Speech by Mr Gan Kim Yong, Minister for Health, at the NKF Sit-A-Thon 2018, 15 September 2018

Mr Tim Oei, Chief Executive Officer, National Kidney Foundation (NKF)
Distinguished Guests
Ladies and Gentlemen

            It is my pleasure to join you today at the NKF Sit-A-Thon 2018. It is encouraging to see many of you here to show your support for patients with kidney failure.

High Incidence of Kidney Failure in Singapore

2          Singapore sees about four new cases of end stage renal disease (ESRD) every day. The projected number of persons with kidney failure is expected to increase, given our ageing population and the rising prevalence of chronic diseases such as diabetes.

3          Diabetes is a leading cause of end stage renal disease, with two in three new kidney failure patients in 2016 known to have diabetes. We therefore expect the number of kidney failure patients to grow significantly in the future if we do not take action now to counter this trend.

Strengthening Upstream Prevention of Kidney Failure4          In order to reduce the incidence of kidney failure, it is important for us to strengthen upstream preventive measures to reduce the risk of developing diabetes. For patients who already have diabetes, we need to help them to achieve good control of their disease and other risk factors, so as to reduce the risk of them progressing to kidney failure.

5          Many risk factors for diabetes, such as an unhealthy diet and sedentary lifestyle, can be modified. One of the key goals in the War on Diabetes is thus to create a conducive environment for Singaporeans to lead healthier lives, with improved dietary habits and increased physical activity. The Health Promotion Board (HPB) has launched several initiatives to provide more healthier meal options in hawker centres, food courts and other F&B outlets. HPB has also partnered with the F&B industry to develop healthier food products, such as whole grain rice and noodles, as well as healthier oils. But beyond efforts by the government, each of us is responsible for our health. We can all take small steps to choose a healthier lifestyle such as choosing kopi-o kosong instead of a regular kopi at your favourite coffee shop. We can also decide to take the stairs instead of the escalator or lift.

6          Regular screening is one of the key strategies to help Singaporeans take charge of their health and improve early detection of health conditions. Since September 2017, MOH has enhanced government subsidies for the Screen for Life (SFL) programme to encourage more Singaporeans to go for regular screening and post-screening consultation at the Community Health Assist Scheme (CHAS) clinics.

7          MOH has also been working with the polyclinics to implement a national chronic kidney disease prevention programme called HALT-CKD, which stands for Holistic Approach in Lowering and Tracking Chronic Kidney Disease. This programme aims to prevent or slow down progression to kidney failure, through control of risk factors such as diabetes and high blood pressure, and the usage of kidney protective medications. HALT-CKD has been implemented at 15 polyclinics and will be progressively rolled out to the remaining polyclinics by 2020.

Supporting Kidney Failure Patients on Dialysis

8          While we work to prevent kidney failure, it is also important to ensure kidney failure patients have access to dialysis or kidney transplant for treatment. MOH is working with VWO dialysis providers, such as NKF, to build more dialysis centres to meet the demand for haemodialysis, also known as HD or blood dialysis. We are also working with our healthcare partners to encourage suitable patients to choose peritoneal dialysis (PD) which is also known as water dialysis. Currently, 88 per cent of dialysis patients are on HD, with the remaining 12 per cent on PD. We encourage patients to opt for PD if they are medical condition permits, as it provides clinical benefits such as a lower risk of blood borne disease transmission, needing fewer dietary restrictions and less medications, as well as lifestyle benefits such as a greater flexibility for patients in their daily routine.

9          Madam Latifah Binte Rawi, a homemaker, started PD ten years ago. She undergoes nine hours of PD at night while she sleeps and can go about her activities in the day without disruption. This allows her to take daily walks with her husband too. I am heartened to hear that Mdm Latifah regularly participates in outings organised by NKF and is now part of NKF’s PD support group where she provides advice and support for new PD patients.

Promoting Kidney Transplant

10         Kidney transplant is the preferred treatment option for kidney failure patients as it provides better quality of life, survival outcomes and cost effectiveness for patients. While the number of patients who have benefitted from kidney transplants has increased from 69 in 2013 to 93 in 2017, there is room to further improve the organ transplant rate in Singapore. I understand that NKF has been encouraging suitable patients to consider kidney transplant. NKF has also set up the Kidney Live Donor Support Fund[1] in 2009 to support kidney donors who may find it challenging to meet the costs of hospitalisation and medical follow-ups. Thus far, 39 beneficiaries have received support from the Fund. I am glad to hear that NKF has since enhanced the scheme. 

Conclusion11        NKF plays a key role in providing comprehensive kidney care, ranging from raising public awareness of kidney disease prevention to providing integrated renal care for kidney failure patients. Today’s Sit-A-Thon is a good example of NKF’s efforts in public education.

12        Even as MOH continues to provide a supportive environment for disease prevention, intervention and management, community partners such as NKF are critical to this mission. Singaporeans must also play our part by choosing positive lifestyle choices and making wise decisions on our health.

13        In closing, I wish all of you an enjoyable evening!

[1] The Fund was set up in 2009 to provide financial assistance to needy kidney donors. It covers the costs of annual health screenings and medical follow-ups, a one-time reimbursement of hospitalisation and surgical insurance premiums, and insurance coverage for the Group Living Policy, for which NKF has doubled the sum insured to $200,000.