Speech By Mr Chee Hong Tat, Senior Minister of State For Health, at the 2nd Global Summit On Circulatory Health, 12 July 2017

Distinguished Delegates

Ladies and Gentlemen

      A very good morning to all.

2    It is my pleasure to join you today at the 2nd Global Summit on Circulatory Health which seeks to address some of the most pressing health issues of our time: cardiovascular diseases. To our foreign delegates, a warm welcome to Singapore.

3     In June last year, more than 25 leading health organisations, including the World Heart Federation, signed the Mexico Declaration on Circulatory Health, which is the most comprehensive global declaration on the prevention of cardiovascular diseases. We thank the World Heart Federation for driving this initiative, and the Singapore Heart Foundation and Singapore Cardiac Society for hosting the Summit.

Cardiovascular Diseases and Diabetes

4     This Global Summit is both necessary and timely. Cardiovascular diseases are the number one cause of death globally. In 2015, it was reported that an estimated 31% of all deaths around the world were due to cardiovascular diseases. The situation is equally serious in Singapore, with cardiovascular diseases being the leading cause of premature mortality and ill health. More worryingly, it accounts for nearly one-third of all deaths in our country.

5     Apart from cardiovascular diseases, diabetes, which is a risk for heart disease and stroke, is also a significant concern for us. Diabetes is the third largest contributor to our total disease burden, after cardiovascular diseases and cancer. One in three Singaporeans have a lifetime risk of diabetes. In 2014, around 440,000 Singapore residents aged 18 years and above had diabetes . If we do not act on this, the number of diabetics in Singapore could rise to 670,000 by 2030 and nearly 1 million by 2050 . Because of the significant burden posed by diabetes and its complications, Singapore’s Ministry of Health declared a War on Diabetes last year. A major part of our war effort focuses on strengthening upstream prevention, so as to reduce the incidence of diabetes.

6     As cardiovascular diseases and diabetes share common lifestyle risk factors, such as unhealthy diets, insufficient physical activity and smoking, our efforts to tackle these risk factors will not only support our War on Diabetes, but also contribute to the prevention of cardiovascular diseases. Similarly, we expect that our efforts to optimise the management of diabetes will also help us to reduce the incidence of downstream complications, such as cardiovascular disease and kidney failure.

Importance of Preventive Health Measures

7     That being said, it is crucial to focus our efforts on upstream preventive health measures. Our approach to prevention centres on two main strategies – increasing our population’s level of physical activity, and improving the quality and quantity of their dietary intake. Through our Health Promotion Board, or HPB in short, we have put in place ecosystems and initiatives to encourage healthy living. For example, HPB introduced the National Steps Challenge since 2015 to encourage Singaporeans to be more physically active by taking more steps. This is the world’s first population level “pedometer+application-based” intervention, which leverages smartphone and wearable technology to drive and nudge behavioural change and mobilise Singaporeans to get active. HPB also partners public agencies such as Sport Singapore and National Parks to make regular physical activity sessions available and accessible, by having these sessions where Singaporeans live, work and play. Over 350 weekly physical activity sessions island-wide are offered at no cost to Singaporeans. As a result of the combined efforts, we are encouraged to see an increase in the proportion of adult residents who achieved 150 minutes of physical activity per week from 53.5% in Oct-Dec 2015 to 59.6% in Jul-Sep 2016.

8     Besides physical activity, food is another key area of our prevention efforts. HPB engages and partners the food and beverage industry to offer consumers a wider variety of healthier meals, and making it easier for Singaporeans to lead a healthier lifestyle by adopting healthier eating habits. HPB also introduced the Healthier Ingredient Development Scheme (HIDS) on 1 July 2017, where they actively engage the food and beverage industry to incentivise them towards healthier product re-formulation and in particular, to encourage ingredient manufacturers and suppliers to develop healthier versions of food ingredients.

9     Besides having a healthy diet and sufficient physical activity, it is also important for individuals to attend regular and age-appropriate health screening for the timely detection of cardiovascular risk factors such as hypertension, hyperlipidaemia and diabetes. With early detection and timely follow up, we aim to avert unnecessary costs and unwanted complications associated with cardiovascular diseases and diabetes. This will ultimately achieve better health outcomes both at the individual and systemic levels.

10     To encourage eligible Singaporeans to step up to participate in evidence-based screening and seek follow up with their family doctor, the Ministry of Health will be enhancing the subsidies for HPB’s national screening programme, Screen For Life (SFL), from 1 September 2017. This will be available at all our 950 GP clinics on CHAS, which allows private primary care to tap on portable healthcare subsidies. Eligible Singaporeans would pay a small fixed fee of no more than $5 for their screening test and first post-screening follow up consultation. Singaporeans from our Pioneer Generation can also undergo such screenings at no cost. Through this enhanced screening programme, we also want to anchor screening, preventive health and chronic disease management within the primary care setting and in the long run, develop meaningful patient-doctor relationships.

11     What I have just shared are just some of the many preventive health initiatives to nudge Singaporeans into adopting healthier lifestyles and ultimately, to live healthier lives. As healthcare professionals, all of you play an important role in educating and encouraging your patients to maintain healthy lifestyle habits so as to reduce the risk of cardiovascular diseases. While all of us have a part to play in creating a conducive environment for healthier living, ultimately, the onus is on the individual to take personal responsibility and ownership of their own health.

Research on Cardiovascular Diseases

12     We have made much progress in treatment modalities for cardiovascular diseases, and this is due to our heavy emphasis on evidence-based treatments. We invest heavily in research on how to better prevent and manage cardiovascular diseases, and it is one of the five priority disease areas under the Singapore Research, Innovation and Enterprise (RIE) 2020 strategy. We will continue to provide strong support for the cardiovascular research community, and forge networks and connections with international cardiovascular experts to forge strengths in combating this highly prevalent disease. Over subsequent years, we hope to translate research and innovation efforts in cardiovascular research into tangible healthcare solutions to ensure the safety, affordability and efficacy of cardiac treatment for all Singaporeans.

13     One such research funded by the National Medical Research Council is the validation of a predictive model that will enable clinicians to assess the hemodynamic significance of coronary artery stenosis in a non-invasive manner. A/Prof Zhong Liang and A/Prof Lim Soo Teik of the National Heart Centre Singapore (NHCS) who are fronting this research, hopes that by using this model, patients with suspected or known coronary artery disease can have their condition managed in a simpler and more cost-effective manner. This model is expected to reduce costs and prevent the use of unnecessarily invasive screening tests for cardiovascular disease patients, and assist physicians in making appropriate clinical decisions when it is implemented in cardiovascular management practices in the future. The team filed for a patent for this technology in 2016.

 
2nd Global Summit on Circulatory Health

14     This year’s Global Summit provides a forum that brings together policymakers as well as scientific experts and public health professionals who are committed to tackling cardiovascular diseases. Through this Global Summit, we can build on the progress from last year’s edition and the Mexico Declaration, which committed to reduce premature mortality due to cardiovascular diseases by 25% by 2025. This commitment will go a long way to realise the WHO’s goal of reducing premature mortality from non-communicable diseases by 25% by 2025 (‘25 by 25’).

15     I am heartened that this year’s Global Summit is even more ambitious than last year’s inaugural event, as we place continued emphasis and focus on encouraging knowledge exchange and the sharing of our unique experiences with one another. I am also glad that the Summit will touch on how we can build effective partnerships and mobilise communities in our continued battle against cardiovascular diseases. More importantly, it also represents a worldwide call to action in light of the urgent need to address issues associated with it.

Closing remarks

16     As public health professionals and scientific experts, all of you play a crucial role in enabling people to lead healthier lives, and for those living with cardiovascular diseases, to help them to receive better quality care and treatment to better manage their condition. I wish all of you an engaging and fulfilling time at the Global Summit.

Thank you.