Professor Ling San, Deputy President and Provost, Nanyang Technological University
Professor Liu Hong, Director, Nanyang Centre for Public Administration, NTU
Distinguished guests, ladies and gentlemen,
1. It is my pleasure to join you this afternoon for the Lien International Conference on Good Governance.
Western and Chinese Medicine
2. Like many of you in the audience today, I am a consumer of both Western and Chinese medicine. When I have diarrhoea, I may take both Imodium and Poh Chai pills. When I have a cough, I take both the cough suppressant from my GP as well the cooling tea made by my wife, from a concoction of different almonds she bought from the Traditional Chinese Medicine (TCM) store.
3. Now that I am the Health Minister, I became conscious of the differences between the two medicines. There are people who describe one as preventive, and the other one as curative; or one treating the person, the other treating the disease. One learned colleague in the Ministry of Health said the key difference lies in the ‘T’ of TCM. Chinese medicine is tradition enshrined in medical practice. It is based on empirical observation and a holistic view of health, rather than specific diseases.
4. Having said that, TCM is not a Chinese phrase, but a Western description of Chinese medicine. In Chinese, it is just 中药，Chinese (or rather, Middle Kingdom) medicine, not 传统中药，which would have been a direct translation of TCM.
5. However, I think the difference goes beyond tradition. Chinese medicine is embedded in the culture, history and philosophy of life of China. I suspect because it dates back so long, just like Ayurveda medicine, it must naturally have a strong emphasis on preventive care. And because it harks back to a time when tribes depended on their environment to survive, it advocates holistic care, and seeks harmony between humans and our environment.
6. It is a complete system, with its own logic, science, and discipline. Western medicine on the other hand, has been rising on scientific advancement and made tremendous progress over the last century. We start to understand the human body in a very profound way, down to the basic building blocks. And the entire system is based on research, trials, data, evidence and approvals.
7. We should respect both systems, but we should never expect or desire them to merge and become one. When proponents of Western medicine question TCM practitioners on where the research data supporting their treatment is, it can be a puzzling question. Because isn’t thousands of years of observation and practice valid and valuable too? It will be equally befuddling to a Western doctor if a Chinese physician asks whether this drug balances the internal energy of the patient, his yin and yang?
8. But if we think never the twain shall meet, think again. The two systems can connect and interface.
9. The twain met at acupuncture, where the West figured out how it works in some clinical settings. They also converge in the discovery of antimalarial artemisinin, which is an active ingredient in the TCM herb Qing Hao (青蒿) used to treat similar symptoms.
10. Every few decades, the World Health Organization’s governing body, the World Health Assembly, will publish the organisation’s global compendium, known as the International Statistical Classification of Diseases and Related Health Problems, or ICD.
11. The ICD is a very significant global document. It categorises thousands of diseases, and affects how physicians make diagnoses, insurance companies determine coverage, epidemiologists ground their research and health officials interpret mortality statistics. The 11th revision of the ICD will come into effect on 1 January 2022. For the first time, the ICD will feature a classification system on traditional medicine, and will make TCM an integral part of global healthcare.
Systems of Governance
12. When we discuss the issue of governance, the differences that exist in systems around the world can be as profound as the two systems of medicines.
13. As bands formed tribes, tribes formed kingdoms, and kingdoms formed nations, the reasons and systems to hold them together become increasingly complex. It also becomes more compelling, so that people of different backgrounds put aside their primordial instincts to come together, live as a people and pursue common national interests.
14. Like many countries around the world, Singapore can exist as a multi-cultural nation because of our governance system. Over the last 56 years, generations of Singaporeans put their faith in this system, because it can better secure theirs and their children’s future. Either we hang together or hang separately. Over time, the sense of commitment and responsibility to one another grew stronger.
15. Governance systems, as the glue that holds diverse people together for a common purpose, are therefore deeply personal to a country. They are outcomes of history, culture and philosophies of living.
16. For the United States, the first immigrants arrived on its shores seeking new economic opportunities and freedom to practise their religion. The Declaration of Independence emphasised the inalienable individual rights to ‘Life, Liberty and the pursuit of Happiness’. Individualism, freedom and enterprise are the DNA of the society, and the governance system that evolved subsequently.
17. Today, the US is a well-developed democracy. At the heart of American culture lies a strong sense of individualism, civic participation, enterprise, entrepreneurship, a very strong work ethic and a drive to embrace competition.
18. The major strength of the system is the ability to use those founding ideals to attract people of all backgrounds to America. It is a huge magnet for talent, which produced many Nobel Prize winners and technological breakthroughs, from nuclear power and electricity, to the Global Positioning System, the Internet, and COVID-19 vaccines. This is the key source of US’ global dominance.
19. Because of its nature, it is also a highly competitive society. Not everyone can thrive in the system. The disparity and inequality can be stark, but this is an inevitable outcome of the nature of the society.
20. Intense contestation extends to politics. Social groups will jostle for influence and lobby for outcomes, which politicians and political parties cannot ignore. With a mature democratic system, people respect the results of elections, and transition of power can happen smoothly and peacefully. However, with the cacophony of political voices and frequent changes in administration, it is also not easy for any Government to develop and see through long-term plans, be it in economic and social policy or infrastructure development.
21. For China, its system has a far longer history – The Qin dynasty in 221 BC ended centuries of wars and united the territories into a single empire. The trajectory continued into the Han dynasty, which consolidated the system of governance. Centralisation of authority brought about peace and unity, and was viewed positively through the lens of history.
22. The empire has always been ruled from the divine authority of the emperor, complemented by a Confucian system where groups and individuals perform their roles and respect their stations in life and society.
23. To ensure that the people’s loyalty was to the State and not their tribe or fellow kinsmen, China developed the first impersonal and merit-based bureaucracy in the world. It appointed court officials based on results of national examinations. That is how government officials are called ‘Mandarins’.
24. In modern China today, the Chinese Communist Party continues to rule with unquestionable authority. It exercises a strict and disciplined system of appointing Government officials by merit and performance. It knows that without a one-person-one-vote system adopted by the West, change of power can be messy and even violent, if it involved people’s uprising. It therefore takes its mandate very seriously, setting out long-term plans, making tackling future challenges its present mission.
25. The system has delivered impressive results. China has risen to be the second largest economy of the world. It is a technological powerhouse. 800 million people have been lifted out of poverty.
26. If we understand how institutions of governance come about in mature societies, we will also realise that it will be inappropriate, or in fact foolhardy, for anyone to conclude which is more superior than the other, or worse, which is right and which is wrong.
27. Historians many generations later may be able to pass their subjective judgement on which system works better at different junctures of history. For now, we live in an unprecedented time in history with two great powers seeking to find a modus vivendi of engagement. In this process, we have to recognise that their governance systems are fundamentally different, and it is impossible for one to convert the other. Each has their unique strengths, but also their inherent contradictions.
Challenges to Governance
28. Notwithstanding, there is overlap even amongst different systems. Like Western versus Chinese medicine, the twain does meet.
29. The first and most important commonality is the sense of purpose and accountability to the people they serve. I believe both the systems of US and China seek to achieve global peace and prosperity, create better lives for their peoples, embrace science and technology, and uphold a vibrant international trading system.
30. Second, both systems can find common ground in tackling global challenges confronting humankind – climate change, pandemics, global terrorism, stability of the international financial system, and inequality brought about by competition and globalisation. The world needs the big powers to collaborate and tackle these issues.
31. Third, all governance systems will also be reshaped by the advent of social media. Every individual now has a public voice. Infinite number of social groupings of all purposes and agendas are sprouting ground up. Knowledge and information can be shared freely, but falsehoods and news that undermine institutions and authorities travel the fastest.
32. Hence, social media is really not just ‘media’. It is changing society, the growing up experience of children, and shifting the texture of politics as we know it. In a governance system based on individual liberty and freedom, it will become even harder to forge consensus and act for the long term. In a system with centralised authority, we must expect rising aspirations for agency and involvement amongst the population. In Singapore we are probably experiencing both aspects.
33. The Nanyang Centre for Public Administration, or NCPA, at the Nanyang Technological University, supported by the Lien Foundation, has been organising this conference since 2013.
34. The conference has a unique membership – 300 students, academics, and policymakers from countries such as China, Thailand, Indonesia, Cambodia, Vietnam, and other parts of our region. This can potentially enable the conference, and NCPA, to play a significant role in this juncture of history.
35. I suggest leveraging the NCPA and this conference, to recognise the very complex problems the world is facing and the challenges it has posed to various governance structures, and critically examine how we can improve governance for the 211st century. Share your ideas and experience openly and freely.
36. The theme for this year’s conference, ‘Good Governance in the Post COVID-19 World’, is relevant and timely. I wish everyone an enriching and rewarding conference.