War on Diabetes in Singapore: A Policy Analysis

Abstract

Background: In April 2016, the Singapore Ministry of Health (MOH) declared War on Diabetes (WoD) to rally a whole-of-nation effort to reduce diabetes burden in the population. This study aimed to explore how this policy has been positioned to bring about changes to address the growing prevalence of diabetes, and to analyse the policy response and the associated challenges involved. Methods: This qualitative study, using the policy triangle framework of Walt and Gilson, comprised analysis of 171 organisational documents on the War on Diabetes, including government press releases, organisational archives, YouTube videos, newspaper reports and opinion editorials. It also involved interviews with 31 policy actors, including policy elites and societal policy actors.Results: Findings showed that the WoD policy generated a sense of unity and purpose across most policy actors. Policy actors were cognizant of the thrusts of the policy and began to make shifts to align their interests with the government policy. Addressing those with diabetes directly would be essential to understanding their needs. Being clear on who the intended targets are and articulating how the policy seeks to support the identified groups would be imperative. Issues of fake news, unclear messaging, and lack of regulation of uncertified health providers were other identified problem areas. High innovation, production and marketing costs were major concerns among food and beverage enterprises. Conclusion: While there was greater public awareness on the need to combat diabetes, continuing dialogues with the various clusters of policy actors on the above issues would be necessary. A shared global diabetes policy, particularly to enhance access to healthier food and beverage would be critical.