MINISTER FOR HEALTH OF THE REPUBLIC OF SINGAPORE, MR ONG YE KUNG'S NATIONAL STATEMENT AT THE HIGH-LEVEL MEETING ON UNIVERSAL HEALTH COVERAGE (UHC) OF THE 78th UNITED NATIONS GENERAL ASSEMBLY, 21 SEPTEMBER 2023

1 Mr President, Distinguished Delegates.

2 The health and wellbeing of populations worldwide are at a pivotal, yet precarious moment. In many parts of the world, the advancement of age and the demographic march is inexorable. With old age comes sickness, and the cumulative impact of which is rising disease burdens on healthcare systems.

3 Many developed countries in Europe, as well as Japan and Korea have been grappling with this challenge. They are already superaged societies, with 21% or more of their population being aged 65 and older. Many more countries will join the league in the coming years.

4 Shifting demography exposes a critical flaw in many healthcare systems around the world, which is that they are designed for sick care, rather than healthcare. The centre of gravity is in acute hospitals, with resources and energy revolving around curing the sick. This works for a young population when relatively few people fall very sick, but it is not sustainable for an ageing population with rising disease burden.

5 Healthcare systems need to be re-organised to build health outside of hospitals, and to support the aged to live healthily. More resources need to be invested in preventive care, as a matter of discipline, even as the workload of hospitals are mounting. Governments need to leverage social, economic and environmental determinants of health such as lifestyles and habits, to promote healthy populations.

6 So when we talk about universal health coverage in an era of ageing, it is no longer just about the right to access acute care in hospitals. It is about having access to education and jobs, and able to enjoy clean air, water and safe neighbourhoods. It also means being served by an effective primary care system, where there are family doctors, community nurses or pharmacists nearby to guide us in building health. It means having social support systems for the aged to live with dignity, respect and good health.

7 In Singapore, this is what we try to achieve with our “Healthier Singapore” strategy, which seeks to mobilise family doctors to deliver preventive care and chronic care management, and harness community resources to forge healthy living environments.

8 It is not easy to invest in population health through primary care, because curing the sick and dying will always be more urgent than preventing a healthy person from falling sick. But in an era of ageing, there needs to be a strong political consensus on population health through primary care. It is the most effective, equitable and universal healthcare policy of our times.

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