That Singapore needs to fight obesity and diabetes on a war footing is clear from the potentially epidemic nature of those diseases. Of the more than 400,000 diabetics here today, one in three does not even know he has the disease. Alarmingly, of those who do know, one in three has poor control over his blood sugar levels. In waging war on diabetes, which can lead to heart disease, stroke, kidney failure, blindness and amputations, attention has focused on preventive measures related to lifestyle choices and consumption habits.
There are no quick victories in this offensive. One suggestion is to introduce a sugar tax to discourage the excessive consumption of a linked commodity. Attention has been given to a bowl of rice which has more than twice the carbohydrate content of a can of sweetened drink. These messages offer a simpler way of breaking down a complex subject that involves many factors. But to fixate on just one idea, like cutting rice from one's diet, would be self-defeating. The larger picture should be kept in mind. Scientific studies affirm a direct link between the amount of sugar consumed and the occurrence of obesity or diabetes. There are also other causes, like fats, a sedentary lifestyle and genetics.
Still, if even a single contributory factor like sugar can be controlled for starters, that would benefit those at risk. Given that sugary drinks, for example, are a choice and not a necessity, there is a case for taxing them to inhibit excessive consumption. Though not as serious as the use of tobacco or alcohol, the potential harm caused when the young develop a sweet tooth invites preventive intervention. The exercise could draw attention to the excessive use of sugar in a host of other foods as well, in particular desserts. It would be useful to study closely the actual experiences of countries, such as Mexico, which have introduced the tax. And it would be sensible to seek strong evidence that links sugar taxes with reductions in obesity or diabetes rates before embarking on such a policy. It would be important, as well, to study the effects of a regressive health tax on white sugar on the less well-off.
Of course, what would be best is when Singaporeans, of their own volition, settle for a less sugar-dependent lifestyle. Diabetes and its related ailments are not merely personal afflictions but impose costs on the health service directly and on the economy indirectly by affecting work and productivity. As one observer argues persuasively, "the social cost of sugar consumption is greater than the private cost of sugar".
Diabetes is no longer just a disease afflicting the rich but increasingly and disproportionately, one that affects the poor. Hence, the need to persuade food producers to not keep leveraging sugar to push their sales and to encourage consumers to demand healthier alternatives from them.