OPENING ADDRESS BY ASSOCIATE PROFESSOR KENNETH MAK, DIRECTOR OF MEDICAL SERVICES, AT THE PRECISION PUBLIC HEALTH ASIA 2021 CONFERENCE

Distinguished guests,

Ladies and gentlemen,

1.      Good morning from Singapore. It is my pleasure to join you today at the Precision Public Health Asia Conference.

2.      With advances in technology and research, we have a growing capability to use diagnostic tests which better identify individuals with a higher risk for developing chronic diseases and to stratify them based on their risk of developing complications. Our treatment capabilities have also expanded to allow greater precision in designing individualised treatrment plans, to optimise clinical outcomes. We need an overarching strategy to guide how this knowledge and use of new therapies can be appropriately utilised for our population. Public health policy has become the vehicle for us to develop these strategies and implement them in our delivery of healthcare services. Precision public health is an amalgamation of medicine, precision medicine and public health. To quote Muin J Khoury (Director, Office of Public Health Genomics, CDC, US), precision public health is about “bringing the right interventions at the right time, every time, to the right populations”.

3.      Data plays a crucial role in harnessing the potential of precision public health. Data on population-level health indicators allows policy makers to formulate more targeted measures and campaigns to address the health needs of their citizenry. There are many programmes and initiatives implemented globally that utilise precision public health. They share in common the aim of improving population health, promoting a better quality of life, changing lifestyle practices, and potentially bringing about lower healthcare expenditure. I understand that conference delegates will be discussing various case studies over the next few days to better understand the potential of precision public health initiatives. This morning, I would like to share three examples of how precision public health is being applied in Singapore to benefit Singaporeans and residents.

Application of PPH in Public Health Campaigns

4.      Advances in precision public health capabilities have allowed the Ministry of Health here in Singapore to better utilise the increasing volume of data we have collected over the years. When formulating public health campaigns, Singapore leverages on technology and uses data to encourage Singaporeans to lead active and healthier lifestyles. For example, we have the National Steps Challenge^TM that aims to promote a healthier lifestyle among Singapore citizens and residents. It was first launched by the Health Promotion Board in 2015, it leverages behavioural insights and technology to motivate participants to improve and incorporate physical activity as part of their daily life. It also tailors rewards for sustained behavioural change when users reach different physical activity milestones.

Application of PPH in Chronic Disease Management

5.      A second application of precision public health is in chronic disease management. Digital biomarkers and other digital metrics can be collected in real time, combined with genomic data and traditional physiological and demographic information and collectively, these data then enable more accurate risk assessment and early interventions. An example is Familial Hypercholesterolaemia, an inherited condition that leads to higher rates of heart attack and vascular disease in affected people when they are young. his is one of several priority diseases that our National Precision Medicine Research strategy is targeting, as early identification and treatment of such individuals, and their affected family members, is cost-effective in preventing severe disease as well as decreasing morbidity and mortality.

Application of PPH to tackle COVID-19 Pandemic

6.      A third application of precision public health is in Singapore’s fight against COVID-19. In Singapore, precision public health has been applied in the use of precision technology and IT solutions across a continuum of measures taken to prevent and control the disease. Let me provide three further examples:

a. First, in preventing spread through importation, the use of wearable devices has allowed incoming travelers to serve their on-arrival quarantine outside of dedicated facilities, while maintaining a high degree of compliance. This has reduced the need for dedicated resources, and facilitated travelers self-isolating in their own homes, while simultaneously maintaining the public health imperative of having incoming travellers quarantined for the required period.

b. Second, in the contact tracing of individuals possibly exposed to COVID-19, the use of applications such as SafeEntry and TraceTogether has provided definitive exposure history to investigation teams. This has facilitated the accurate and tailored public health assessment for quarantine of affected individuals, and outbreak management.

c. Third, in epidemiological investigations, the use of whole-genome sequencing on COVID-19 positive cases has enhanced epidemiological investigation capability in determining transmission patterns and this has allowed the prompt roll-out of subsequent public health measures that are targeted to the situation at hand.

Maintaining public trust with the use of PPH

7.      While precision public health has immense benefits, the greater use of personal data and data analytics requires that we exercise greater responsibility and accountability in order to maintain public trust. In this regard, data privacy and cybersecurity are important governance issues that must be addressed. The Ministry of Health is developing a common set of Information and Communication Technology (ICT) policies and standards, known as the Health Technology Instruction Manual for public healthcare. This common policy set draws from the government’s own ICT management policies as a base, and can be adapted for use in different healthcare settings based on the needs of public healthcare providers. This allows for information technology to be used consistently in a manner which is both effective and secure.

Closing 

8.      Overall, the relevance of precision public health has never been greater. Today, we find ourselves in the midst of a global pandemic, confronted by a growing myriad of diseases and ailments that threaten to afflict populations, in developing and developed countries alike. The use of precision public health allows us to collaborate further across countries, specialties and disciplines – to share best practices, information and resources. This conference is one such opportunity for us to have more of these collaborative conversations.

9.      To conclude, Singapore is honoured to host the Precision Public Health Asia Conference this year. We aspire to work together with the local and international community to be at the forefront of novel and emergent technologies and to provide Singaporeans with the benefits that these technologies can bring. It is my hope that this conference will facilitate the pursuit of these agendas in a meaningful, fruitful and lasting way.
 
10.      Thank you.