Speech by Parliamentary Secretary for Health, Associate Professor Muhammad Faishal Ibrahim at the Singapore International Conference on Dengue and Emerging Infections, 21 November 2012

Professor Mary Ng, Chairperson of the Organising Committee

Professor Duane Gubler and Associate Professor Leo Yee Sin, Chairpersons of the Scientific Committee

Distinguished guests

Ladies and gentlemen

1. It gives me great pleasure to be here this morning to officiate the opening of the Singapore International Conference on Dengue and Emerging Infections.

2. This is the first international conference in Singapore that combines two major public health challenges, Dengue and Emerging Infectious Diseases. This reminds us that even as we tackle the potential threat of new diseases, we should not forget the ongoing threat posed by “old” diseases such as dengue.

Emerging Infectious Diseases (EIDs)

3. Emerging infectious diseases are now well recognised as significant threats not just to public health, but also to the economy and society as a whole. Singapore and several other countries experienced this in 2003 during the SARS outbreak. Flights and hotels were empty as tourists stayed away. Businesses, such as shops and restaurants, which depend on tourist spending also suffered. People lost their jobs as the economy took a down turn. Families were inconvenienced as schools experienced prolonged closures. We were more fortunate that 2009 influenza pandemic we experienced was mild. A severe pandemic would be devastating to any society. For us, the large number of cases would have required social distancing measures to prevent the spread of the virus. A pandemic not only interrupts peoples’ daily lives and threatens their livelihoods, but causes entire nations to lose their peace of mind.

4. It was in response to this unseen threat of emerging infectious diseases that the World Health Organization (WHO) revised the International Health Regulations in 2005 to combat emerging infectious diseases which are capable of spreading across the world in a matter of days. The Regulations came into force in 2007 and countries are now required to inform WHO of any public health event that may be of international concern. More importantly, the revised Regulations require all countries to develop and maintain certain core capacities to ensure that they have the ability to detect, assess and contain such public health threats. Countries were given five years till June 2012 to attain these core capacities. I am happy to note that the WHO has accepted Singapore’s report and that we have attained the required core capacities.

5. Some countries have requested for a two-year extension to achieve their obligations, and we hope that every country will be able to attain their core capabilities by 2014 so that the world can be a safer place as the international community works together to safeguard global health security. The recent reporting of three cases of severe respiratory illness caused by a new coronavirus in the Middle East is a timely reminder to the global community that we cannot afford to be complacent.

Dengue

6. Let me now say a few words about dengue. Dengue is a major public health concern worldwide. The WHO estimates that over 40 per cent of the world's population are currently at risk from dengue with an estimated half a million people hospitalised due to severe dengue each year. About two to three per cent of these severe dengue cases result in fatalities.

7. Dengue is endemic in Singapore. There were major dengue epidemics in Singapore in 2004, 2005 and 2007 involving between 9000 to 14000 cases each time¹. Since then, the National Environment Agency (NEA) has worked tirelessly to control dengue through a comprehensive approach to minimise vector breeding sites. This includes getting the support and involvement of all government agencies involved in land and property management as well as engaging the entire community to be vigilant against the threat of dengue. I’m pleased to note that our efforts have been fairly successful and we have not had another large dengue epidemic since 2007.

8. I must say that a large part of these efforts, beyond the medical ones, are effected through the community engagement process - which I myself was involved in as a community leader in 2004 and 2005. l remember visiting homes to encourage them to practice good habits to try to minimise the impact of dengue in the community. And until today, even though we have overcome that challenge, we will get updates on the dengue situation at every monthly Citizen Consultancy Committee meeting. We will also continue to remind our community leaders to help the community to fight dengue. So we take a holistic approach in Singapore where we work with the different stakeholders to ensure that we are safe from dengue.

9. Dengue is a constantly evolving public health threat, due to its changing epidemiology brought on by factors such as behavioural adaptations in the mosquitoes and mutations in the dengue virus. Dengue and vector research plays a key role in helping us understand and combat Dengue. Over the years, a number of dengue research projects have been carried out in Singapore. The largest has been the STOP Dengue project to improve the clinical management of dengue and better prevent dengue infections. The project was awarded a $25 million grant over five years by the National Research Foundation in 2008. Worldwide, researchers are working on dengue vaccines, dengue treatments and innovative ways to control the vector population. I believe that it is only through new knowledge and innovation that we can better control dengue in Singapore.

Conclusion

10. I am confident that this conference will provide a major platform to contribute to the sharing of ideas and knowledge to address the public health threats posed by emerging infectious diseases and dengue.

11. I wish each and every one of you a fruitful and enriching experience during this conference. Thank you.

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¹ The breakdown of dengue cases and deaths in each of the epidemic years are as follows:

2004: 9459 cases and 9 deaths; 2005:14209 cases and 27 deaths; 2007: 8826 cases and 24 deaths.