His Excellency Jose Manuel Barroso, former President of the European Commission
The Hon. Malcolm Turnbull, former Prime Minister of Australia
Her Excellency Tarja Halonen, former President of Finland
Dr Joseph Phaahla, Minister of Health, South Africa
Dr Jane Ruth Aceng, Minister of Health, Uganda
Ladies and gentlemen
1. Thank you for choosing Singapore as the venue of the Global Health Security Conference and inviting me to deliver the opening address.
2. The world is closely monitoring the clusters of cases of monkeypox infection that have been detected in many countries around the world.
3. As far as COVID-19 is concerned, Singapore is now in a relatively stable position. We have managed to step down most of our social restrictions and reopened our borders to allow free travel for vaccinated persons. Many people now go about their lives normally, with COVID-19 almost out of sight and out of mind, until yesterday when we announced higher cases.
4. However, those of us who have been deeply involved in the fight know that the pandemic is not over. We cannot let our guard down as we are likely to see new waves arising from new variants of concern. Indeed, we are beginning to see an increase in COVID-19 cases in our community, largely driven by newer Omicron subvariants BA.4 and BA.5. These variants are also causing a surge in cases worldwide.
5. We must be prepared to deal with future challenges, and we must learn from the lessons of the past as we deal with new pandemics. So today, let me focus on the immediate issue of global health security against pandemics.
An Unprecedented Global Response
6. A pandemic is a serious security threat. Because it threatens the functioning of global supply chains, prevents the delivery of food and essential items, forces border closures and suspends the exchange of peoples, causes a global scramble for vaccines and medical supplies, and over six million deaths (and that is probably an underestimation), it is a serious security issue.
7. Like all security issues that threaten our lives and the world, we need the collective will and action of the international community. If we look back at how we have responded to COVID-19 as an international community, I think it is a picture that is far from gloom and doom, because there are many unprecedented positive responses. Let me give a brief run down.
8. Due to the advancements in genomics science, days after its initial outbreak in Wuhan, the genome of the virus was sequenced, uploaded on a very established platform and made available to the world. This facilitated the development of tests enabling detection in infected persons. This, in turn, formed the foundation of infection control.
9. This contrasted with SARS in 2003, during which a test kit was not available until a month into the outbreak here, and we had to rely on clinical features, such as temperature-taking, to detect potentially infected persons.
10. Because of advancements in digital technology, our smart phones have become contact tracing devices. In Southeast Asia, there is the My Sejahtera in Malaysia, TraceTogether in Singapore and PeduliLindungi in Indonesia, and in Europe there is Germany’s Corona-Warn-App, Ireland’s COVID Tracker and Italy’s Immuni. These help us map the trajectories of virus transmission and alert us to potential exposure to infections.
11. International institutions were already in place when the outbreak happened to try to pull together a collective response for the world. This includes the relentless work of the World Health Organization (WHO), as well as the significant contributions of organisations such as GISAID, CEPI, FIND, Gavi and the Global Fund in helping the world understand the development of the virus, driving and catalysing the development of vaccines, diagnostic tools and therapeutics, and making them as accessible as possible throughout the world.
12. For example, GAVI, the Vaccine Alliance and the Coalition for Epidemic Preparedness Innovations (CEPI) have brought governments and businesses together through the Access to COVID-19 Tools (ACT) accelerator to rapidly develop, produce and improve equitable access to diagnostic tests, treatments, and vaccines. Under this effort, 1.3 billion doses of vaccines have been shipped to 87 low and lower-middle income countries around the world in 15 months. It also accounts for 82% of the vaccines delivered to low-income countries.
13. I think the most significant was the unprecedented speed at which vaccines were developed. It took only ten months, or about 300 days, from the initial outbreak of COVID-19, for mRNA vaccines to available. This, of course, was built on years of experience, research and testing that had gone on beforehand to understand coronaviruses, mRNA technology, refinements of the evaluation process and innovations in performing clinical trials.
14. Today, pharmaceutical companies are working on multivalent, or pan-coronavirus vaccines, to better protect humankind against a fast-mutating virus. Scientists, under the coordination of CEPI, are working on the ambitious 100-day vaccine development project for the next pandemic threat. This amazing compression of vaccine development timeline was unthinkable during the previous pandemics.
The Case for Global Coordination
15. The global health response against the pandemic, while I think overall positive, has not gone smoothly. Vaccines and diagnostic tools may have been made available, but the lack of consumables had impeded large scale production at certain points in time. There were disruptions in supply of raw materials due to export controls imposed by certain countries. There were complaints about patent protection that prevented more widespread production and supply of vaccines.
16. These are all part of the unhappiness and discontent against the global system of innovation and production. However, if this system did not exist in the first place, there would not be any international scientific collaboration, no global sourcing for rapid production and delivery, nor any incentive for commercial pharmaceutical companies to invest in innovation and technological breakthroughs. Without the pre-conditions made possible by globalisation, we would not likely have had COVID-19 vaccines in record time in the first place.
17. The risks and benefits of globalisation, free trade and international collaboration are most stark to small countries like Singapore. For us, globalisation made available COVID-19 vaccines which we would not have been able to develop on our own. International trade strengthened our security due to diversification of supply. Often, it lowered costs as we were able to identify more cost-efficient sources from which to purchase products and services.
18. On the other hand, export controls and protectionism in the name of self-sufficiency will ultimately harm all of us. We cannot afford for multilateralism to be dead nor for globalisation to reverse its course.
19. We live in a globalised world, with global problems needing global solutions. We must embrace the good and bad of an inter-connected and mutually dependent world and make the best of it. Corruption, greed, poor policies and weak institutions are often at the heart of societal problems, but the realities of politics mean that globalisation often takes disproportionate blame.
20. Globalisation and multilateralism must be part of the solution of future pandemics. The impact of COVID-19 has been catastrophic, but I believe history will judge humankind’s response to be on the whole, swift and effective.
Capabilities Disparity and Vaccines Inequity
21. Now let me talk about a significant shortcoming of our pandemic response. There is a major one, which we need to collectively address, and that has to do with disparity and inequity between countries – in terms of capabilities in managing the pandemic and access to vaccines.
22. Delays in the detection of new variants of concerns or new pathogens will mean losing precious days and weeks to contain the spread of new threats. Today 92% of genomic surveillance data comes from high income countries and only 8% from low- and middle-income countries.
23. More importantly, so long as there are regions in the world which have limited access to vaccines and their population under-vaccinated, we risk the virus undergoing evolutionary pressure and mutating into something we cannot deal with that knocks us back to square one in this game of snakes and ladders.
24. We are collectively building a global commons here. Until all regions and countries in the world have the local capabilities to mount an adequate response to detect deadly viruses and build up their population immunity, our collective response is incomplete and we are only as strong as the weakest link.
25. The underlying conditions that will give rise to future pandemics – urbanisation, climate change and globalisation – continue to be the realities of the world we live in. We will therefore face another pandemic in time to come, and the problems of capability disparity and vaccines inequity will need to be narrowed and fixed, so that in the next pandemic, the virus cannot outrun us.
26. What should be our starting point? It should be to marshal global resources and determine how they should be used to best effect.
Strengthening Global Commons
27. To that end, in January 2021, the G20 established the High Level Independent Panel (HLIP), which recommended actionable solutions to achieve what I just mentioned. The HLIP’s proposals were considered at last year’s G20 meeting in Rome, and this year, under the chairmanship of Indonesia, further progress was made with the establishment of the Financial Intermediary Fund (FIF) under the World Bank.
28. This fund will serve as a dedicated source of resources for pandemic prevention, preparedness and response. What is different and encouraging is FIF has attracted over US$1 billion of funds, with contributions from the United States, European Union, Germany, Indonesia and the Wellcome Trust. Singapore has pledged a contribution of US$10 million, and we hope that more country and philanthropic contributions will follow.
29. I believe the establishment of the FIF is one of the most significant developments in international pandemic response over the past year. In the coming months, G20 Health Ministers and officials will have to work out the intended usage of the funds, and its governance structure and interface with the WHO.
30. Indonesian Health Minister Budi Sadikin, who chairs the G20 Health Ministers’ meeting, set out the parameters very well in our meeting last week in Yogyakarta. The source of funding has to be “new” money, and cannot be a diversion of “old” money that is currently used by other international institutions now; the fund has to be allocated between normal time and crisis time, including strengthening local healthcare capabilities in responding to a pandemic; deployment of funds needs to leverage the capabilities and work of existing infrastructure and institutions, so that we do not have to reinvent current practices.
31. Crucially, Minister Budi said that we need to work with the producers of the emergency medical countermeasures from the private sector, like pharmaceutical companies, because they will continue to be a critical part of the solution. This will include working with them to ensure adequate production capacity and a better distribution of vaccines between countries of all income levels.
32. Much work remains to make the FIF a significant addition to institutionalised global response against pandemics.
Forging Effective Partnerships and Regional Cooperation
33. Forging sustainable solutions also requires effective partnerships with all existing key institutions and agencies. The WHO will need to contribute its technical expertise to guide the allotment of FIF funding.
34. Existing global institutions, agencies and commercial companies continue to be vital in providing the infrastructure to develop, manufacture and deliver vaccines to all countries and regions in need.
35. Regional groupings, whether in Southeast Asia, Latin America, South Asia – various parts of the world – can play an important role, to serve as a bridge between countries and the global community. As a region, countries can more quickly work out solutions, such as to ease the movement of goods to those in need within the region, and facilitate clinical trials or expedite regulatory approvals, so that vaccines can reach the market faster.
36. The recently concluded WTO Ministerial Conference achieved several agreements, including changes to the Trade-Related Aspects of Intellectual Property Rights (TRIPS) regarding the use of patents during a pandemic crisis. It is a very encouraging development. While the agreements were not as substantive as the conclusion of a new round, it reinforces the relevance and importance of multilateralism and international cooperation, at a crucial time in human history.
37. Ladies and gentlemen, in the wake of COVID-19, it is Singapore’s sincere hope that the international community can strengthen the mechanism and support to bolster our global commons of preparedness and response against future pandemics.
38. I hope that this conference can be a platform for a good, constructive, honest exchange of ideas and a launch pad for partnerships. I wish everyone a thought-provoking and fruitful conference and I thank you for your commitment to global health security.
39. Thank you and have a great conference ahead.