Speech by Dr Lam Pin Min, Senior Minister of State for Health at the Singapore International Infectious Diseases Conference

Prof Leo Yee Sin
Chairman of the Singapore International Infectious Disease Conference Organising Committee

Prof Ooi Eng Eong
Co-Chairman of the Singapore International Infectious Disease Conference Organising Committee

Distinguished Guests

Ladies and Gentlemen

           A very good morning to everyone. It is a pleasure for me to join all of you at this landmark infectious diseases conference which brings together clinicians, scientists and public health experts from the region and beyond. The meeting theme, “Changing Paradigms in Infectious Diseases”, is timely, as the infectious disease field is constantly evolving. We must keep abreast of new developments, and improve and adapt our programmes and technologies in response to the changing circumstances so that we remain vigilant and prepared against emerging infectious threats.

2        Although the needs of our population in Singapore have shifted toward more chronic diseases, the threat of infectious diseases remains very real and we cannot forget the lessons from SARS and influenza A(H1N1 2009) in Singapore. Collaborative, multi-disciplinary research is critical to develop evidence-based measures to fight these diseases.

Need for robust surveillance systems and diagnostic capabilities

3        Given the ease of global travel and Singapore’s status as a travel hub, we are susceptible to emerging infectious diseases. It is no longer a matter of if but rather when infectious diseases affecting the global community will reach our shores. As such, strong surveillance, evidence based treatment, and state-of-the-art laboratory and diagnostic capabilities are fundamental to identifying, managing and controlling the spread of infectious diseases.

4        The Ministry of Health (MOH) has been providing strong support for infectious disease research over the years. One example is the outbreak control modelling study by Tan Tock Seng Hospital (TTSH) and the Communicable Diseases Centre, which helped clinicians translate lessons learnt from the historical SARS and influenza outbreaks into future contingency plans for outbreak containment. The team then applied the models to answer key questions in the surveillance, control and management of hospital resources needed for dealing with respiratory pathogens, in particular for pandemic and non-pandemic influenza.

5        MOH has also supported the National University Health System (NUHS) to pioneer a new line of immunological intervention against tuberculosis (TB). This therapy is among one of the first in the world. The team has joined efforts with the industry to conduct further clinical trials aimed at shortening the treatment for drug-sensitive TB and improving the prognosis for multiple drug-resistant TB.

6        Translational research is also fundamental in bringing research findings into clinical practice. One such example is TTSH’s research into dengue admission protocols to enable mild cases to be managed in the community, while identifying high-risk patients for admission. The findings from the evidence-based research were initially implemented in TTSH, then used to guide national policy and has led to substantial reductions in the need for dengue admissions.

7        Apart from research laboratories, MOH’s National Public Health Laboratory (NPHL) provides microbiological expertise in testing for new and difficult to diagnose infective agents.  It works with clinical laboratories and research institutions to prepare and respond to future outbreaks. For example, before the zika outbreak in Singapore last year, NPHL had developed testing capability for zika virus infection and worked with some of our public hospital laboratories on this. As such, our public hospital laboratories were well-equipped to scale up testing for zika when it arrived on our shores.

Role of physicians in tackling emerging infectious diseases

8        While systems and technology can enhance our preparedness and response to infectious diseases, the key factor are the people who form the core of our healthcare community. Physicians play an essential role not only in providing clinical care, but they are also our first line of defence in alerting the public health authorities and wider community of any outbreaks. Astute physicians with a keen sense of what is happening on the ground will be alert to signs and symptoms of an emerging infectious disease among their patients. Prompt notification to MOH will enable rapid response for outbreak prevention and disease control.

9        We have witnessed how prompt notifications by doctors have helped to enhance our responses to diseases - such as SARS in 2003, and more recently, the zika outbreak in Singapore. Last year, three family physicians at their clinic noticed an unusual cluster of cases with fever, joint pain, rashes and sore eyes, and alerted MOH. Their actions led to the identification of the first locally transmitted case and the first local cluster of the zika virus infection in Singapore, which resulted in a coordinated response by various agencies in the management of this outbreak.

10      Such two-way communication between public health authorities, physicians and other healthcare workers is crucial in initiating and facilitating the necessary response measures in a speedy and efficient manner.

Multi-disciplinary approach key to address emerging infectious diseases

11      Our public healthcare system is growing increasingly complex over the years, and with the constant evolution of infectious diseases, there is a need for a more comprehensive and multi-disciplinary effort beyond ID physicians and throughout the healthcare system, to enable us to respond and adapt to these rapid developments expediently.

12      For instance, the reported association between microcephaly in babies born to women who were infected with the zika virus during pregnancy prompted MOH to form a clinical advisory group (CAG) on zika and pregnancy. This CAG is made up of experts not only from infectious diseases, but included experts from obstetrics and gynaecology, paediatrics, as well as laboratory medicine. The CAG reviewed and provided expert advice on the clinical management of pregnant women diagnosed with zika, and this led to the establishment of a national surveillance programme to track the development of babies born to pregnant women diagnosed with zika with colleagues from O&G and paediatrics. This multi-disciplinary support and coordination across disciplines enabled us to provide a more holistic and comprehensive approach to the care and monitoring of these individuals. 

Conclusion

13      By building capabilities and strengthening our partnerships, we can develop better coordination and support in the control of infectious diseases, so as to reduce the burden on our public healthcare system. This conference is an excellent platform for us to gain new insights on the latest developments in our fight against infectious diseases. I look forward to your continued support as we work together to strengthen Singapore’s capabilities to manage the disease burden and maintain a high level of responsiveness to outbreaks of emerging infectious diseases.

14      On that note, I wish everyone a fruitful conference. Thank you.