Singapore’s Minister of State for Health, Chee Hong Tat, has announced a Government-Industry Partnership scheme as part of a multi-pronged ‘war on diabetes’. The strategy follows hot on the heals of him announcing in the Singapore Parliament mid last month that he was “declaring a war on diabetes”.
A largely preventable disease, some 400,000 Singaporeans or 10.53 per cent of the population aged between 20 and 79 are believed to be afflicted, with four amputations every day and two in three kidney failure cases attributable to the disease. According to Mr Tat, if left unchecked the number of Singaporeans with diabetes will top one million by the year 2050.
Announced at Food Vision Asia, a three-day long food industry event, the Government-Industry Partnership scheme comprises multiple components: Support for companies undertaking healthier product innovation; a supportive regulatory environment to encourage innovation and experimentation; and help for companies using Singapore as a region HQ and launch pad to access other Asian markets.
The new Government-Industry Partnership scheme follows the launch last month of the Healthier Ingredient Development Scheme (HIDS), which will see the Singapore government invest S$20 million (about US$14.193 million) over the next three years in supporting food manufacturers in creating healthier staple food ingredients such as wholegrain rice, wholegrain noodles, and healthier cooking oils.
“Unlike most grants that typically cover only capability building costs such as R&D, HIDS will also provide end-to-end support, from product development to marketing, publicity and trade promotions. With such comprehensive support, we hope to work closely with the industry to shift the market towards healthier food products,” Mr Tat said.
Singapore Second Most Diabetic of Developed Countries
Pointing out that while Singapore’s obesity rate is lower than countries such as the UK and Australia, “we have a higher diabetes prevalence compared to these western countries”. In fact, according to a 2015 report by the International Diabetes Federation (IDF), Singapore has the second-highest proportion of diabetics among developed nations globally.
Blaming the rising Singapore diabetes rate on factors such as ageing, lifestyle, the proportion of refined carbohydrates in the modern-day Singapore diet, and a lack of exercise”, Mr Tat said it was up to industry to create “foods that are not only tasty and convenient, but also good for health. My belief is that health and taste are not mutually exclusive”.
Noting that Singapore’s Healthier Choice Symbol labelling programme was attracting an increasing number of food and beverage manufacturers, Mr Tat said the key to winning the war on diabetes lay in working with industry “so that there is a greater variety that benefit our consumers”.
Highlighting work done by several companies in the field of natural sugar alternatives, Mr Tat praised work being done in Singapore by Alchemy Foodtech on creating lower Glycemic Index (GI) white rice that tastes the same as regular rice, and noodle manufacturer Prima who has developed noodles that are 50 per cent wholegrain, but retain the taste and texture of regular noodles.
Inviting food industry representatives who have not already been in contact with the Health Promotion Board (HPB) to do so, Mr Tat said the government was “very happy to work with the industry to see how we can co-create and collaborate to come up with these healthier products”.
Noting that the natural sugar alternative, Allulose, had already been approved for use in Singapore ahead of approvals in other countries, Mr Tat said the regulatory path will be eased and the approval process hastened. The Ministry of Health (MoH) will be a progressive regulator, supportive of med-tech product innovation in proving opportunities for start-ups and SMEs in healthcare-related sectors, he said.
“Food manufacturing is one of Singapore’s strengths. We have got many traditional and new food companies. We are recognised worldwide for the quality and safety of our products. We also have a good mix of food from different regions. We have strong R&D capabilities. So I think we have a good ecosystem to support our companies to come up with innovative food products that will not only appeal to consumers in Singapore but also consumers in overseas markets”.
“The government will continue to strengthen support for companies to use Singapore as a region HQ and launch pad to access other Asian markets, Mr Tat said.
The Singapore government is the first in Asean to declare a war on diabetes, despite a World Health Organization (WHO) 2016 global report finding that more than 1.5 million people died in 2012 as a direct result of diabetes, with a further 2.2 million deaths attributed to high blood glucose. With Asia accounting for 60 per cent of global diabetes afflicted people, that equates to about 2.22 million deaths in Asia annually.
Ranked as the sixth most frequent cause of death globally in 2015 by the WHO, the number of people with diabetes has quadrupled since 1980, largely due to increased consumption of high GI foods such as white rice, white bread, glucose (dextrose, grape sugar), and breakfast cereals.
In Asia where rice forms a staple of daily meals one study published in the British Medical Journal (BMJ) found that “each daily serving of 5.6 ounces (about a cup) of cooked white rice comes with an 11 per cent higher risk of developing diabetes”.
While Singapore is the first to take positive action, other Asean countries are equally, if not more at risk of a diabetes epidemic.
Diabetes Reaching Chronic Levels in Malaysia
In neighbouring Malaysia the prevalence of diabetes is becoming chronic, with an average of 100 deaths a day – 35,000 deaths a year – attributed to diabetes. In 2015 the IDF recorded 3.3 million cases of diabetes in the country; about 10 per cent of the population.
Based on a National Health and Morbidity Survey (NHMS) in 2015, Dr Noor Hisham Abdullah, Ministry of Health Director-General, said that one out of five adults, including 18-year-olds, would be living with diabetes by 2020.
Speaking at the opening of the Malaysian Diabetes Educators Conference 2017, Dr Hisham blamed a 13 per cent increase in Malaysian diabetes on “the practice of an unhealthy lifestyle among Malaysians, such as the excessive intake of carbohydrates and sugar”.
Thais Sweet Tooth Fuelling Diabetes Growth
In Thailand, where sugar or sugar syrup, is added to all manner of food and drinks, including fresh fruit, the diabetes rate in 2015 was put at 7.1 per cent of the population – some 4.5 million people.
According to Dr Sutha Jiaramaneechotechai, deputy director-general of the Department of Health (DoH), Thailand, “an average Thai consumes about 26 teaspoons of sugar or 104 grams per day (four times the recommended amount of six spoonfuls per day), with most people getting their daily dose from sweet beverages, such as soft drinks which contain about nine teaspoons per serving.
The result? Thailand now has the dubious title of the second most over-weight country in Southeast Asia, with Bangkokians most risk of becoming obese. Amongst measures under consideration by the DoH to combat the sugar intake rate include banning advertisements for green tea and soft drinks.
In the Philippines, where a survey commissioned by the Philippine American Life and General Insurance Co. (Philam Life) found that Filipinos were among the least healthy in the region, diabetes is put at affecting about 5.1 per cent of the population – 3.5 million people in 2015.
In Myanmar where 17.4 per cent of the population is overweight and 9 per cent is said to be physically inactive diabetes is said by the WHO to affect 2.9 per cent of the country’s 53.9 million people, some 1.563 million people.
With some 10 million people in 2015 said to have diabetes, Indonesia is ranked as one of the world’s top five diabetes afflicted nations globally, with high dietary intake of rice, instant noodles, and oily fried food being blamed.
Second in the region for noodle consumption behind Indonesia, according to the World Instant Noodle Association (WINA), Vietnam is also experiencing a growing diabetes population. In 2015 the IDF put the total number of diabetes afflicted Vietnamese at some 3.5 million people. Coupled with some 66 per cent of male Vietnamese being smokers and the country’s healthcare sector is facing two major challenges. With rising incomes and more affluent lifestyles the Vietnam diabetes population is forecast to reach 8 million by 2025.
In Cambodia where the consumption of white rice is high, the IDF put the number of diabetes afflicted people in 2015 at 230,812, 3.02 per cent of the population. Similarly afflicted with high numbers of diabetes is Lao PDR where some 3.62 per cent of people aged 20-79 were afflicted in 2015 – 106,387 – with 2,764 diabetes related deaths.
Whether the Singapore government’s top down approach to tackling the rising incidence of diabetes proves effective in arresting the spread of the disease is yet to be seen, but with the first projects under the HIDS scheme due to begin in July this year it will no doubt be a programme that will be closely monitored by others facing a similar problem.
Feature photo: Steve Buissinne
- The war on diabetes: Time to stop pussyfooting and fight to win (Foodnavigator Asia)
- Msia diabetes cases growing at alarming rate (New Straits Times)
- Sugar: Its many disguises (Harvard Health Publications)
- How Singapore can win the war against diabetes (Today Online)
John Le Fevre in Bangkok contributed to this story