No Child Shall Die in the Dawn of Life

04 Mar 2009

By Khaw Boon Wan

1. The global recession is wreaking havoc in all countries.  I worry particularly for the healthcare sector.  In 2000, global leaders pledged to achieve a set of eight Millennium Development Goals by 2015. Two of the goals pertain to the young: to achieve universal primary education and to reduce childhood mortality by two-thirds from the 1990 baseline. Progress has been patchy and the current global recession will further dim the prospects that the goals would be met. 

Small Is Easier

2. In Singapore, we have been luckier. Our children have universal access to primary education; our under-five children mortality rate (of 3 per 1000 live births) is among the lowest in the world. Last week, the World Health Organisation announced that the KK Hospital had won an UAE Health Foundation Prize for the outstanding quality of its perinatal team, contributing to very low rates of perinatal and maternal mortality in Singapore.  As a small city state, we face fewer constraints as compared to countries with a large rural sector.

Going Beyond Millennium Goals

3. So we are going beyond the Millennium Goals, striving to ensure that our children are among the healthiest in the world. Mortality data suggest that they are.  But we need more comprehensive wellness data to confirm it.  Unfortunately cross-border data on wellness are not as easily available as mortality data. 

4. Keeping our children healthy is a priority for my Ministry as prosperity and globalisation are creating new health risks for them. The chances of our youths being afflicted with obesity, sexually transmitted infections or type II diabetes are now higher. Harmful lifestyle habits among the young such as smoking, binge drinking, casual sex and addiction to computer games are on the rise. We must tackle these issues before they get out of hand. We cannot be satisfied with just having children surviving past their fifth year – we want to build a strong foundation of habits and behaviourial traits, so that they can continue to lead long and healthy lives.

5. We will put in more effort. We must learn new techniques to reach out to them in a way which is not off-putting. Top-down preaching will not work.  We are experimenting and have launched some peer-led initiatives to get our youths to motivate one another. We need to learn how to use the new media more effectively and to support many more ground-up ideas.  

Battle Against Cancer

6. For all our efforts on prevention and wellness, there will still be a small minority of children who will fall very sick with cancer.  Although we have made some progress, cancer remains a major killer in Singapore.  Fortunately, the success rates of many childhood cancers are improving rapidly, especially in recent years.  But we still have much to do and we will not allow the current economic recession to derail our efforts.

7. First, we continue to invest in medical research and development. We are committing $1.55 billion to support translational-clinical research. We have launched several flagship research programmes including in gastric cancer.  We are funding a Cancer Research Centre of Excellence at the National University Health System.

8. We intend Singapore to be a major player and contributor to the science and treatment of childhood cancer.  We think we have some advantages.  All the major pharmaceutical companies have a strong presence here in Singapore, including many biotech start-ups.  We have attracted many top scientists to continue their research here.  Our natural mixture of major racial groups, including a large number of foreign patients seeking treatment here, place us in a good position to contribute to the science of genomics and epi-genetics of cancer, especially when diagnosis and treatment get down to the molecular level.

9. Second, we will continue to invest in and grow global partnerships. Sharing information across borders helps to maximize outcomes.  We have a long history of such collaboration.  As an example, the Cancer Therapeutics Research Group, formed in 1997 between NUH and the Sydney Cancer Centre, has drawn in key players worldwide to jointly conduct clinical trials on new anti-cancer drugs specially catered to Asia-Pacific needs. They have established themselves as an important centre for early phase drug development.

10. We have been particularly fortunate to have Prof Pui Ching-Hon, Chair of Oncology at St. Jude Research Hospital, help us in this area.  St. Jude’s research and its commitment to sharing knowledge with the world through its International Outreach Programme is world renowned.   Prof Pui has helped cement the collaboration between St. Jude, Viva Foundation for Children with Cancer, NUS and NUH. And he continues to foster this relationship as the Chair of Viva’s External Advisory Board.  On behalf of Singapore, we thank Prof Pui deeply.

11. In turn, St Jude and Viva Foundation have accepted the responsibility to share their research findings with other doctors in this region, to raise the overall standards of care, and especially so in countries where cure rates for childhood cancers remain low.  Through these collaborations, leading clinicians in the field of childhood cancer have generously donated their materials and their time to come here to teach and share their ideas.

12. This annual St Jude-Viva Forum in Paediatric Oncology is one such platform for doctors and researchers from different parts of the world to share their findings and learn from one another. Our presence here today is a testimony to the hard work put in by Mrs Theresa Foo, Mrs Jennifer Yeo and their many wonderful volunteers at the Viva Foundation.  Since its inception, Viva has raised $24 million to establish the Viva-University Children’s Cancer centre and kick-start the Viva Children’s Cancer Programme.  You have helped many children survive their battle against cancer and live out their lives in full.  You are the angels to these children.

13. And we welcome more angels.  The Goh Foundation is the latest; it has joined the cause to help cure childhood cancer.  It has donated $12 million to NUS’ Yong Loo Lin School of Medicine, to establish a Professorship in Paediatric Oncology and four strategic research programmes on the treatment of childhood cancer. On behalf of NUS and the children for whom you toil, I thank the Goh Foundation for your generosity and support.  Your donation will be put to good use.

Remaking Healthcare

14. Ladies and Gentlemen, the global recession is a major discontinuity which will cause millions to suffer.  Nobody welcomes the crisis, but recognizing that it is a discontinuity will allow us to rethink our old model and remake it for a new post-crisis world.  In healthcare, there are particular opportunities for a transformation.  It cannot be business as usual.  Society cannot afford the current model of healthcare delivery whereby more and more expensive treatment become less and less accessible to the masses. This is particularly so in the case of cancer treatment.

15. President Obama has declared his intention to remake America and to re-mould its healthcare sector.  We look on with admiration for his ambition and we wish him success.  Over here in the Asia, we too should do our part to help our children to live longer and live better than their parents and grandparents, and to transform the healthcare sector to make it better and cheaper.  Let us help realize the hope of Mr Danny Thomas, the founder of St. Jude: “That no child shall die in the dawn of life”.

16. On this note, let me wish the 2009 St Jude-Viva Forum a great success.