Closing Remarks by Mr Gan Kim Yong, Minister for Health, at the End of the Ministerial Roundtable of the Ministerial Conference on Diabetes, 27 November 2018

Your Excellencies
Distinguished Guests
Ladies and Gentlemen 
Good morning. 

1. Let me take this opportunity on behalf of Singapore, to thank you for joining us in the Ministerial Conference on Diabetes. The global call to fight the scourge of diabetes among our people transcends our differences in language, culture and even healthcare systems. Your open sharing of ideas and insights over the last two days has been most valuable, and reaffirmed our belief that indeed, we can win the war against diabetes if we work together and remain steadfast in our efforts. 

Multi-faceted approach to tackling diabetes

2. Non-communicable diseases (NCDs), in particular diabetes, are the leading cause of death and disability worldwide. With ageing populations driving the rise of NCD prevalence, the impact on our healthcare systems and our societies are worsening. The direct annual cost of diabetes to the world has been estimated to be a staggering US$827 billion . For Singapore, the situation is also worrying as the cost of diabetes is projected to double from $940 million in 2014 to $1.8 billion in 2050. The diabetes epidemic now poses an immediate crisis to population health globally. This calls for an urgent response from all governments and stakeholders to address this issue. 

3. I am heartened that the World Health Organization (WHO) and many Government leaders, have committed to take concrete steps to tackle NCDs, including diabetes, at the recent Third United Nations High Level Meeting on NCDs, held in New York. The WHO Independent High-level Commission on NCDs, of which I have the honour to be part of, has also made a strong case for governments and stakeholders to deliver on the pledge to achieve a one-third reduction in premature mortality from NCDs.

4. Beyond strong political commitment, a holistic response to address the plethora of challenges in diabetes prevention and management requires sustainable financing mechanisms, innovative approaches and bold health system reforms. We have heard some good and interesting ideas. For example, His Excellency Datuk Seri Dr Dzulkefly Ahmad shared that fiscal measures such as taxation to promote healthier diets could be considered. On the other hand, Professor Paul Zimmet, cautioned that while it is useful, taxation needs to be complemented by other measures. Her Excellency Professor Sophia Chan also shared that a key objective is to create equitable health promotion to empower individuals to lead healthier lives. All these can be supported by bringing customised interventions to people where it is natural and convenient, as well as reforming the primary care landscape to increase its capability to better deliver prevention and care interventions. Several speakers also highlighted the need for a multi-sectoral approach beyond the healthcare sector. We have to act swiftly because we are facing a “diabetes tsunami”, as aptly pointed out by The Honourable Dr Saia Ma’u Piukala yesterday.

5. Nonetheless, this global diabetes crisis also presents enormous opportunities to enhance population health, especially with emerging technologies in healthcare. For example, we have seen how health technology rapidly transforms the way we deliver care, from telemedicine to personalised health apps. For many individuals, our lives are intricately intertwined with technology, from wearables to phone apps that can nudge individuals towards healthier habits. There is also much to be gained from the insights mined from the vast volume of health data gathered through such technology. We learnt about how behavioural nudges and technology can effectively nudge individuals towards healthier behaviours.

6. As policymakers, the onus is on us to identify and seize these opportunities. We have to remain nimble and flexible in adopting such technologies to create supportive environments for individuals and their families, to introduce more effective and efficient interventions, and to shape better healthcare delivery. Changes we implement today will make an immense difference in enhancing our population health outcomes in the long term, and brings us another step closer to realising our pledge. 

Need for a strong global response

7. Much more needs to be done in our fight against diabetes but the government cannot do this alone. I would like to broadly lay out three key actions to consider as we continue on our journey in this war against diabetes. 

8. Firstly, we must be prepared to take Decisive Action. This means moving fast, as well as having the courage to persevere and do things that may be difficult or painful at times, but are important and beneficial in the long term. We may not have the luxury of time as population ageing picks up momentum. We must try to shape the future of health promotion, prevention and care delivery by experimenting with game-changing concepts and innovations. If things do not work out as well as we expected, we will need the courage to quickly change course and relook at how to do better. Through our discussions earlier at the Roundtable, I am glad that we agree that adopting innovative approaches will help us to improve our care, reduce costs and ultimately deliver better value for our patients and population.

9. Secondly, we need to involve all stakeholders by being Inclusive in our actions. Earlier, we discussed how governments play a crucial role in engaging the society to raise awareness of diabetes and other NCDs, as well as encourage and motivate our citizens to embrace healthy living. Better community participation and engagement through a whole-of-society approach will strengthen the sustainability of our health programmes. We need to pay particular attention to vulnerable groups in our society, such as those who may not have access to information about better diets and lifestyles, or may not be able to look after themselves. Deliberate and targeted efforts are often necessary to better involve them, so that we can develop policies and programmes that are truly effective. All these underscore the need for a broader and deeper collaboration with all stakeholders. 

10. As an extension of taking decisive and inclusive action, we also need to foster Open Collaboration, not only within, but also beyond national boundaries. There are many stakeholders beyond the government, who can play a crucial role. Public-Private Partnerships (PPP) can produce synergistic effects in improving population health outcomes. This enables the various sectors to pool together limited resources and leverage different providers’ unique advantages and capabilities. Increasingly, countries will also have to foster deeper and more frequent collaborations in a global response to addressing diabetes and other NCDs at the regional and global level.

11. So, as leaders, lets commit to being bold and taking Decisive Action, involving others, including the vulnerable groups, through Inclusive Action, and forming alliances amongst like-minded partners through Open Collaboration.

Closing

12. We have had a truly fruitful discussion over the past one and a half days. I will ask our Secretariat to summarise the findings and key learning points of this Conference into a summary report, which I hope would be useful for governments in our continuous fight against diabetes and other NCDs. I also hope for the opportunity to present the report at other appropriate forums such as the WHO meetings, to share our insights and recommendations, beyond this Conference. 

13. Last but not least, I would like to express my sincere gratitude to our keynote and panel speakers, moderators, and participants, especially all the Ministers, who have taken the time and effort to make yourselves available for this conference. We have greatly benefited from your insights, your views and ideas. It is also our hope that the Conference has deepened our ties and strengthened our collaborative efforts among nations, to jointly address the common challenges. On this note, I wish you all an enjoyable stay in Singapore, and a safe journey home. 

Thank you.