Speech by Dr Amy Khor, Senior Minister of State, Ministry of Health, at the "Healthy Hearts, Healthy Aging" Asia Pacific Report Launch at Innovfest Unbound 2019, 27 June 2019, 3:00pm at Sands Expo & Convention Centre, Marina Bay Sands

Mr Ernst Coppens, Managing Director & Chief Financial Officer, Bayer ASEAN

Mr Kenneth Sim, Country Medical Director, Bayer Pharmaceuticals Division, Singapore/Malaysia/Brunei

Ladies and Gentlemen

1.     A very good afternoon to all of you. It is my pleasure to be here today at the official launch of the Healthy Hearts, Healthy Aging Asia Pacific Report.

2.     Today, I address a topic that is literally close to our hearts. In 2017, we saw an average of 33 heart attacks a day in Singapore. During the same period, we reported another 21 cases of stroke per day. Together, they accounted for 1 in 4 deaths in 2017.^[1] Since age is a risk factor for these cardiovascular diseases (CVDs), these figures are set to rise given ourrapidly ageing population.

3.     CVDs can lead to severe disabilities, long and frequent hospitalisations, and caregiver burden. These are daunting issues for health and social care systems to grapple with. There is therefore a need to find better ways to prevent and manage CVDs.

Ageing and Lifestyle Trends a ‘Perfect Storm’ For Exponential Rise in CVDs
4.     Across the world, people are more sedentary, while affluence has also led to greater calorie consumption, not always with healthy food choices. Furthermore, smoking, another major risk factor for CVD, remains a concern in many countries in Asia and the Pacific.[2]

5.     These social and lifestyle trends coupled with an ageing population make for what some might call a ‘perfect storm’ to cause an exponential increase in the number of people living with CVDs.

Moving Upstream – Tackling the Risk Factors of CVD Among Younger Adults6.     Our health care systems have made advancements in delivering efficient and high quality treatment for CVDs. Innovations in treatment and management have reduced deaths from CVDs by more than 70% in many countries since the 1970s^[3]. These include new medicines and early revascularisation procedures that have continued to push the boundaries of medical care for patients suffering from CVDs, leading to significantly better outcomes.

7.     While we must continue in these areas, prevention is still far better. As a treatment-centric approach to handling chronic diseases will not be sustainable in the long run, there is a strong impetus for us to shift from healthcare to health, and away from just focusing on treatment to disease prevention. As we venture into these less chartered waters, we need to be creative, and innovate.

8.     Given that the major risk factors for CVDs are behavioural in nature, our daily choices, repeated over our entire life course ultimately determines our risk for CVDs.

9.     Hence, prevention requires us to move upstream and tackle behavioural risk factors earlier in life. We have to modify unhealthy behaviours before they lead to chronic diseases like diabetes, hypertension, and hyperlipidaemia – the precursors of CVDs. Take obesity for example: prevention needs to start as early as childhood, where many habits in life are formed.

Innovation in All Domains that Affect Cardiovascular Health      10.     Different types of novel solutions may work synergistically together to solve long standing challenges. When it comes to technology, the use of wearables that track physical activity and heart rate to drive health promotion has gained much traction. Locally, the Health Promotion Board’s (HPB) National Steps Challenge is one successful example where the use of step-trackers coupled with gamification and rewards, have led to significant increases in physical activity among participants. We are also seeing a proliferation in the use of artificial intelligence and data analytics to deliver personalised recommendations to individuals to improve their health.

11.     Promoting healthy living is an ongoing journey and there are still areas of innovation that we need to work on. For example, HPB’s Healthier Ingredient Development Scheme (HIDS) introduced in 2017 seeks to support the food & beverage industry in the reformulation of their products, to offer foods that are healthier. But beyond this, industry partners should find ways to modify their supply chains and business models such that these healthier foods can be offered at lower prices.

12.     Another area that we are looking at is innovating our infrastructure and city design. Our neighbourhoods and workplaces could be designed in ways that promote physical activity and fosters community spirit. The Land Transport Master Plan 2040 for example, envisions a land transport system that is safer and healthier, filled with vibrant community spaces. You can expect more walking and cycling paths, more sheltered link ways, and lower noise levels from public transport.

13.     The third area of innovation is the application of behavioural science in our policies, programmes and services. Evidence has shown that applying behavioural insights can have significant impact on the choices that people make. For example, studies on consumer’s response to food labels have led to the use of simplified labels that are effective in nudging consumers towards making healthier choices. Similarly, insights on a person’s tendency to go with the default or pre-set option, also known as status quo bias, have led to the successful implementation of healthier choice defaults.

14.     Since the major CVD risk factors are behavioural in nature, we should apply behavioural insights creatively to nudge individuals towards healthier lifestyles.   

Closing15.     I hope that today’s discussions will guide Singapore and the region on how we can better embrace innovation to tackle the challenges of CVDs and ageing. Investing in good heart health can lead to good pay offs in old age. I hope that all of us can continue to drive health innovations that would lead to future generations of healthy and successful agers.

Thank you.

[1] Singapore Stroke Registry Report 2017 and Singapore Myocardial Infarction Registry Report 2017

[2] World Health Organization global report on trends in tobacco smoking 2000-2025 – First Edition. Accessible at: https://www.who.int/tobacco/publications/surveillance/reportontrendstobaccosmoking/en/index4.html

[3] Baker Heart & Disease Instititute. (2019) ‘No Second Chances: Controlling Risk in Cardiovascular Disease’. Accessible at: https://www.baker.edu.au/-/media/documents/impact/Baker-Institute_No-second-chances.pdf (last accessed 14 March 2019)