“The soft sell over the years, including reformulation of drinks so there is less sugar, has not resulted in any reduction in sugar consumed here” (War on Diabetes Will Have Effect on “Innocent” Bystanders, Salma Khalik).
Given the medical and economic costs associated with diabetes – and the alarming statistic the one in four Singaporeans already has diabetes or is at high risk of contracting it – few would disagree with the proposals by the Ministry of Health (MOH) to take tougher actions (ST, Dec 6): To ban high sugar drinks, to tax these drinks, to disallow their advertisement, or to stipulate prominent labels on them. Yet absent from the discourse is an evaluation and communication of how these proposals and their effects may vary (based either on MOH projections or case studies from abroad), the effectiveness of past and ongoing campaigns to increase awareness of excessive sugar consumption and of diabetes, as well as the persistence of these campaigns in the future.
Without expounding on the evaluation of the four proposals and their effects, the perceptions of the Singaporean public – in the context of a public consultation exercise – are likely to be shaped by their past beliefs or habits they grew up with, or based on what is most convenient to their personal interests, as opposed to that of the collective. All of which, it should be noted, may not necessarily be grounded in facts. Teasing the differences between both sides and deciding on the policy, as a result, is fraught with difficulties. This is compounded by the observation that pre-packaged sugar-sweetened drinks are not the only source of high sugar consumption, and any attempt to extend taxation or regulation to the other sources would not be as straightforward.
Where there is potential consensus – and which is conspicuously absent from the present discussion, especially in terms of ascertaining its effectiveness – is the importance of awareness or education programmes to make Singaporeans not only more cognisant of diabetes and the concerns around sugar consumption, but also to nudge them to make more active decisions for themselves. A useful starting point would be to find out the demographics and socio-economic background of those living with pre-diabetes or diabetes, together with the lifestyle habits and activities which could be correlated with the disease. Subsequent (research) questions could include an understanding of their daily dietary patterns and what these Singaporeans think about the campaigns launched by MOH or other public health agencies, to further improve the messages and their delivery. In other words, mobilise more tools and monitor their implementation, and complement the war on diabetes with better education on diabetes.
A version of this article was published in The Straits Times.