The Right Honourable Helen Clark
Excellencies
Ladies and Gentlemen
1. I thank the Independent Panel for Pandemic Preparedness and Response (IPPPR) for inviting me to speak at this launch event today. My task today is to share the lessons Singapore has learnt from the COVID-19 pandemic, and how we are putting these lessons into practice, to prepare ourselves for the next pandemic.
2. Post COVID-19 pandemic, Singapore did a comprehensive review of our responses and documented it in a White Paper which we debated in Parliament. We noted the responses that were effective, but we also acknowledged areas where we have fallen short. Overall we think this is quite a transparent and open process.
3. The lessons are many, so let me focus on one key thrust, which is that governments, just like any other organisations, are prone to make the mistake of fighting the last war. And that was the case for COVID-19. Let me explain.
4. In many East Asian countries, our response was based on what we learnt from SARS. During SARS, we could snuff out the pandemic through thorough contact tracing and isolation. In Western countries, on the other hand, their responses, I think, are based on what they learned during a bad influenza season, so they tried to ride through the epidemic with higher than usual patient load at hospitals, but eventually, things would subside and go back to normal.
5. Both approaches turned out to be unworkable because they were fundamentally responses to the last war that the respective regions had experienced.
6. So in many East Asian countries, including Singapore, we soon realised that COVID-19 was far more transmissible than SARS, and we could not possibly contain it through tracing and isolation. On the other hand, Western countries found out that COVID-19 was much more severe than influenza, and trying to ride through the transmission wave overwhelmed their hospitals, leading to more deaths.
7. While we learnt lessons from the COVID-19 pandemic, the more enduring insight, or even wisdom, is to expect the next pandemic to be different from COVID-19. We need to be prepared for the worst-case scenario – meaning the next pandemic could be as severe as SARS, and as transmissible as an influenza virus.
8. When that happens, and we accept that in a pandemic the common mission as a healthcare jurisdiction is to minimise deaths, then we need a full range of measures. I would summarise these full range of measures into three categories, which was Singapore’s conclusion.
9. First, we need social restrictions, up to and including a lockdown, to minimise the number of people infected by the disease.
10. Second, we will sooner or later need vaccines and other medical countermeasures, so that we minimise the risk of infected persons from developing severe illness.
11. Third, we will need adequate and competent healthcare facilities, so that even those who are infected and have developed severe illnesses can be treated successfully and saved.
12. The first response, social restrictions to minimise infection, is entirely domestic. Governments need to prepare people to accept such measures, no matter how draconian they are, in an emergency. In Singapore, we amended the Infectious Diseases Act to confer the authorities the ability to implement appropriate social restrictions and response during a pandemic alert or during an emergency.
13. However, the second response of having vaccines and medical countermeasures, and the third response of adequate healthcare facilities, are not merely domestic efforts.
14. Developing vaccines and medical countermeasures, for example, is a global effort. Singapore is contributing to the 100-day mission with our niche expertise, but that is all we have – niche expertise. We do not have all the expertise to develop an effective vaccine for the next time. So we are not seeking to develop a Singapore vaccine for the next pandemic; we are working with scientists around the world to develop the best possible vaccine in as short a time as possible.
15. The world experienced the trauma and agony of vaccine inequity during COVID-19, which continues to be a major contention today. In my view, the best way to address vaccine inequity is to build up production capacity when we have the time and space to do so.
16. Capacity is not built up through coercion and force, but by encouraging and facilitating investment from the pharmaceutical industry. Governments need to be a strong partner to industry, to incentivise them to conduct R&D, formulate, produce and distribute the vaccines.
17. Through this approach, we have thus far attracted five vaccine manufacturers to set up their production facilities in Singapore, which will, in steady state, produce over a billion vaccine doses annually. Our domestic needs are relatively small, so we have no doubt that these facilities will be producing for the region and the world.
18. As for the adequacy of the healthcare system, while it is a domestic response, many countries of the Global South require support and help. They will need capacity building to strengthen disease surveillance systems, better equip primary care and expand acute care.
19. This will require global financing. That is the motivation in setting up the Pandemic Fund under the supervision of the World Bank. That is also why Singapore pledged about US$18 million to support the World Health Organization Investment Round for its 14th General Programme of Work 2025-2028. We hope to prioritise our contribution for capacity building amongst developing countries, and hopefully catalyse contributions by other nations.
20. Finally, I would like to thank the IPPPR for its work over the past few years, and I look forward to your continued efforts to better inform the world as we brace ourselves for the next pandemic, which is a matter of when and not if. Thank you.