Abstract
Existing studies demonstrate how biomedical researchers construct multiethnic populations as biovaluable. A multiethnic population with a diverse gene pool allows for the scaling of disease research and treatments to other countries. This “fact” serves an important role to attract investments in the national bioscientific sector. Yet these studies do not describe how such promissory narratives are translated for public consumption, an important step given how science policy requires public buy-in. My research asks how the relationship between Singapore and Asia is constructed as biovaluable through the media. Examining the media discourse on diabetes in Singapore, I find that the construction of biovalue in the media (1) relies on emotional and pragmatic appeals to Asian inclusivity in scientific research, (2) highlights biological Asian difference and market opportunities based on scaling, and (3) enacts the connection between Singapore and Asia in a distorted manner where ethnic minorities are sometimes excluded. This research builds on the existing literature on the political economy of the biosciences through examining the intersection between science policy, public health, race and ethnicity, and scientific communication in postcolonial nations such as Singapore, where the media plays an authoritative role in communicating scientific information to the public.
Keywords
Introduction
Research conducted at the intersection between race and ethnicity studies, and the social studies of science show how “science-backed” ethnic and racial categories were mobilized in contemporary movements to push for inclusion and representation of marginalized groups in medical research (Epstein 2008; Fullwiley 2014; Montoya 2011). A similar narrative of inclusion can be seen at a broader level, where population genomics becomes entangled with national (Sung 2010; Kuo 2011; Kent et al. 2015) as well as transnational (Burton 2018) identity formation. The state’s involvement has been instrumental in these processes. Keen to extract the potential “biovalue” (Waldby 2002, 2009) from populations, researchers in national science projects have either constructed narratives of population homogeneity (Rose 2003; Tupasela et al. 2015) or diversity (Benjamin 2009; Ong 2015, 2016) in the hope of attracting talent and investment needed to grow a bioeconomy. In Singapore, for instance, researchers project the multiethnic population (comprising Chinese, Malay, Indian and Others) as a microcosm of Asia, which allows for scaling therapeutics developed locally, to co-ethnic populations across the continent (Ong 2015).
Yet these studies miss out on an important component in the enactment of science policy and governance. Jasanoff (2005, 248) explains that “big ticket, big science enterprises” can rarely be steamrolled without public buy-in. Moreover, in order for this buy-in to be successfully negotiated, science needs to be presented to “fit…into established ways of knowing in order to gain broad-based support” (ibid., 249). Ethnography and analyses of scientific literature allow for the reconstruction of promissory narratives that emerge from the bioscientific world but these are not necessarily the same narratives accessible to lay people.
This research fills the gap by examining the media as an instrument of governance that plays a central role in building science policy legitimacy. Focusing on a specific public health issue (type 2 diabetes in Singapore) as a case for analysis, I ask the following questions: How is Asia constructed in relation to Singapore in the media discourse? More importantly, how is this relationship rendered biovaluable? Catherine Waldby (2002) explains that biovalue is created by mobilizing biotechnology to induce greater productivity at the “cellular or molecular fragment, the mRNA, the bacterium, the oocyte, the stem cell” (p. 310); in short, specific technoscientific practices allows for the manipulation biomaterial to generate value. I take Waldby’s (2002) ideas beyond the lab to examine how the Singaporean state—the main “venture capitalist” (Ong 2015, 327) in the bioeconomy—constructs and communicates biovalue in the media.
Singapore is an interesting case for examining science policy communication because the media continues to reflect how the state exercises power in controlling narratives (Rodan 2003; Weiss 2014; Holman and Arunachalam 2015) 1 and due to the inextricability of health and medicine from political authority (Clancey 2012, 2018). Another reason for examining Singapore is the emerging public health concern over type 2 diabetes. A report released in 2016 projected the cost of diabetes will reach approximately US$1.8 billion by 2050, 2 more than double the amount in 2010 (Khalik 2016b), leading the government to declare a “war on diabetes” (Lin 2016).
The increasing prevalence of diabetes also represents an opportunity for Singapore’s maturing bioscientific sector. A 2016 report from a panel of government-appointed experts highlights the need for the country to advance research capabilities to capitalize on the expanding global type 2 diabetes market, which is set to triple in value from US$17.4 billion in 2013 to US$45.4 billion in 2022 (Diabetes Taskforce Report 2016, 3). Diabetes can therefore be understood as an “intéressement” device (Callon 1984, 207-8) that brings together public health, technoscientific innovation, and state economic planning, thus providing an ideal locus for analyzing how biovalue is rendered legible to the broader public.
My study concludes that, like ethnographic accounts, the construction of biovalue in the media hinges on appeals to include Asian populations in biomedical research. The portrayal of “Asian” diabetes as having a distinct etiology to diabetes in “the West” lends urgency to this broad inclusionary imperative. Tethered to this narrative is the construction of Singapore’s potential as a leader in Asian diabetes research due to twin comparative advantages: the prevalence of diabetes in its multicultural population and a well-established bioscientific sector. In media discourse, Asian difference serves as an indicator of market potential, given that commitments to Asian diabetes in Singapore would likely be scalable, which could yield enormous returns.
The construction of biovalue in media discourse reveals a unique facet. Singapore’s multiethnic population as representative of Asia is problematically rendered in the media because of instances where minority subpopulations—Malays, Indians, and Others—are excluded. Such instances of exclusion when translating Singapore’s multiethnic population into the category of “Asian” is a distortion in the process of constructing Asian biovalue. This is quite different from Ong’s (2015, 2016) ethnographic research, where the multiethnic tracked onto Asian fluidly as scientists sought to create biovalue. The implication of such a distortion is serious, because it assigns differential biovalue to Singapore’s different ethnic groups. Ultimately, this pattern of inconsistency, where both inclusion and exclusion coexist to create Asian biovalue, captures a discourse of national science inflected by the tension of competing forces—ethnoracial politics, global biocapitalist aspirations, and regional geopolitics.
“Asian” Diabetes in Singapore
Diabetes is commonly recognized as high level of blood sugar in a person’s body, which leads to a host of health complications such as diabetic retinopathy, diabetic ketoacidosis, kidney disease, high blood pressure, and stroke, if not properly treated (American Diabetes Association n.d.). There are three main types of diabetes: type 1, type 2, and gestational diabetes. Type 2 diabetes, which accounts for 90 percent of total cases of diabetes worldwide (What is Diabetes n.d.), is caused by insulin resistance or impaired production of insulin in the body. It is estimated that 60 percent of the world’s diabetic population is Asian (Malik, Willet, and Hu 2013). This figure presents a staggering picture of disease prevalence in the continent but, as mentioned earlier, it has also been figured as a colossal market opportunity for Singapore, a small nation with big biotech ambitions (Van Epps 2006). But how has Singapore positioned itself in relation to Asia to take advantage of this opportunity?
Ong’s (2016) ethnographic account of bioscientific research in Singapore describes researchers conjuring connections between Singapore and Asia using both technoscientific and affective reasoning. To create a multiethnic genome database, locally sourced DNA samples are aggregated with samples from all over Asia and then realigned (using biostatistical techniques) under familiar ethnic categories such as Chinese, Indian, and Malay. Ultimately, Indians in Singapore can be linked with Indians elsewhere 3 (Ong 2016, 16). This established linkage has important economic implications, such as developing pharmaceutical drugs and treatments based on Singaporean populations for use in coethnic populations across Asia (Ong 2015).
This mobility of ethnic categories in medical research grants bioscientific enterprise in Singapore and elsewhere the scale used to justify the pursuit of biocapital 4 (Rajan 2006). Asian bioscience in Singapore is undergirded by more than a mere technoscientific assemblage. Ong (2015, 333) describes the affective reasonings—in particular the discourse of inclusion—that emphasizes the need to correct imbalances in existing genome databases to conduct research on “major diseases that disproportionately affect people in Asia.” Affective reasonings relating to Asian inclusion also feature in recent work by Vimal et al. (2021) which links the creation of Asian genome databases based in Singapore with the island nation’s bioscientific aspirations. These works on Asian bioscience cast a spotlight on unique and novel modes of Asian knowledge-production and identity.
Existing scholarship explores the convergence between identity-making and the bioscientific enterprise by reconstructing the narratives of scientist-administrators, researchers in the public and private sectors (or both), and medical experts. Yet they miss an aspect of scientific discourse integral to the state–citizen compact. By contrast, Ong’s (2015, 2016) research derives its analytical power from expert articulations of ethnic heuristics based on notions of genomic pan-Asianism. Vimal et al.’s (2021) research also leans heavily on expert interviews and institutional information to reconstruct national and pan-Asian technoscientific imaginaries. 5 But can we safely assume that such articulations take a similar form in public-facing discourse?
Jasanoff (2005) argues that the communication of science and its potential benefits to society is an integral aspect of the state–citizen compact. Crucially, scientific communication can only be effective if it fits into “established ways of public knowing in order to gain political support” (ibid., 249). Yet there has been a lack of research examining the public-facing scientific discourse in the case of Singapore—a problematic gap considering that the media (both newspapers and social media) is the primary platform through which the public consumes scientific knowledge (Ho et al. 2015).
Although the general impression is that the Singaporean government is able to steamroll bioscientific policy because of its political structure, 6 there have been high-profile challenges to the government’s planned investments in the sector (Shanley 2007). 7 The media therefore serves an important purpose in not just disseminating scientific and public health information but also in co-constructing public consensus in relation to public policy. This paper builds on the research by Ong (2015, 2016), Waldby (2002, 2009), and Vimal et al. (2021) by capturing how biovalue is constructed in news media to understand the ways in which the state, as the main driver of Singaporean bioscientific enterprise, justifies the use of public monies for “Big Science” projects (Fuller 2002; Van Epps 2006).
Method
For this research, I examined newspaper reports relating to diabetes published in Singapore between January 1, 2010 and December 31, 2019. The corpus was compiled using the Factiva database and is based on four sources: The Straits Times, The New Paper, Channel NewsAsia, and Today—all Singapore-based mainstream publications that operate through print and online platforms. Although the media landscape has experienced some degree of democratization over the years (see Weiss 2014), the state continues to assert its influence through a combination of “regulatory instruments and strategies of co-optation and autoregulation” (Lee and Willnat 2009, 100). This virtually guarantees that content delivered through various media platforms remains in line with state narratives and interests, unlike in the United States and elsewhere, where health, biomedicine, and biotechnology are deconstructed and debated by a multitude of lay and expert voices in the media (Briggs and Hallin 2010).
Given that the paper focuses on publicly accessible communication relating to diabetes and how it is connected to portrayals of Singapore as Asia, the following search parameters and key terms were used: diabete* and Singapore and asia*. The search yielded 149 articles, all of which were closely read, coded, and analyzed. I began by conducting open coding, in which themes were extracted from a reading all of the articles. This yielded a total of ten thematic categories, some of which were connected. A second round of coding was conducted and the ten categories were consolidated into three. These are (1) Racialized medicine, (2) Asian Difference and Inclusion, and (3) Asia as Singapore. From there, I try to analyze more specifically why these narratives were emphasized, how they are presented, and how they feed into constructions of biovalue and “Asian diabetes.”
The primary mode of studying the corpus is through qualitative critical discourse analysis rather than a quantitative corpus approach. The shortcomings and merits of each approach have been thoroughly debated (see Baker and Levon 2015). For the purposes of this research, I note that although the qualitative approach may be unable of presenting trends and patterns based on frequency of terms or lexical combinations, it does afford a critical understanding of the conditions, systems, and principles that organize the content of discourse—“what is said and what is left out” (Baker and Levon 2015, 233)—that reflect broader configurations of power in society.
Analysis of media discourse is distinct from direct lines of communication afforded by ethnographic research or in-depth interviews. For one, journalists writing on science and medicine add a layer of meaning to the information derived from experts. The frames journalists adopt in their articles are tied to the objectives and interests of news organizations, which are themselves shaped by broader social and political forces in Singapore and globally (Rodan 2003; Weiss 2014; Holman and Arunachalam 2015). Scientific press releases too cannot be divorced from the state machinery. Widely publicized research serves as a signal for what state funding agencies deem to be “desirable,” thereby influencing research agendas that align with overarching state objectives. The reporting of scientific knowledge is therefore a collective endeavor with the final product ultimately being inflected by state politics and a vision of a national bioeconomy.
Analysis
Constructing Biovalue through Asian Difference
How is biovalue constructed and communicated in relation to diabetes in the media, and where does Asia figure in this relationship? The very notion of biovalue rests on the foundational assumption of ethnoracial biological difference or, in this case, Asian difference. Press releases for bioscientific research lend authoritativeness to the narrative of Asian difference. Asian difference references claims about belly fat accumulation among Asians that contribute to higher false negatives in the detection of diabetes, reduced ability to produce insulin rather than insulin resistance as in Western populations, and an unhealthy Asian diet. The idea of Asian difference in diabetes research was initially raised in the Asian Metabolic Phenotyping Singapore (AMPS) project 8 that sought to identify ethnic-specific factors to explain the prevalence in Asian societies of metabolic diseases such as diabetes (Chang 2011). In the newspaper article, researchers explain how diagnostics and treatments have mainly been designed for Western populations and are not as effective when applied to Asian populations. AMPS is therefore framed as a correction for the population gap in research on metabolism—not unlike calls for broader representation in other fields of bioscientific research (Epstein 2007; Fullwiley 2008; Benjamin 2009).
However, the rationale for inclusion does not stop at the affective dimension in Ong’s terms. A researcher working on the AMPS project, Dr. Tai, hypothesizes that perhaps “we” Asians “tend to put on more abdominal fat than Caucasians, and there may be differences in our ability to secrete insulin” (Chang 2011). This was not a definitive statement, but even as a hypothesis, it introduced the idea of ethnic biological difference to the public imagination. This “making up” of the Asian, to paraphrase Ian Hacking (2007), is crucial because it provides the scientific reasoning for supporting new a “research program” (Lakatos 1976), one that generates questions and hypotheses on Asian difference in diabetes research. Essentially, this is what the Asian Diabetes research program constitutes: a wide range of studies in multiple institutions that center on diabetes and how it manifests among Asians. This would be reflected in later research and scientific reporting in the media. The following example from 2012 further illustrates Asian difference as a growing concern in diabetes research: Professor Paul Zimmet from the Baker IDI Heart and Diabetes Institute said Asians have an increased risk of diabetes and heart disease at lower body-mass index (BMI) levels compared to Europeans due to more abdominal fat. When European BMIs are used to determine eligibility of patients for diabetes surgery, these BMI thresholds are too high for Asians, whose bodies are built differently. (“Diabetes Surgery Can Save Lives, Say Doctors” 2012)
This issue of BMI and abdominal fat is echoed in subsequent newspaper reports. A 2017 (Boh 2017) report, for instance, explained that in Asian populations, the risk of dying from fatty liver disease is higher if a person is thin and diabetic as opposed to overweight diabetics. The risk for liver disease is therefore much higher, and according to Professor Koh Woon Puay, an expert cited in the article, this finding has “important implications in Singapore and other Asian populations, where patients develop diabetes at lower Body Mass Index (BMI) levels compared to Western populations.” This statement builds on previous research on abdominal fat in Asian bodies, but by this time, what was previously hypothetical becomes an important consideration in the interpretation of new research.
The body fat reasoning to explain higher Asian susceptibility to type 2 diabetes would later be supplemented by another finding based on the “Assessing Progression to Type 2 Diabetes” study (henceforth APT-2D). Headlined “Asians may be more prone to diabetes due to reduced ability to produce enough insulin,” the APT-2D press release clarifies the disease etiology, describing a biological mechanism unique to Asians (Choo 2017). The study, jointly funded by the Singapore Ministry of Health and Janssen Pharmaceuticals, found that for Europeans, type 2 diabetes develops because of insulin resistance, a condition where the cells around the body are unable to efficiently respond to insulin and so they do not convert glucose into energy. The problem with Asian bodies, according to principal investigator Dr. Toh Sue-Ann, is that they do not produce enough insulin in response to a glucose load. This does not invalidate the abdominal fat or BMI argument, in fact complements it: where insulin resistance for Europeans is positively correlated with obesity (which justifies the use of BMI as a risk factor for diabetes), a deficiency in insulin secretion can happen at lower levels of obesity, which is why abdominal fat would be a more accurate risk indicator for Asians.
Asian difference is constructed through several narratives. The discovery of factors and mechanisms that explain the disease prevalence in Asian populations opened up discussions on how Asians can better manage their lifestyles to keep diabetes at bay. Diet—more specifically the consumption of rice—was thrust to the center of the debate on diabetes prevention and management: Dr. Ling said that for the same amount of carbohydrates consumed, the glucose response in the blood of Asians could be as high as double that of Caucasians…. Dr. Ling said people here are consuming about the correct proportion of carbohydrates, which make up 52 per cent of the food they eat. The problem is that instead of taking rice and wheat in their natural form, most consume refined carbohydrates. (Khalik 2016a) Dr. Zee is armed with data…. One, it showed each plate of white rice eaten in a day—on a regular basis—raises the risk of diabetes by 11 per cent in the overall population. Two, it showed that while Asians, like the Chinese, had four servings a day of cooked rice, Americans and Australians ate just five a week. (Khalik 2016a)
Asian body fat and Asian diet are two narratives that solidify the perception of Asian difference in media discourse, spoken by experts and medical scientific research. The category of Asian becomes “racialized” (Omi and Winant 2014) in a way that renders Asians as biologically and culturally distinct from European, Caucasian, or Western populations. Crucially, Asian diabetes is constructed as a relatively novel research area with emerging knowledge and the promise of opportunity. The discourse conveys the existence of an advanced biomedical sector populated by experts, a situation that affords Singapore considerable comparative advantage in its noble quest to tackle Asian diabetes.
Asian difference is emphasized through a specific condition—type 2 diabetes—which strengthens the association between susceptible Asian bodies and a chronic condition. Even if the biocapitalistic implications of a chronic disease (see Hatch 2016) do not appear explicitly in the news stories discussed here, 9 the notion of a continental population being inherently more susceptible to T2D suggests enormous market potential for Singapore. Taken together, the construction of Asian difference regarding diabetes and how it has been communicated in Singapore news media between 2010 and 2019 serve the nation’s biocapitalistic aspirations and commitments through the promise of biovalue.
Janus-faced Inclusion: Which Asian Bodies Are Biovaluable?
We have seen Asian difference rendered biovaluable in the media discourse in the 2010s. But what exactly is meant by Asia? Who counts as Asian? Which Asian bodies are rendered biovaluable? The question of who gets represented in the imagination of “Asia” is not an entirely new one. The very idea of Asia, often in contrast to “the West,” obfuscates complex internal geopolitical and power dynamics that intersects with nationalism (Abraham 2006), imperialism (Sun 2016; Liu 2017) or even “reverse orientalism” (Hill 2000). I argue that beyond the model of Singapore as a microcosm of Asia explored elsewhere (Ong 2015, 2016), Asia is projected in Singaporean media discourse in a distorted way that can sometimes exclude ethnoracial minorities. This pattern of inconsistency captures a national science project inflected with the tension of competing forces—ethnoracial politics, global biocapital aspirations, and regional geopolitical histories. 10
The term Asian was popularized in Singapore (and a few other countries in the East and Southeast Asian region) as part of an Asian Values discourse of the 1980s and 1990s to explain the unique cultural characteristics that drove the phenomenal economic success of the Asian Tigers. The Asian in Asian Values may seem to imply a generously inclusive category that is “ethnically ambiguous” (Chong 2002), yet the ideology was framed by the Singapore government as deriving from Confucian ideals that include “hard work, emphasis on education, pragmatism, self-discipline, familial orientation, and ‘collectivism’” (Chua 1999, 573). Unsurprisingly, the adoption of a Sino-centric ideology as national ethic led to considerable discomfort among minority ethnic groups in Singapore (Chong 2002).
Barr (2000) argues that this Sino-centric orientation of the Asian Values discourse is deeply rooted in the worldview of Lee Kuan Yew, a key figure in Singapore’s historical and political landscapes. Barr (1999) also points to Lee’s view of Chinese genetic and cultural superiority, which has shaped policy and racial politics in Singapore. Among other things, it has led to continued population policy that maintains a Chinese ethnic majority through selective immigration (Barr 1999; Frost 2021) and even eugenics (Palen 1986; Barr 1999). Moreover, the Singapore government has also attempted to establish closer cultural historical connections to China, going as far as sponsoring a revised historiography (Tan 2003, 765), claiming that Chinese revolutionary Dr. Sun Yat Sen provided the “energy” for Singapore’s anti-colonial nationalist movement (Yeo in Tan 2003, 766). This contrived attempt at rebranding Singapore vis-à-vis China is part of a strategic attempt to secure relationship with a rising power in the region (Tan 2003).
This contextual information helps demonstrate how hypermodern technoscientific discourses that seek to generate biovalue from Asian difference are shaped by geopolitical currents. This results in a projection of Asia that is distorted and exclusionary, despite the message of inclusion tied to the broader Asian Diabetes program and Singaporean institutions’ strong multicultural orientation.
I start by describing the different ways in which Singapore is constructed as Asian in media discourse within the corpus of diabetes-related news articles in my sample before scrutinizing what Asia means in this context. The connection between Singapore and Asia is enacted in two distinct ways. The first is rather innocuous. In scientific communication about a new research initiative, Singapore is presented as being part of an Asian whole: The National Heart Centre Singapore (NHCS) will lead 10 Asian countries, as well as Taiwan and Hong Kong, in this collaboration with the American College of Cardiology (ACC) to share data…. Aside from Singapore, Asian data will come from China, India, Indonesia, Hong Kong, Malaysia, the Philippines, Sri Lanka, South Korea, Taiwan, Thailand and Vietnam. (Khalik 2015) Chinese people who are overweight, for instance, have a dramatically higher chance of developing diabetes and heart disease than Malays and Indians. Indians and Malays, though at higher risk of diabetes and heart disease, possibly for genetic reasons, appear better able to resist the detrimental effects of weight gain. Being Asian alone is considered a risk factor for diabetes. (Chang 2011)
This equivalence surfaces in other reports, reinforcing the relationship between Singapore’s multiethnic population and Asia. However, in some cases, the equivalency is enacted in a way that does not completely represent Singapore’s ethnic diversity. In a study led by a Professor Koh Woon Puay from the National University of Singapore, researchers found that Asians who shifted to eating Western-style fast food instead of traditional Asian diets are at higher risk of dying from heart disease and diabetes: The study, which specifically tracked Chinese-Singaporeans, found eating Western fast food more than four times a week can increase the risk of dying from heart disease by up to 80 per cent. It also found that those who go for fast food more than twice a week are 30 per cent more likely to develop type 2 diabetes…. The joint study—by researchers from the National University of Singapore (NUS) Saw Swee Hock School of Public Health and the University of Minnesota—is the first of its kind that looks at the impact of fast food on Asians. (Pang 2012) When we think about long-term complications of diabetes, osteoporosis is not one that immediately comes to mind. But researchers at the National University of Singapore (NUS) have found that Asians with diabetes, like their Western counterparts, experience an increased risk of hip fracture…. The team investigated the association of the two conditions using the Singapore Chinese Health Study, a cohort study of more than 63,000 Chinese aged between 45 and 74 years. The study was established between 1993 and 1998, and participants were followed up for a duration of 12 years. (Tan 2010)
Although one might hope that such a narrow definition of Asian is limited to older research where inclusion and diversity in scientific research was less of a concern, Indians, Malays, and, to a lesser extent, Eurasians (who are often lumped under Others) are excluded from the Asian category as recently as 2017: To beat a disease, you need to first understand it. That is why a study by local researchers which uncovered why Asians might be more prone to developing Type 2 diabetes than their Western counterparts is a significant step forward for Singapore’s war against diabetes…. A study of 140 mostly Chinese participants found that Asians were more prone to this type of diabetes because they could not produce enough insulin, and not because they were insulin-resistant. (Boh 2017) Said Dr. Toh Sue-Anne, principal investigator of the study: “These early findings may suggest that Asians develop diabetes at much lower levels of obesity because they are unable to mount an appropriate insulin response to a glucose load. So it can potentially explain why we seem to see so much of diabetes even if we won’t look particularly obese or overweight.”…The five-year, ongoing study, launched in 2016, is called Assessing Progression to Type 2 Diabetes, or APT-2D. It is led by the National University Hospital (NUH) in collaboration with Janssen Pharmaceuticals, and has so far recruited close to 900 participants, most of whom are Chinese. (Boh 2017)
The same logic is appreciable in the news reports cited above, where ambiguous reporting of the sample affords the researchers and reporter a wider latitude to make claims about the applicability of the findings. The limitations of the research sample are glossed over, and assertions are made regarding a larger population of Asians than what the sample supports. It must be noted that the principal investigator in the APT-2D study expressed the need to diversify the sample to obtain results that can be applied to the broader Singaporean population. There could also have been logistical constraints that led to the limited diversity in the sample. Yet the critique about extending findings to Asians beyond Chinese (the more logical and accurate move given the sample constitution) still applies here. More importantly, the implications of this exclusion at the discursive level also need to be discussed.
In the news articles above, we see two ways in which the distortion of Asian representation is enacted. The first is through the outright exclusion of minority bodies in study samples. The second is through ambiguity in sample detail, albeit emphasizing connections with the Chinese ethnoracial group. In both cases, the results from the studies were problematically extended to Asians. How does this impact the discursive construction of “Asian” in the media? What do the silences in the articulations of “Asian” mean for our understanding of the broader Asian biovalue discourse? Where Ong (2015) asserts that the value of Singaporean biosciences lies in the projection of the country’s multiethnic population as representative of Asia, my own analysis of the media discourse reveals this process to be somewhat distorted because this extrapolation excludes minorities.
These examples of exclusion are not isolated. Of the 149 articles analyzed, 65 featured an association between Singapore and Asia, where Singapore is portrayed as representative of Asia, or as part of Asia. Of the sixty-five, about a quarter (sixteen articles) presented a distorted narrative of Singapore as Asian where ethnic minorities were totally excluded (twelve) or de-emphasized through ambiguous sample profiles (four). Again, the research and reporting were enacted in a sociopolitical context with strong multiethnic policy and history, so while a quarter may seem like a small proportion to the outsider, it certainly grates against well-established ethnoracial representational norms in Singapore.
In making this line of argument, I want to make clear that I do not regard ethnoracial inclusionary politics as a panacea to a perceived lack of representation in biomedical research or scientific reporting in the media. To do so would mean blindly accepting the use of ethnoracial categories in scientific practice, a point that has been extensively debated elsewhere (Fujimura, Duster, and Rajagopalan 2008; Fujimura and Rajagopalan 2011). Rather, by problematizing the construction of Asian-ness in media discourse, I want to draw attention to the inconsistencies within the broader biocapitalist project and the construction of biovalue. Ethnoracial categories, the idea of difference, and the inclusionary rhetoric are all emphasized in some instances but downplayed in others.
For instance, the construction of Asian biovalue in the media’s discourse repeatedly invokes the idea of inclusion, calling for what is essentially a recalibration of the biomedical research lens to attend to a public health threat faced by an underexamined population—Asians. This narrative is intertwined with Singapore’s biocapitalistic aspirations, as well as its multiethnic sociopolitical configuration as explained in the previous section. Yet constructions of Asian biovalue in the media do not correspond with these ideals, which exclude minority ethnic groups from certain articulations of Asian. Even though these instances of exclusion from research and scientific reporting may not be consciously enacted, they still have an impact on how Asian-ness is projected and perceived by the public.
Of Distorted and Differentiated Asian Biovalues
The silences in the construction of “Asian” discussed in the earlier sections does the symbolic work of excluding and de-emphasizing ethnic minorities. This is consistent with the political and cultural history of Singapore where, as noted earlier, the state led Asian Values programs beginning in the 1980s to reengineer Singaporean society into one that is culturally “Chinese” and has a shared history and affinity with China, thereby marginalizing ethnic minorities (Chong 2002; Tan 2003). At the material level, the exclusion of ethnic minority bodies in the framing of Asia can also be said to reflect the state’s economic priorities. After all, China remains Singapore’s number one trading partner and is undisputedly the largest market in all of Asia (China Market Profile: Enterprise Singapore). In fact, recently Singapore, expanded its scientific and economic relationship with China by establishing the Sino-Singapore Biotech Hub in China, the first of its kind for Singapore (Sino-Singapore Biotech Hub Opens Gateway of Biomed Technology 2019; “Official Launch of Sino-Singapore Biotech Hub in Lushunkou, Dalian” 2019). The initiative involves Singapore biotech company Biosyngen; the Singapore government; Singapore’s Agency of Science, Technology and Research (A*STAR); and Institute of Molecular Cell Biology (IMCB); and the biotech hub located in the city of Dalian is set to focus on the health-care and pharmaceutical industries.
The distortion in the construction of Asian biovalue should therefore be understood within these symbolic and material realities that connect Singapore’s biocapitalistic goals with its historical and aspirational relationship with China. It becomes fairly clear that the exclusion of certain groups from ideas of what is Asian points to the privileging of certain relationships and aspirations in Singapore society. Beyond the Singapore-as-Asia narrative, the distortion of Asian biovalue also implies value differentiation in the national body politic. Studies have documented national populations being commodified and marketed by their governments as intrinsically valuable for bioscientific research, be it through promoting a population diversity model in Singapore (Ong 2015) or by underlining the potential advantages of “population isolates” with reduced genetic variability that supposedly led to identifying disease-causing genes more easily (Tarkkala and Tupasela 2018). The growth of biobanking alongside advances in whole genome sequencing has helped tremendously in these efforts to reimagine populations as a source of untapped value.
In this context, populations can be understood as a resource that can be strategically aligned to the demands of biocapital in order to carve out an advantage within an increasingly competitive global bioeconomic landscape. What was missed in prior analyses of value creation in populations was the further fragmenting of populations to create differentiated value. If we think about the media’s construction of biovalue as an instance of promissory “use value” creation (Waldby 2009, 310), then the distortion of Asian biovalue implies a corresponding perception of value differentiation where minority bodies deemed to have lesser “use value” can be de-emphasized in the discursive space. In several instances, the high prevalence of diabetes among Indians and Malays in Singapore was construed as a burden on the national health-care system and the national economy—a notable departure from the technoscientific and affective framings of “Asian” diabetes surveyed in this study. This was made especially clear in an article discussing the impact of diabetes on specific ethnic communities, where a diabetologist and endocrinologist expressed that: A higher prevalence of diabetes in these ethnic groups translate to a heavier healthcare burden for individuals, families, the community and the nation, he added…. “It is not just a healthcare burden of coping and living with diabetes and struggling to manage it by changing ingrained lifestyle practices, but also the socio-economic impact of complications when they arise,” he said. (Abu Baker 2017)
Yet, when considering differentiated Asian biovalue through the lens of biocapital, the co-occurrences of inclusion and exclusion, and the inconsistencies it gives rise to, it is almost normal, given that biocapitalism (much like capitalism) is borne out of contradictions from which it seeks to escape (Rajan 2006, 59). This duality of inclusion and exclusion is discussed by Benjamin (2009, 350) in a study about a similar national science initiative in Mexico, which sought to market the “Mexican Genome brand” to the global bioscientific community. The Mexican biovalue initiative relied on both the participation and erasure of indigenous populations to create an authentic narrative of admixture, which ironically strengthens the “mestizo” (ethnoracially mixed citizen subject) identity in the national discourse at the expense of indigenous identity. Ironically, such inconsistencies seem to be a consistent feature of hypermodern biocapitalist endeavors.
Conclusion
This article investigates how Asian-ness is constructed in relation to Singapore, and how the relation is rendered biovaluable in the media. By analyzing Asian diabetes in public-facing discourse, this study builds on existing ethnographic work that features the voices of medical and scientific experts on the topic of Asian identity in biomedicine. The construction of biovalue in the media’s discourse is different from how scientists construct biovalue in ethnographic accounts, and this divergence sheds light on broader science policy processes. Particularly, this approach allows us to understand how governments build science policy legitimacy through public-facing discourse. Singapore is an especially pertinent case because of the ample funding that the government has provided for biosciences in the past decade. The choice to study diabetes is not just because of its visibility in the national public imagination: it is worth investigating diabetes in Singapore because it is a public health matter that converges with state biocapitalist aspirations.
My study concludes that presentations of biovalue in the media still hinge on the connection between the Singapore population and the rest of Asia, while incorporating emotional appeals to Asian inclusivity. The portrayal of Asian diabetes as having different biological and cultural foundations than Western diabetes lends urgency to this broad inclusionary imperative. Tethered to this narrative is the construction of Singapore’s potential as a leader in Asian diabetes research, owing to its twin comparative advantages—the presence and prevalence of diabetes in its multicultural population, and a very well-established bioscientific sector. Lastly, Asian difference solidifies the imaginary of scalable diabetes treatment and management solution that goes beyond just diabetics in Singapore, signaling larger potential returns to the government’s investment in the bioscientific sector.
However, the construction of biovalue in Singaporean media discourse is different from prior ethnographic accounts. My analysis concludes that rather than being inclusionary and multiethnic as highlighted in existing scholarship, the connection between Singapore and Asia is enacted in a way that at times de-emphasizes the minority ethnic populations, thereby distorting representation. This despite the nation’s vaunted multiethnic policies, as well as the inclusionary imperative on which the construction of Asian diabetes is predicated upon. This is a glaring inconsistency within the broader biocapitalist project. Crucially, this distorted picture of Asian-ness engenders differentiated perceptions of value within Singapore’s multiethnic population; rather than being a singular Asian biovalue constructed in the media discourse, there are in fact Asian biovalues. Lastly, I argue that this inconsistency may well be a consistent and even normal feature of biocapitalist endeavors.
The construction of knowledge in the media discourse remains an important tool for scientific governance and legitimacy-building in Singapore. As I have argued, ethnoracial politics, biocapital, and geopolitical conditions continue to shape public-facing medico-scientific discourse. Yet one wonders whether the inconsistent portrayals of “Asian” in the construction of Asian biovalue would invite greater public scrutiny, especially given the emergent conversations on racial privilege—defined as “unearned assets cash[ed] in” by members of the dominant racial group at the everyday level (McIntosh 2018)—in Singapore society (Tang 2021). Part of racial privilege entails never having to worry about being excluded in public life, which as this paper demonstrates, is not necessarily the case for ethnic minorities in the construction of Asian biovalues in Singapore. It remains to be seen whether Asian diabetes and other state-led science projects also become entangled with similar vocabularies and generate new visions of biocapital. This is certainly a space worth watching.
Footnotes
Acknowledgments
I am indebted to Daniel Navon, John Evans, Shirley Sun, and Hallam Stevens who helped sharpen the framing of the paper and refine the arguments. I am additionally grateful to the anonymous reviewers and the journal editorial team for their comments and patience. Thank-you also to Yusri Supiyan, Isabel Chew, Nursyazwani Jamaludin, Shamil Zainuddin, Chuncheng Liu and Carolina Mayes for their emotional and intellectual guidance throughout the life of the paper.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: University of California San Diego Global Health Institute and University of California Institute for Practical Ethics.
