Brunei Darussalam: Boosting the nation’s health

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Faced with a steady increase in the incidence of diabetes, Brunei Darussalam’s health officials are stepping up efforts to counter the illness by boosting awareness programmes, deploying more treatment facilities and even debating a proposal that could place the Sultanate at the forefront of international research to combat the disease.

Following heart disease and cancer, diabetes is the most common cause of death among Bruneians, with some estimates claiming that up to 25% of the population have either been diagnosed with the disease or found to be impaired glucose tolerant, meaning they are in the pre-diabetes stage. This percentage translates to 90,000 or more people, a number that is steadily rising as the mean age of those suffering from diabetes is falling.

Local health authorities have warned that there has been a steep increase in the number of young people contracting diabetes. If left unchecked this could be detrimental to the economy in the coming years.

Shahiran Sheriffuddin Shahrani Muhammad, a health facilities officer, said there was a very real risk that the Sultanate’s future workforce would be depleted due to the rising number of children and teenagers being diagnosed with diabetes.

“Diabetic patients as young as 12 who do not control their diabetes will contribute less, as they face complications of diabetes in 10 to 15 years at their most productive age,” Shahiran said during the launch of a public awareness campaign in early August.

Apart from the potential loss of productivity is the cost of treating the illness itself, along with the many associated ailments that often accompany it, including kidney failure, vision impairment and cardio vascular disease, said Shahiran.

In the 2010–11 financial year almost BN$295m ($241m) was allocated for health services out of a national budget totalling BN$4.9bn ($4.01bn), about 6%. However, over the past few years, supplementary funds have been allocated to bridge budgetary gaps. Late last year Brunei Darussalam’ss health minister, Johan Pahlawan Setia Hj Adanan Begawan Siraja Khatib Setia Hj Md Yusof, said that lifestyle illnesses such as diabetes were the major force driving the need to increase health care spending.

“The costs of managing and controlling these diseases and providing health care to an increasingly unhealthy population are rising more and more each year,” he said during the launch of the Fourth Annual Brunei Surgical Scientific Session. “To reduce health care costs, it is our responsibility to adopt a healthy lifestyle.”

To help promote a healthy lifestyle and raise awareness of diabetes and its causes, officials announced in mid-August that they would be distributing 2000 posters across the country and airing messages about the disease on radio and television in an effort to conduct an information campaign.

But while trying to build awareness and promote the prevention of diabetes, Brunei Darusslam is also considering investing to become part of the cure.

In mid-August, representatives of the Warwick Medical School in the UK came to the Sultanate to meet with officials about the proposal to establish a diabetes research centre in the Sultanate. In recent years, the school has been focusing on studies aimed at limiting the impact of some of the most damaging effects caused by diabetes, particularly examining how the consumption of the vitamin Thiamine (B1) by diabetic patients can improve their kidney functions, reducing or eliminating the need for dialysis.

Dr Naila Rabbani, an associate professor of experimental systems biology at Warwick, said the Ministry of Health, the Ministry of Education and Universiti Brunei Darussalam’s Faculty of Health Science were interested in the proposal for collaboration. However, local authorities will have to weigh the scheme’s costs, which Rabbani put at between $1.6m and $3.2m, a price worth paying if the research programme were to bear fruit.

“By tackling the issue early, the government will be able to save the costs of care for diabetics,” Rabbani told the Brunei Times in August. “Say the effect of B1 in the long term prevents kidney disease; it will save millions, if not billions on health costs worldwide.”

An added advantage of having the project based in Brunei Darussalam would be that many of the medical professionals involved in the study would be locals. This would help deepen the experience pool of domestic researchers.

There is still no indication of whether the Sultanate is going to convert its expressed interest into funding for the research programme, but in recent years the government has been working to raise the profile of the country’s pharmaceuticals sector, backing the development of halal-compliant medicines production, as well as promoting the country as a potential health tourism destination. By investing in research projects, Brunei Darussalam could further boost its credentials as a centre for international health and help find a cure for the ills of its own citizens.

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