SPEECH BY PROF KENNETH MAK, DIRECTOR-GENERAL OF HEALTH, MINISTRY OF HEALTH, AT THE OPENING CEREMONY OF THE ASIAN PACIFIC SOCIETY OF CARDIOLOGY CONGRESS 2023, 13 JULY 2023, 10.25AM, RAFFLES CITY CONVENTION CENTRE

Dr Issei Komuro, President, Asian Pacific Society of Cardiology (APSC)

Dr David Foo, President, Singapore Cardiac Society

Dr Yeo Tee Joo, Organising Chairman, APSC Congress 2023

Dr Colin Yeo, Organising Co-Chairman, APSC Congress 2023

Distinguished Guests

Ladies and Gentlemen

     Let me wish you a warm welcome to everyone here at the Asian Pacific Society of Cardiology Congress 2023. I will first start by wishing the Singapore Cardiac Society a happy Golden Jubilee as well.

2.     The theme of this year’s Congress is “Emerging from COVID-19, Stronger than Ever.” The COVID-19 pandemic has created unprecedented stress on healthcare systems around the world, but also presented opportunities for us to learn and build more resilient healthcare systems. As we emerge from the pandemic, our healthcare system has emerged stronger and is more prepared to face future challenges.

Cardiovascular disease burden in the Asia-Pacific region

3.     One such challenge for the Asia-Pacific region is the rising disease burden from cardiovascular diseases (CVD). This is similarly observed in Singapore, with CVD accounting for about one-third of all deaths since 2010. The number of acute myocardial infarction (AMI) episodes in Singapore had increased from about 7,400 episodes in 2010, to close to 11,700 episodes in 2020.

4.     Some countries in the region, including Singapore, are also seeing a rise in the prevalence of major CVD risk factors, such as obesity and hypertension. If these CVD risk factors are not appropriately addressed, individuals and families will face significant health, emotional and financial burden in the coming years. Thankfully, these risk factors can be mitigated by our everyday lifestyle choices.

Focusing on preventive care through Healthier SG

5.     To tackle the rising chronic disease burden, the Ministry of Health (MOH) has embarked on Healthier SG, a multi-year strategy to transform our healthcare system. Healthier SG focuses on preventive care to help our residents stay healthy, to detect health issues early, and to manage their chronic conditions well to prevent deterioration.

6.     One week ago on 5 July, MOH launched the national enrolment programme for Healthier SG, starting with those aged 60 years and above and with chronic conditions, followed by those 40 to 59 years. We are progressively inviting Singapore Citizens and Permanent Residents via SMS to enrol with a Healthier SG General Practitioner (GP) clinic or polyclinic of their choice. This enables our residents to build a long-term and trusted relationship with their preferred family physician clinic, which is the starting point for building good health.

7.     Enrolled residents will receive support from their trusted family doctor and community partners to take steps towards better health. This includes creating a personalised health plan that comprises important health actions to manage or keep diseases such as CVD at bay, such as lifestyle adjustments, nationally recommended screenings, and regular follow-ups with their doctor. We have also designed Healthier SG care protocols outlining these essential care elements, so that residents can be assured that these are consistently carried out, regardless of the clinic they choose to enrol with.

8.     Under Healthier SG, our public healthcare clusters will facilitate partnerships between primary and specialist care, and strengthen shared care management of patients with chronic conditions. For those who are more ill or have more complex conditions that require specialist care, family doctors and specialist doctors will work closely together to manage different aspects of our residents’ health. This ensures that enrolled residents receive holistic and quality care in both the community and specialist care settings.

9.     Healthier SG will also provide greater financial support for those with chronic diseases including CVD. From early 2024, enrolled residents will be able to use their MediSave to fully pay for the treatment of approved chronic conditions at their enrolled clinic, up to the prevailing withdrawal limits. In addition, Community Health Assist Scheme (CHAS) cardholders enrolled in Healthier SG GP clinics, who have higher chronic medication needs and bills, can opt for a new Healthier SG Chronic Tier subsidy framework, where they can enjoy access to a selected whitelist of chronic medications at prices that are more comparable to that in polyclinics.

Continuing our health promotion efforts alongside Healthier SG

10.     We will continue to build upon our ongoing health promotion efforts alongside Healthier SG, and encourage healthier lifestyles to lower the risk of developing CVD.

11.     To encourage more active lifestyles, the Health Promotion Board (HPB) has been working with community partners to keep its physical activity programmes accessible to residents, progressively scaling this up, so that the overall capacity of these programmes rises in tandem with the Healthier SG enrolment. Under Healthier SG, residents will also be encouraged to come on board the enhanced Healthy 365 mobile app to access a wider range of health-promoting programmes and community activities, including the National Steps Challenge.

12.     To promote healthier eating, we have been supporting consumers in making informed and healthier choices, while working with the industry to spur product reformulation so that more healthier options are available. Most recently, Nutri-Grade measures have been rolled out, requiring prepacked beverages to display gradings based on their levels of sugar and saturated fat. These measures will be extended to freshly prepared beverages from 30 December 2023.

13.     We are also working on lowering Singaporeans’ daily sodium intake to reduce their risk of hypertension. More lower-sodium alternatives have been made available in the retail and food service sectors, and we will continue to work with more suppliers to increase the range of lower-sodium salt, sauces and seasonings. HPB has also launched a multi-year public education campaign to raise awareness of the effects of high sodium intake and to educate the public on ways to replace salt without compromising on taste.

14.     Smoking is also a major risk factor for the development of heart diseases, and we continue to educate on the importance of leading a nicotine-free lifestyle. Smoking cessation services are also available to support smokers to quit smoking and sustain a nicotine-free lifestyle in Singapore. Under Healthier SG, family doctors can support smokers who intend to quit by referring them to smoking cessation counselling services, such as HPB’s I Quit Programme, and following up on their progress.

Efforts to improve care for cardiac patients

15.     Beyond Healthier SG, we continue to strengthen care delivery and management of cardiac patients through piloting new models of care. One example is the AMI-HOPE (Acute Myocardial Infarction – allied Health-Oriented, Patient-centered and digitally-Enabled care) jointly piloted by the MOH Office for Healthcare Transformation (MOHT), Integrated Health Information System (iHIS), HPB and our three public healthcare clusters. This pilot, which started in October 2022, aims to improve post-discharge care for patients with AMI co-led by the cardiologist and pharmacist through tele-monitoring and tele-consultations. Once the patient’s condition has stabilised, the patient will continue follow-up at the polyclinic.

16.     The AMI-HOPE pilot uses the national vital signs platform, Health Discovery+ (HD+) which enables hospital and polyclinic pharmacists to remotely monitor blood pressure levels and heart rate readings uploaded by the patients. These guide the titration of medications and identify patients who require further clinical assistance. In addition, patients are guided to make necessary lifestyle changes, such as greater physical activity, healthier diets and smoking cessation, through automated personalised nudges in HD+.  

Closing

17.     As healthcare systems across the Asia-Pacific region prepare to face future challenges, it is necessary for the cardiology community to continue innovating and to work collaboratively across the full spectrum of cardiac care.

18.     To achieve better health outcomes for those at risk of, or with CVD, we must continually advance our knowledge, practice, and research in cardiovascular medicine. This Congress is a good platform where we can learn more from one another, share our experiences and ideas, and contribute to the advancement of cardiology in Singapore and within the Asia-Pacific region.

19.     I would like to thank the Asian Pacific Society of Cardiology for organising this event and once again congratulate the Singapore Cancer Society on its Golden Jubilee milestone.

20.     I wish all of you a fruitful and enriching Congress ahead.