St Jude-Asia Forum In Paediatric Oncology

09 Mar 2007

By Ms Yong Ying-I, Permanent Secretary (Health)

Friends, ladies and gentlemen, Good morning. To our distinguished international guests, a very warm welcome to Singapore. It gives me great pleasure to be here today to speak at the opening of the Inaugural St Jude-Asia Forum in Paediatric Oncology.

Introduction

This forum is a significant milestone in childhood cancer research for Singapore and for the region. It provides a platform in Asia for world leaders in paediatric oncology to share important advances in the field and explore opportunities for international collaboration. I would like to commend the organisers, St Jude Children's Research Hospital, National University of Singapore, National University Hospital, and Viva Foundation for Children with Cancer, for establishing this important annual discussion and learning platform in paediatric oncology.

St Jude - Viva Programme for children with cancer

Singapore is pleased to have the opportunity to collaborate with St Jude through the St Jude-Viva Programme for Children with Cancer. St Jude is the foremost Children's Cancer centre in the world. At 90% remission rate, St Jude's results are among the best in the world. Under the capable leadership of Dr Pui Ching-Hon, St Jude has very generously sought to share its expertise in childhood cancer, through partnering Singapore to raise the cure rates for childhood leukaemia in Singapore and the Asian region. We are hopeful that this partnership will establish Singapore as a world class centre in Asia for paediatric cancer treatment, clinical research, and training of doctors and nurses from Singapore and the region. This can translate into many more precious lives saved.

NUH Children's Cancer Centre

As the seat of the St Jude-Viva programme, the NUH Children's Cancer Centre (CCC) will offer advanced therapies like specialised stem cell transplants. When completed in December this year, the NUH CCC will be able to treat about 150 new children with cancer every year. The NUH CCC will be a regional training centre in paediatric oncology, to train teams of doctors and nurses from designated centres of excellence within ASEAN. These professionals will establish paediatric oncology programmes in their respective countries, to be supported by their own charities. Indeed, over the past 6 years, NUH has already trained 3 Filipino doctors for 3 years each, through funding from Lee Foundation secured by Viva even before its formal establishment. The first Filipino doctor has already returned to head the St Jude-Davao Medical Centre Children's Cancer programme. I believe Dr Mae Dolendo and her team are in the audience today.

Viva & its supporters

This is thus a timely opportunity for me to congratulate Viva Foundation for its strong leadership in bringing together the diverse expertise and resources of multiple players: public institutions, private enterprise, and philanthropy so that we in Singapore have an important new capability today. Viva Foundation has raised $11m so far - no mean feat for an organisation just launched one year ago. I believe that everyone in the audience today fully realises that this initiative would not have happened without the passion, dedication and creativity of Mrs Jennifer Yeo who set up Viva Foundation to champion this endeavour. Let me also express my appreciation to the many donors, foundations and sponsors who have willingly come forward to lend their support. Novena Medical Centre-Far East Organisation is this Forum's largest sponsor. The St Jude-Viva programme is also generously supported by the Singapore Totalisator Board, Lee Foundation, Goh Foundation, Kuok Group of Companies, Mrs Betty Wu-Lee, Mr Tang Wee Sung, and many others. Many of you are in the audience today. I should also acknowledge the contributions of Viva's International Scientific Advisory Board, since Prof Ed Holmes and Prof Anjo Veerman are in the audience today as well. All of you have the joy of knowing that your generous gift of time, energy and funding will give NUH the opportunity to develop the institutional capabilities to advance the cure rate of children with cancer in Asia.

Strong Government Support for Community Initiatives

Some people have asked me why the Government shouldn't be responsible for funding the Singapore costs of the St Jude collaboration. The challenge that the Government faces is to prioritise its limited healthcare resources to serve the greatest public good. Unfortunately, no tax system in the world has enough funds to pay for every healthcare treatment that patients need or would like to have. More broadly, no country or society can become resilient if all challenges were left to the Government to tackle. Indeed, money is seldom the sole answer to a problem, if the other critical success factors are not in place. I understand that a major factor in the tie up between St Jude and NUH is the initiative, imagination, and determination of Viva and the demonstrated support from its friends in the community that impressed St Jude's leaders to support the collaboration. We will grow stronger when we pool our wits, our resources, our energy together to tackle challenges.

The government strongly welcomes community-driven initiatives such as Viva's. My Ministry will support and partner the community to enable such efforts where possible. To support Viva's work, my Ministry will make available funding under our Health Manpower Development Programme for 6 nurses to go to St Jude for specialised training over the course of 3 years. At St Jude, these nurses will undergo 6-months training attachments in cellular therapy, leukaemia and solid tumour treatment which are the strategic focus areas of the St Jude-Viva programme.

Such specialist nursing training is important because it equips our nurses to play an expanded role in advancing patient care. These nurses will also be involved in educating and training other nurses on their return. For example, the specialist training they receive at St Jude will prepare our nurses to contribute to the Certificate in Paediatric Oncology Nursing, a specialized training platform at NUH for local and regional nurses to obtain appropriate training in paediatric oncology. St Jude has started its support for this certificate course, with 2 nurse experts coming out to Singapore this January under HMDP and St Jude co-funding to conduct the course. I read the visit report written by one of the nurse experts, and I am delighted to see how well this collaboration had begun.

Singapore's Pursuit of Medical Excellence

This is an exciting time of great possibility in medicine and in the global healthcare landscape. Frontiers of medical knowledge are advancing rapidly. Singapore has achieved high standards of medical care, but we cannot stand still. We are therefore actively pursuing clinical and translational research as a strategic thrust to enhance our standards of medical excellence. We hope that new knowledge gleaned through clinical research can enable us to offer better treatments that can improve clinical outcomes, both for Singaporeans and patients worldwide who seek treatment in Singapore. The Government has recently and substantially expanded its competitive funding for clinical research. I encourage the NUH Children's Cancer Centre to explore with St Jude the submission of strong research proposals which the National Medical Research Council (NMRC) will consider alongside other competing grant proposals.

Role of Academic Medicine

A key prong of Singapore's future research and clinical delivery strategy will be the development of centres of academic medicine. Efforts at raising cure rates in areas such as paediatric oncology must be built on a sound foundation of strong medical capabilities and an atmosphere conducive to learning and research. We think that we have these ingredients at NUH and Government is currently studying how to take NUH to the next level as a centre of international standing, where high standards of clinical care delivery, education and research are integrated effectively. NUH is well placed to leverage the capabilities of the Yong Loo Lin School of Medicine at NUS, which currently ranks amongst the world's top ten universities for biomedicine. With the Government's expanded support for clinical research, NUH is now positioned to develop the 3 arms of research, teaching and service in a more holistic way. Let me not underplay the scale of the challenges ahead. These ambitions are high mountains to climb. But we hope that St Jude and Viva are positive about this story line, and feel confident that they have chosen a good base at NUH for their initiative.

In case I mislead you about NUH's ambitions to develop new capabilities in cutting-edge treatments based on new research, let me clarify that the Government's focus is not on esoteric treatments that come at enormous cost to the system and can only benefit a tiny handful of patients who can afford them. For our public sector system and nationally, our goal is cost-effective care that can benefit many people. And we hope that the research and care delivery in an environment that emphasises learning and a continuous quest for improvement will help us improve our understanding of how to deliver cost-effective care. My Ministry is therefore delighted that NUH started publishing some of its clinical outcomes online last July. This development has spurred other institutions across Singapore to follow, and this will raise clinical standards nationally. I encourage NUH to publish further comparisons of its clinical outcomes to international standards, especially to centres of excellence worldwide. At this stage of our development, we must think about benchmarking against the best in the world -- like St Jude. Our collaboration will give us the confidence to think this way.

In our shared quest to reach new peaks of clinical excellence, clinicians and researchers should draw upon the broader strengths of Singapore's vibrant medical eco-system. Our strength is our small size, and our weakness is also our small size. One key weakness is that with a small domestic population, parties in any one institution will only see a small pool of patients, too small to learn or grow capabilities. Our strength is that being small, we can easily bring together parties with relevant capabilities into a room, never mind an auditorium this size. I encourage NUH to see how to forge closer collaboration with KK Women's and Children's Hospital, and explore capabilities present in NUS in bio-engineering. The Biopolis has capabilities in stem-cell research and in bio-imaging that may be helpful. We will be stronger if parties in the clinical, scientific and academic communities know more about each others' capabilities and can collaborate together. (Prof Ed Holmes, Chair NMRC, will encourage more wine and cheese parties.)

Closing

As an international medical centre, Singapore is deeply committed to the advancement of medical knowledge and improvement in care delivery outcome for patients. In closing, may I say that we are happy to host this inaugural forum, which I hope will be the beginning of many future international collaborative efforts in childhood cancer. I wish you a stimulating and fruitful discussion. Thank you.