2.

I am struck by the diversity of participants at the Summit. We have repres

entatives from Asia, Africa, the Americas and Europe. There are academics, docto
rs, public health officials, CEOs, and journalists among us. Our jobs range from
delivering basic primary care in rural areas to developing cutting-edge, person
alised medicine.
3.
Despite our diverse backgrounds, we all agree that health is the foundatio
n of human and social wellbeing. Healthy people are happy individuals, productiv
e workers and engaged citizens. A healthy population underpins economic growth a
nd social progress. That is why almost half of the Millennium Development Goals
are directly related to health.
4.
Yet achieving good health is a challenging endeavour. Individuals, familie
s, companies and Governments must all work closely together. We need sound polic
ies and effective delivery across many areas
preventive and public health; prima
ry, secondary and tertiary care; traditional and complementary treatments, etc.
Healthcare services must be accessible, affordable and of high quality.
5.
As Singapore developed from Third World to First, so too our approach to k
eeping citizens healthy has evolved. I thought it might be useful to share our e
xperience as a basis to discuss our common challenges and possible solutions.
SINGAPORE S HEALTHCARE JOURNEY
6.
When Singapore became self-governing in 1959, we faced serious problems of
over-crowding and poor public sanitation. The top causes of death were infectio
us diseases like tuberculosis and pneumonia.
7.
Our first priority was to get our basics right. We focused on developing o
ur primary and preventive services. We invested in public sanitation and cleaned
up the Singapore River
relocating pollutive industries, dredging the riverbed t
o remove rubbish, and bringing wholesome leisure activities to the River (e.g. d
ragonboating, kayaking). We built a wide network of outpatient dispensaries and
primary health clinics, especially for maternal and child health. We introduced
Nutrition Supplement programmes to help malnourished children. We vaccinated chi
ldren against infectious diseases such as measles, diphtheria and polio. Our sma
ll size helped us to reach our whole population quickly and efficiently, althoug
h back then doctors and nurses had to travel along dirt trails to rural villages
or endure choppy boat rides to offshore islands!
8.
As we made progress on these basic public health challenges, we consolidat
ed our outpatient dispensaries and maternal and child health clinics into polycl
inics. Polyclinics acted as one-stop centres for general curative treatment, scr
eening, immunisation and dental services. We sited them in our public housing es
tates, so we could deliver primary healthcare to Singaporeans doorsteps.
9.
Subsequently, we built up hospitals and specialty centres to deal with mor
e complex medical challenges. We corporatised our public healthcare institutions
to make them operate more efficiently and be more responsive to patients needs.
If our healthcare institutions had continued to run as government departments, i
t would have been much harder for them to improve, and upgrade themselves.
10.
We also restructured our healthcare financing to strike the right balance
between individual responsibility and state support. The Government continues t
o subsidise hospital and primary care generously, especially for the lower-incom
e and elderly. We built up our health financing system progressively over the ye
ars. Medisave is our compulsory individual savings scheme for healthcare expense
s. MediShield is a national insurance scheme for catastrophic illnesses. Medifun
d is a social safety net to help those who are unable to pay for their own medic
al expenses. This combination of state subsidies, insurance, and co-payments out

of compulsory savings has helped keep our healthcare spending at 4% of our GDP
while delivering good outcomes.
11.
More recently, we invested in the biomedical sciences (BMS) industry. Thi
s enables us to understand diseases better and develop improved treatments for o
ur patients, especially diseases that affect Asians in unique ways. One example
is gastric cancer which is the second leading cause of cancer death worldwide. G
astric cancer is considered an Asian disease , and Chinese men are especially susce
ptible. We established the Singapore Gastric Cancer Consortium comprising multip
le universities, research institutes and hospitals. The Consortium has identifie
d two sub-types of gastric cancer using genetic profiling, and is currently cond
ucting clinical trials to improve treatments for gastric cancer. The BMS industr
y has become one of the engines of our economy, with positive spillovers to job
creation, manufacturing and logistics.
12.
At the heart of any healthcare system is people. Hence besides building p
hysical infrastructure, we also introduced training programmes for our healthcar
e professionals. We created many opportunities for promising officers to further
their knowledge after graduation, such as through the Health Manpower Developme
nt Programme. Most importantly, we uphold the ethos of care and concern for all
patients. I am proud of our healthcare team and their commitment to Singaporeans
health.
13.
Overall, Singapore s healthcare system has not done too badly. The Lancet s G
lobal Burden of Disease Study 2010 ranked Singaporeans as having one of the high
est healthy life expectancies in the world, while Bloomberg ranked Singapore the
world s healthiest country. These are encouraging endorsements, but we still try
to do better. For example, we need to improve the way we screen Singaporeans for
diabetes and hypertension. Our outcomes in certain chronic diseases, such as ch
ronic obstructive pulmonary disease, can be improved, compared to the best-perfo
rming OECD countries. We must continue to learn from one another to improve our
healthcare systems.
MEETING FUTURE CHALLENGES
14.
Looking ahead, there are four challenges that we need to prepare for. The
se are not unique to Singapore, but face all countries in Asia and around the wo
rld.
15.
First, non-communicable diseases (NCDs). Over 60% of all deaths each year
are due to NCDs. According to the WHO, the leading risks for NCDs are high bloo
d pressure, high blood glucose, physical inactivity, and obesity. These are chal
lenges for developed and developing countries alike.
16.
Singapore has adopted a community-based approach to promote healthy livin
g, through volunteer Health Ambassadors, who champion healthy lifestyles, and or
ganise health promotion activities. We have also introduced Healthy Hawker Centr
es, more public spaces for exercise, and are working on food advertising guideli
nes for children. There is tremendous potential for innovation here. For instanc
e, the UK has gotten some fish and chip shops to use salt shakers with fewer hol
es to reduce salt consumption. Stanford University researchers have found that p
eople who watched avatars of themselves running on a treadmill were more likely
to exercise, compared to those who watched their avatars lounging. We look forwa
rd to learning from other participants how to encourage people to live healthily
.
17.
Second, ageing. From now until 2050, the number of people aged 65 or olde
r worldwide is expected to triple from around half a billion to 1.5 billion. Sev
eral of the world s fastest ageing countries are in Asia, such as China, Korea and
Singapore. Developing countries are in fact ageing three times faster than deve

loped countries. Today s elderly are more healthy and active, but their growing nu
mbers will increase the load on our healthcare systems.
18.
We are making Singapore more elderly-friendly by making neighbour-hoods b
arrier-free, and building more nursing homes and Senior Care Centres so our seni
ors can age gracefully in the community. More importantly, we are encouraging ou
r seniors to lead active lives through Wellness Programmes and community work. F
or example, the YAH! (Young At Heart) Community College in Singapore promotes ac
tive ageing by running lifelong learning programmes for seniors and encouraging
them to forge new friendships with one another.
19.
Third, healthcare affordability. Healthcare must be affordable both to th
e patient and the State. In many Western countries, healthcare financing is a se
nsitive political issue. It is not yet such a vexing problem in Asia today, but
healthcare spending will inevitably rise as populations age, expectations increa
se and medical cost increases continue to outpace general price inflation. Keepi
ng healthcare affordable is a key challenge for many countries.
20.
We are currently reviewing Singapore s healthcare financing system, to cont
inue to give Singaporeans peace of mind. The Government will take on a larger sh
are of healthcare costs, make insurance play a bigger role, and allow greater fl
exibility in the use of Medisave. We will ensure that out-of-pocket costs remain
affordable, and provide additional help to needy Singaporeans. We will also stu
dy how the state can provide more targeted financial support, such as in chronic
disease management, preventive care and long-term care.
21.
Keeping healthcare affordable also requires an efficient delivery system.
It is better and cheaper to keep Singaporeans healthy and manage diseases at th
e primary or community level instead of in hospitals. We are thus developing Reg
ional Health Systems which integrate primary, acute and long-term care providers
in the community to serve patients better. Other countries have also introduced
interesting innovations, such as e-consultations and mobile phone diagnostic ki
ts. There is much that we can learn from one another.
22.
Fourth, emerging infectious diseases. This year marks the 10th anniversar
y of SARS. It was a dark episode for many countries, especially in Asia. More th
an 8,000 people were infected, and about 800 died. New infectious diseases have
continued to emerge around the world, including the first cases of H7N9 infectio
n in humans just days ago.
23.
Many Asian countries improved their capabilities to deal with infectious
diseases after SARS. In Singapore, we strengthened coordination across the whole
of Government to prepare for future pandemics. We are also building a new infec
tious diseases hospital in case of future outbreaks.
24.
One important way to fight infectious diseases is to strengthen internati
onal cooperation. Infectious diseases do not respect geographical boundaries. Ea
rly warning surveillance systems, information sharing and coordinated cross-bord
er infection controls remain critical to combatting this threat. We must therefo
re continue to strengthen our links with the WHO and other public health agencie
s as a vanguard against future pandemics.
25.
Besides global public health crises and pandemics, international cooperat
ion is also useful for sharing information and experiences. Our circumstances an
d needs may vary, but we share a common goal of keeping our people healthy.
26.
Hence, healthcare platforms at the UN, WHO, APEC and ASEAN are useful cha
nnels for countries to share experiences and professional expertise. Institution
al collaborations
between universities and research institutes also help us to e
nhance our capabilities. Our medical education landscape has been enriched by th

e collaborations between the National University of Singapore (NUS) and Duke Uni
versity, as well as between Nanyang Technological University and Imperial Colleg
e London. Our recently established Saw Swee Hock School of Public Health has als
o benefitted from a strategic partnership with the London School of Hygiene and
Tropical Medicine, whose Director Peter Piot is with us this evening.
CONCLUSION
27.
International cooperation also includes sharing experiences at conference
s like these. The annual World Health Summit in Berlin is a unique gathering of
academics, policy-makers and practitioners. Singapore is honoured to host the in
augural World Health Summit in Asia.
28.
The focus on Asia is timely. With economic growth, urbanisation, environm
ental change and ageing societies, Asia is facing significant healthcare challen
ges. By bringing this Summit to Asia, we can bring our collective wisdom to bear
on the diverse challenges and opportunities we face in Asia. At the same time,
we hope that the solutions and models we have in Asia can enrich the discussions
back in Berlin later this year.
29.
I hope that you will make use of the Conference to interact with one anot
her, and build new friendships. I wish you all a successful Summit.