OPENING ADDRESS BY MR CHAN HENG KEE, PERMANENT SECRETARY, MINISTRY OF HEALTH, AT THE OPENING CEREMONY OF THE 14TH PUBLIC HEALTH AND OCCUPATIONAL MEDICINE CONFERENCE

Dr S R E Sayampanathan, Master, Academy of Medicine Singapore

A/Prof Vernon Lee, President, College of Public Health and Occupational Physicians

Dr Kyle Tan, Organising Committee Chairman

Distinguished guests

Ladies and gentlemen

        A very good morning.  I am delighted to join you at this 14^th Singapore Public Health and Occupational Medicine Conference.

2.        Broadly speaking, there are five key determinants that affect our health:
            •     Genetic makeup, which we inherit
            •     Physical environment, at where we live, work, study and play
            •     Lifestyle, the way we live
            •     Socio-economic conditions
            •     Disease prevention and healthcare services

3.        The work of public health professionals contribute to three of these determinants – bringing about a safe and hygienic environment; encouraging and supporting healthy lifestyle choices and driving disease prevention efforts. Whenever I meet foreign visitors who commend Singapore on our healthcare system and outcomes, I make it a point to emphasise that much of our achievements are due to our good work in public health.

4.      Today, Singaporeans enjoy high standards in water and food safety, air quality, sanitation, housing and other aspects of the physical environment. We have a good communicable disease surveillance and management system. Coverage of recommended vaccinations against childhood diseases is high. We are doing a lot more to encourage and support Singaporeans to engage in healthier eating, active lifestyles and timely disease screening.

5.        While we have come a long way in public health, we must however bear in mind that public health is a dynamic field that is constantly evolving. There are fresh risks that we have to watch out for, such as the threat of new and re-emergent infectious diseases. At the same time, there are also new opportunities, such as those brought about by technology and big data, that can lift us to whole new levels. Let me speak a little on both.

Threat of New and Re-emergent Infectious Diseases

6.     First, the threat of new and re-emergent infectious diseases.With increased movements of people and goods, and our status as a trade and travel hub, Singapore is vulnerable to the threat of importation of infectious diseases. The recent case of Monkeypox imported from Nigeria is a stark reminder of the real and imminent threat of emerging infectious diseases. Fortunately, the vigilance of our healthcare workers on the ground, together with timely incident response measures, prevented further spread in our community.

7.       In April last year, the World Health Organization (WHO) conducted a Joint External Evaluation (JEE) on us, and commented that Singapore demonstrated strong leadership and a highly developed capacity to detect and respond to potential public health emergencies. We must continue to ensure that we have an effective and coordinated national plan and response against existing and new disease threats and other public health emergencies.

8.         Globally, there has also been a re-emergence of infectious diseases long thought to be under control. Many countries, for example, are experiencing new measles outbreaks. Regionally, there has been an upward trend in dengue cases, including in Singapore.  Despite sustained vector control efforts, dengue outbreaks like the one this year do occur periodically. We are therefore exploring new tools and technologies to improve dengue control such as the use of Wolbachia-carrying male Aedes mosquitoes to suppress the mosquito population.

9.      We must therefore remain vigilant and continually improve our measures to prevent the importation and the spread of infectious diseases, both new and re-emerging ones. There is no room for complacency.

10.       On our part, MOH will continue to strengthen Singapore’s capability and capacity to prevent and respond to new public health issues. Just last month for example, we officially opened the National Centre for Infectious Diseases (NCID). NCID is a purpose-built facility equipped with a comprehensive suite of facilities benchmarked to international standards for research, testing, treatment and management of infectious diseases.

Opportunity Offered by Technology and Big Data

11.     On the flipside, rapid developments in fields such as big data, AI and smart wearables offer new opportunities to advance our work in public health. There is immense potential to make use of these enablers to help predict disease outbreak, strengthen vector control and personalise health promotion and disease screening.

12.     I am told for example that Ping An Technology, a tech company in China, has helped healthcare authorities in Chongqing and Shenzhen to predict influenza outbreaks with accuracy rates of over 90 percent. Ping An’s prediction models combine and analyse data from hospitals, regional health authorities and environmental samples. The predictions are circulated to city authorities to take prompt actions to prevent outbreaks from happening or spreading. Locally, researchers from the Saw Swee Hock School of Public Health and NEA had developed an algorithm to forecast dengue outbreak up to 4 months in advance.Such forecasts facilitate early interventions such as targeted vector control measures.

13.        In health promotion, we are seeing a rise in the use of smart wearables.Many of these wearables enable us to monitor our personal health, physical activity, food intake and sleep patterns. Some provide customised advice, alerts and behavioural nudges to get us to engage in health seeking and enhancing behaviours.

14.      Locally, the Health Promotion Board (HPB) has been using mobile apps and smart wearables in its work.The number of sign-ups in HPB’s National Steps Challenge has grown steadily. In 2018, the Challenge garnered more than 800,000 sign-ups, five times of that in 2015. HPB has also embarked on Health Insights Singapore, a population health study to gather novel insights into the lifestyle behaviours of Singaporeans with the use of wearable technology. This study presents many possibilities for designing individually tailored solution to support healthy lifestyles.

15.       In the medical world, the concept of “precision medicine”, or the customisation of a patient’s treatment according to one’s genes, clinical test results and diagnosis and environment, is generating much excitement.Precision medicine rests on the ability to collect, synthesise and make sense of large amounts of data. I hope that not too far from now, the concept of “Precision Public Health” would reach similar levels of interest, research and experimentation in the various domains in public health.

Closing

16.     Ladies and Gentlemen, the work of public health professionals is important and wide ranging.Your roles include infectious disease surveillance, outbreak prevention and management, vaccination and disease screening, and health promotion.Your responsibilities encompass creating safe and hygienic environments in where Singaporeans live, work, study and play, setting policies and regulations, and carrying out research and public education.

17.      A large part of the progress and achievement in Singapore’s healthcare system and health outcomes is due to your good work. Let me register our appreciation for your contribution to public health in Singapore and the health of Singaporeans, whatever specific role you play.

18.      We are counting on you to continue to safeguard our public health system, by responding effectively to new threats and capitalising on new opportunities on the horizon. On that note, I wish you a rewarding conference. Thank you.