Speech by Director of Medical Services, Professor K. Satku at the 12th Western Pacific Congress on Chemotherapy and Infectious Diseases

02 Dec 2010

By Director of Medical Services, Professor K. Satku

Venue: 12th Western Pacific Congress on Chemotherapy and Infectious Diseases

It gives me great pleasure to join you at the opening of the 12th Western Pacific Congress on Chemotherapy and Infectious Diseases. 

Let me begin by extending a warm welcome to all, and a special welcome to our overseas delegates and speakers.

The theme for this Congress “New Pathogens, New Challenges” is a perennial issue as new microbes will always be emerging, and existing microbes will never stop mutating. In recent times, we have experienced the Nipah virus outbreak of 1999, the SARS outbreak of 2003, and as recently as 2009, the global Influenza A pandemic. We have also been subject to challenges posed by mutations of existing  pathogens such as Vancomycin Resistant Enterococci, NDM1 strain of enterococci and MDR and XDR TB.

Whether it is a high impact acute infection characterised by an outbreak or an infection characterised by a new strain of a prevalent microorganism, the emerging new pathogens have often created considerable human suffering.

The ID community, comprising Infectious Disease Physicians, Microbiologists and Public Health Specialists, has played a significant role in safeguarding global health security.

As the Director of Medical Services my responsibilities include the health security of the population. Without your excellent work and contributions I would have had great difficulty protecting the health of our people.

I believe I echo the sentiments of many healthcare administrators across the globe. Let me place on record our deep appreciation for your contributions. From my perspective, as an administrator, I recognise four domains where your contributions were vital and have made a difference. Let me elaborate.

First in the domain of informed public health policies; Your deep understanding of the epidemiology of the various infectious diseases informs public health policy. Policy makers rely on your knowledge and your advice on which measures will make a real difference and which will not.

For  example in the area of pandemic preparedness governments rely on the ID community’s advice on whether and what to stockpile with regards to vaccines and antimicrobials, which areas of healthcare services to beef up, whether and how we should implement containment measures when we should move from containment to mitigation and whether we should close schools. The quality and timeliness of these advices is vital as decisions that are made have significant impact not only on the healthcare sector but the rest of society. Singapore benefited from our informed pandemic preparedness during the H1N1 pandemic last year. Another example of current concern is in the area of zoonoses in particular avian influenza. The ID community correctly and very early on diagnosed the root of the problem as poor agricultural and wet market practices.

So unless governments and local authorities put in place robust policies and programmes to ensure good agricultural and wet market practices, the public health threat of zoonotic infections leading to new epidemics and pandemics will remain significant.

A third example is in the area of emergence of antibiotic-resistant pathogens. This is a complex problem that requires long-term solutions and not quick-fixes. Thus the policy of antibiotic stewardship in medical practice that you helped to shape and lead is necessary to contain this problem.

The second domain is the development of dynamic surveillance systems. I am impressed by the way the ID community continues to develop their surveillance systems so that we stay ahead of the pathogens.

After the SARS outbreak of 2003, a plethora of horizon scanning systems was developed in many countries around the world. Dedicated teams trawl through these huge amounts of news reports and data every day to identify public health threats as early as possible.

Complementing these horizon scanning teams are risk assessment teams which rapidly assess threats and inform decision makers so that quick responses can be implemented if necessary.

Recently, there was some excitement about the spread of NDM-1 resistance around the world. In Singapore and elsewhere, as the ID community had systematically stored clinical samples from patients with carbapenem resistance, we were quickly able to ascertain whether  the resistance had already appeared within our borders and estimate the extent of the problem.

The next domain you have excelled in is in your ability to apply the advances in science and technology to aid clinical diagnosis and surveillance. You have made good use of molecular methods like PCR to enable definitive diagnosis of specific infectious diseases.

During the SARS outbreak of 2003,  PCR played a pivotal role in identifying cases early so that health care resources could be maximized. Otherwise, we would have had to isolate many suspect cases unnecessarily.

PCR diagnostic methods also played a vital role in the early stages of the H1N1 pandemic last year in Singapore and around the world. In Singapore, due to the early availability of pandemic H1N1 primers, we were able to track when H1N1 appeared within our borders, and how it subsequently spread within Singapore.

We were able to screen large numbers of people with influenza-like illness and isolate only actual cases. PCR testing of samples of cases with influenza-like illness enabled us to track the rise of H1N1 in the community.

This was necessary information to help us decide on when to move from containment to mitigation and on policies on the use of antivirals among other issues.

And the final domain where you have excelled in is in effective networking. Effective networking saw the unprecedented identification of the causative agent in SARS, its complete DNA sequenced and PCR primers available in less than a month. This contributed in no small measure to the containment of the SARS epidemic.

During the recent H1N1 pandemic influenza my colleagues were able to obtain information on the outbreak in Mexico, 3 days before WHO made the official announcement. This gave us ample time to prepare.

On that note I urge you to keep in touch and keep connected.

We do not know when the next new acute, high impact infectious disease will emerge. But we are comforted that the ID community will strive to make it safer for us. Without your support and collaboration we would not have been able to respond to the recent pandemic or the past outbreaks so quickly and efficiently.

Let me wish everyone a productive congress.  Thank you.

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