the promotion of good health (WHO 2020a). Qualitative or safe food is free from chemical or microbial contamination and is stored (in a cold chain where necessary) and transported, labelled, prepared, processed and cooked correctly (Ten Have & Patrão Neves 2021b).

Why did the political world community consider it necessary to formulate this global bioethical and human rights norm? About 600 million people (1 in 10) become ill annually and 420 000 die due to contaminated food (WHO 2020a). Children under five years of age carry about 40% of the burden of contaminated food, and 125 000 of them die per year. Diarrhoea caused by eating infested food is by far the most prevalent occurrence around this and affects approximately 550 million adults of which 230 000 die each year. Approximately 220 million children get diarrhoea-related illnesses and 96 000 die each year (Ten Have 2019; WHO 2020a). About 1.9 million people, many of whom are children, die annually due to illnesses caused by contaminated food (Ten Have 2019).

This brings into focus that, in 2015, the WHO indicated that approximately 31 different bacteria, viruses, parasites, toxins and chemicals that occur at global and regional level are responsible for foodborne diseases (WHO 2020a), and these are subsequently briefly discussed in terms of contaminated, toxic and malnourishing foods.

Kenney (2011:308–309) is correct when he argues that, in Scripture, ‘the readings pertaining to food are varied and not always congruent’. Scripture should therefore be treated with caution in the development of a theological foundation of the food ethics of the UDBHR. This study takes Kenney’s warning seriously, hence employing the hermeneutic or congruent biblical theology of Vorster (2021) in order to avoid the possible challenges Kenney brought to our attention. Vorster’s hermeneutics consists of four directives. The first is based on the view that all readers interpret texts according to their own presuppositions. To counteract this, one’s own interpretations must always be compared with the interpretations of others’ presuppositions (Eph 3:16–19). The second states that the Bible was not only written by different authors, but also consisted of various genres, namely historical narratives, poetry, symbols, metaphors and prophecies, as well as the teachings of Jesus and the apostles. These different genres must be considered, and each must be interpreted according to its own method. The third centres on grammatical and historical exegesis. Scientific methods such as textual criticism, editorial criticism, analysis of the grammatical structure within its context, as well as lexicography must be used. The fourth directive is called the congruent biblical theology or hermeneutics. This directive is extremely sensitive to an atomistic (isolated) use of a single text (see also Douma 1997) and, instead, advocates that the part (such as a text verse in the Bible) should be illuminated by the whole. In these terms, themes from both Testaments such as sin, the covenant, Christology and pneumatology will be used to assess or test the food ethics of the UDBHR.

Food forms part of God’s creative work in the beginning and is described as good (Gn 1:30). From the beginning, it was God’s will that one should have access to enough food. The Garden of Eden carried abundant food (Gn 1:29; Kenney 2011). However, all of this changed after the Fall into sin. Genesis 3 is the narrative that addresses the reality of sin, and it links the existence of sin with food challenges (Kenney 2011). ‘Most notably, sin enters the world in Genesis 3 through an act of rebellious eating’, Gordon (2017:321–322) avers. By its very nature, this statement does not imply that food is inherently sinful, although there are forms of sinful eating such as debauchery (Nm 11:4, Ec 23:3; 1 Pt 4:3). The connection between food and sin indicates that food was affected by the far-reaching influence of the Fall with the result that too little and unsafe food has become destructive realities in a sinful world (Samuel 1995).

The reality and cruelty of famine and a lack of enough food is found early in the Old Testament (Blanshard 1995; Gn 41–42). Brueggemann (2013) notes that the Fall into sin and the consequent lack of food and profound famine are profound events in any person’s life (Gn 41:31); these will even drive people into slavery (Gn 47:13–26). As early as Genesis 47:13–19, a connection is found between enough food and health when it is stated that people had become weak, had fainted and even died due to a lack of food. Job (6:7) acknowledges that certain (unsafe) foods can make one sick. Daniel 1:15 indicates that there is a close connection between (insufficient, unsafe) food and health (Hall 2020). Throughout the Old Testament, the phenomenon of insufficient food or famine occurs (2 Ki 4:38).

The concept of the covenant between God and his people is a prominent theme in the Bible, especially in the Old Testament (Vorster 2021). The covenant centres on the agreement or the relationship between God and the believer. Within the covenant, God is seen as the God of history who carries out his government and care in and through his people. Because God governs and cares for his people, the people also have the responsibility to be obedient to God within this covenant in terms of their hearts and deeds (Gn 17:7–9). Covenant and behaviour (ethics) are closely linked (Vorster 2017). Both Macaleer (2014) and Rusthoven (2014) used the covenant doctrine as a Protestant (reformed) foundation of global bioethical principles of the Belmont report. The ethical question that arises here reads: What would be, to God, the acceptable ethics with regard to sufficient and safe food within the covenant?

Brueggemann (1977) believes that the dominant biblical model for the distribution of or access to enough food is the supply of food in the desert (Ex 16). According to Kenney (2011) and Hall (2020) this narrative indicates God’s power and willingness to provide access to sufficient food. The first observation is that God ‘rained down’ enough food from heaven; this made bread and meat so accessible that they could just walk and pick it up as needed (Ex 16:4, 17). Secondly, what is clear from the Exodus narrative is that access to food is realised in the desert, an environment where people are without resources and extremely vulnerable (Ex 16:2). God provides food for the orphan, widow and stranger (Mackler 2014; Dt 10:17–18). With this, Brueggemann (1977) warns modern society against political and economic processes that make food, especially for poor people, unaffordable. He refers in this regard to the prophet Amos (8:4–6) who warns the people and leaders that they should not make food excessively expensive and therefore exploit folk. Expensive food leads to hunger and poor health and is ethically unacceptable.

The basic premise within the covenant is that food is a gift from God for the purpose the purpose of giving vitality (Gordon 2017; Kretzschmar 2021; Ps 104:14–15, Ec 2:24). All food belongs to God (1 Cor 4:7), is provided by God (Kretzschmar 2021; Ps 136:25; 145:15–16) and, even though mankind is the producer of food (Ez 29:3), it is not the primary property of humanity. Therefore humanity, created in the image of God (Gn 1:26–28; Lv 25:23), has the calling to ensure access to enough food (like God), especially defenceless people (Blanshard 1995; Gn 2:16, 3; 2; Lv 19:9–10; Dt 24:19–22; Mt 6:25–32; 1 Tm 6:8). God wants people to have access to enough food (Ps 104:27–28) and categorically speaks out against people who eat lavishly, while poor people go hungry (2 Ki 4:42–44, Ez 16:49; Brueggemann 2013). The Old Testament eschatological vision for redeemed mankind in Isaiah 65:17–25 clearly depicts God’s care for the hungry where people will plant food and will have enough to eat (Samuel 1995). Samuel (1995) also points to the fact that the believer has a global responsibility for access to sufficient food. In this regard, Samuel (1995) refers to the work of Joseph in Egypt who produced enough food so that, during a global famine, hungry people all over the world could obtain food at a fair price (cf. Gn 41:56–57).

Regarding unsafe and unhealthy foods, Zwart (2000) comes to the following conclusion, as based on his study of Leviticus 11:1–4 and Deuteronomy 14:3–7:

These passages of Scripture do not directly link unsafe foods to health, but the idea of contaminated foods is not foreign to Scripture. Kenney (2011) believes that Scripture points out that food is essential, but sometimes also dangerous.

Undoubtedly, the influence of sin not only caused too little food and famine, but also brought about the reality of unsafe or dangerous foods that could make one sick or lead to death. A well-known example from the Old Testament is found in the narrative of Elisha in 2 Kings 4:39–41, where unsafe and even toxic food was gathered (Blanshard 1995). Konkel (2006) explains these events and the concomitant danger as follows:

The striking thing about the narrative is ignorance about unsafe food. They picked and prepared it without realising the potential danger, non-nutritional value and potential impact on their health (2 Ki 4:39). Verse 40 clearly objects to dangerous food. Not only is unsafe and even dangerous food a reality after the Fall, but also the possibility and reality of food with poor nutritional value. In this regard, Brueggemann (1977) refers to Amos 8:6, where chaff is sold at a high price to poor people. It was sometimes mixed with little wheat or low-quality material and had poor or no nutritional value. Sweeney et al. (2000) describe it, ‘useless as food’. Smith (2001) states the consequent injustice as follows:

This exploitation of people, whenever low-quality food was sold, ignored people’s health for the sake of self-enrichment. Clearly, Scripture negatively judges low-quality food.

According to Frame (1988), the sixth commandment expresses a crucial covenant principle in bioethics and calls for solidarity around the protection of physical and psychological integrity (Ex 20:13). People must be protected from harmful, unsafe and malnourished practices and actions that include too little and unsafe food (Blanshard 1995; Ex 21:28–36; 22). This commandment forms the basis of the bioethical principle which says: ‘first, do no harm’ (primum non nocere). Douma (1992) and De Bruyn (1993) regard starvation and unsafe food as forms of mutilation of the body (and mind) that are forbidden by the sixth commandment, which calls on governments, civil society and the individual to promote adequate and safe food.

All in all, it is clear that too little, unsafe and poor-quality food is a reality in this world, and the UDBHR criticises it by formulating a principle to oppose it. The Old Testament covenant furthermore objects to too little, unsafe and poor-quality food, that is, in quantitative and qualitative terms, and even regards it as a form of injustice. It can therefore be inferred that, from an Old Testament covenantal perspective, the food ethics of the UDBHR should be wholeheartedly supported.

The theme of access to sufficient, safe and healthy food is continued in the New Testament, where food ethics enjoy a strong Christological and pneumatological grounding and form a crucial aspect in the ministry of Christ (Kenney 2011).

The two narratives in which Jesus fed crowds of people suggest a meaningful argument in this regard (Mt 14:13–21; Mk 8:1–10). Three inferences can be made from the narratives (Samuel 1995). The first is the revelation of Jesus’ compassion and care for hungry people (Mt 14:13–21; Mk 8:2). The second is that Christ provides food for the hungry (Gordon 2017; Mt 14:13–21), and the third equivalent of Exodus 16: Christ, like God the Father, feeds people in the ‘wilderness’ in abundance. It is striking that people have access to the food (that is, food is distributed; Mt 14:19; Mk 8:7) and that enough food was provided to the people; in fact, there were ample leftovers (Mt 14:20; Mk 8:7). Matthew and Mark show that the crowds of people were located in deserted places and did not have easy and quick access to food (Mt 14:15; Mk 6; Brueggemann 2013). Fourth, Christ acknowledges the close connection between enough food and health when he points out that, when people do not eat enough, they may faint and seriously injure themselves (Mk 8:3).

The New Testament focuses not only on access to enough food, but also on good, safe and nutritious food. In the song of Mary (the Magnificat), which forms the theme song of Luke (Lk 1:53), Mary sings of food and that Jesus will provide good things for the hungry (see Brueggemann 2013). The Greek word for ‘good’ can also be translated as ‘valuable attributes’ (Louw & Nida 1988). This would mean that Christ not only gives people enough food, but also good, safe, valuable and nutritious food.

According to Wirzba (2013), the image of Jesus as the Bread of Life (Jn 6) is a critically important metaphorical theme in the debate about food that encompasses its quantity, safety and value. The context of this metaphor is the series of events in which Jesus fed large crowds of people (Jn 6:1–14). The multiplication of food emphasises access to enough food (Mt 6:11), while the metaphor emphasises its value, life-giving capacity and nutritious quality. After all, Christ is the Bread that gives good life (Harper 2016).

According to Coetzee (1990), John consistently refers to eternal life as a life that is qualitatively different from that of the fallen people who are subject to sin and decay (Jn 6:33, 40, 47, 51). The logical conclusion is that Jesus, the valuable Bread, gives himself to be ‘eaten’ by faith which leads to a quality and eternal life. The ethical and practical implication of the metaphor is that, like Jesus, people must be provided with quality food that contributes to a healthy life of quality. The opposite is poor quality food, which leads to disease and (eternal) death and, in light of the metaphor, it is unacceptable. Revelation 22:1 indicates that life and healthy living (the water of life) flow from Christ. In Revelation 22:2, John indicates that there is a connection between food and health when he writes ‘and the leaves of the tree are for the healing of the nations’ (Hall 2020). Good vegetal foods promote health. The opposite is food which harms you. Hall (2020:138) remarks, in view of Revelations that, in the ‘twenty-first century, the form and amount of food consumed may constitute the biggest harm’.

Hall (2020) believes that the metaphor that the body is a temple of the Holy Spirit (1 Cor 6:19) amounts to an ethical call for food to be safe and nutritious. Grudem (2018) makes the statement that this metaphor provides encouragement to promote health of the body. The body belongs to the Spirit of God. Your body is a temple, a building in which the Spirit of God dwells. If you live in a building that belongs to someone else, then it is your responsibility to act according to the rules of the owner and promote the best interests of the building. Against this background, in his dogmatic discussion of 1 Corinthians 6:19, Heyns (1981) is convinced that that the pericope contains a definite bioethical significance:

The new man, who does not belong to him- or herself, will in no way be able to take pleasure in any form of contempt or neglect of the body by means of unsafe and innutritious food. Because humanity is a temple of God and belongs to him, they will cultivate, prepare and choose their food to the advantage of the body (Douma 1992).

It is therefore clear that sufficient, safe and nutritious food is supported by Scripture in terms of a Christological and pneumatological perspective. The food ethics of the UDBHR, as found in Article 14, should therefore be supported from a New Testament perspective.