Defending the nation against diabetes

MALAYSIA today has the highest prevalence of diabetes in Asean and ranks eighth globally, according to the latest International Diabetes Federation (IDF) estimates.

Often treated as a public health concern, diabetes should now be recognised as a national defence issue. Across the world, defence planners now speak of whole of government and whole of society defence (Wogos), where security is measured not only by military capability but also by a nation’s ability to withstand, weather and win under stress.

It is no longer confined to old age, as individuals who are economically productive and socially active are increasingly being diagnosed with it. On a weekday morning in many Malaysian hospitals, more dialysis chairs are being occupied not by the elderly but by people in their 30s and 40s.

This trend mirrors a broader national profile. Malaysia ranks among the highest in Asia for overweight and obesity, conditions that are correlated with diabetes incidence and progression.

When chronic illness presents earlier, national readiness declines earlier.

Like many high-prevalence countries, Malaysia has normalised a diet dense in sugar and refined carbohydrates. The foodie culture is being pursued without restraint while physical activities have steadily declined.

Diabetes often develops silently, long before symptoms demand attention. Malaysia shares a critical metabolic trait with many Asian populations, who accumulate visceral fat and insulin resistance at lower BMI thresholds compared to the Western benchmark.

This means Malaysians may look comparatively lean but they carry significant metabolic risk.

From a defence and resilience perspective, this matters deeply. A disease that presents earlier persists longer. It reduces productivity during prime working years and narrows the pool of physically fit citizens. Over time, national resilience is weakened not by a sudden external shock but by steady attrition, a defining feature of modern warfare.

Modern defence doctrine recognises that resilience is built long before a crisis emerges. The same logic applies here.

Treating diabetes-related complications such as kidney failure, cardiovascular disease and vision loss costs far more than expenses on prevention. Every ringgit spent on treatment is a ringgit denied to future defence capability.

Rising healthcare expenditure reduces fiscal flexibility, limiting strategic options not only for defence but also for other critical sectors such as education and infrastructure. A nation whose people are chronically unwell cannot sustain credible long-term deterrence.

Moreover, deterrence rests not only on weapons and platforms but also on a nation’s capacity to sustain itself under prolonged pressure.

At the government level, diabetes must be treated as a structural risk to national resilience. This includes reshaping food environments, regulating sugar consumption more decisively, embedding healthier procurement standards in public institutions and expanding early screening for high-risk groups. Urban planning must support daily movement so that healthier choices become the default rather than the exception.

At the community level, norms must shift. Workplaces, schools, religious institutions and neighbourhoods shape behaviour more powerfully than campaigns alone. No defence system is stronger than its weakest component.

At the individual level, the narrative must move away from guilt and fear. Early detection is not weakness; it is preparedness. Small, sustained changes in sleep, movement, diet and stress matter more than short bursts of discipline.

National defence is often imagined in terms of hardware doctrine and borders. A nation’s strength ultimately rests on the health of its people.

If Wogos is truly our organising principle, then resilience must begin with healthier bodies and sustained well-being. In defence of our future generations, deterrence must begin not at the border but with diabetes prevention at home.

MUHAMMAD AMMIR HARON

Undersecretary

Policy and Strategic Planning Division

Ministry of Defence Malaysia