In declaring war on diabetes, Singapore is doing no more than the minimum needed to keep an attritional health threat at bay. The disease exacts a human cost and over $1 billion for treatment a year. In 2010, the cost of diabetes was already almost 10 per cent of healthcare spending. Alarmingly, of the more than 400,000 diabetics today, one in three does not know that he has the disease. Worse, of those who do know, one in three has poor control of his condition. This mixture of ignorance and denial bodes ill for Singaporeans, particularly if forecasts - that the cost of diabetes will soar beyond $2.5 billion by 2050 - prove true.
Medical treatment would account for only a part of the impact of the disease; the rest would be due to indirect productivity-related losses. The irony is that while dreaded ailments such as heart attacks and strokes are feared widely for their fatal or debilitating effects, diabetes - which is a contributory factor to those illnesses - hardly causes the same alarm. This is the problem with what could be called diabetic apathy here.
Singapore's experience reflects a global phenomenon. Around the world, 415 million adults have diabetes and, by 2040, this figure is expected to rise to 642 million. Obesity, which is related to diabetes, has more than doubled worldwide since 1980. According to World Health Organisation figures, more than 1.9 billion adults were overweight in 2014; of them, over 600 million were obese. Once considered a problem only in high-income countries, excess weight and obesity are now on the rise dramatically in low- and middle-income countries, particularly in urban settings.
Yet, the survival instincts that alert people to the dangers of cancer, heart disease and strokes hardly feature in the public consciousness of diabetes. This is so although kidney failure, blindness and amputations add to the mutilations that await those who do not seek medical help in time for one of the most pernicious diseases on earth. It harms stealthily because it is not accompanied by pain that could force patients to seek urgent medical attention.
The new Diabetes Prevention and Care Taskforce will need to engage Singaporeans with a programme that leaves no one in any doubt about the enormity of the disease. Public education must focus on encouraging people to come forward for early screening, particularly if they have a family history of diabetes. The task force's diverse make-up - which will include representatives of government agencies, the private sector and patient advocacy and caregiver groups - should enable it to tap into a broad social network. One key message is to assure Singaporeans that while it could be lethal to ignore diabetes, the disease can be controlled through diet, medication and exercise. The war can be won.