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Defining the Times
2007 Spring Dialogues
Defining Singapore's Future
Ying-I Yong, Permanent Secretary, Ministry of Health, Republic of Singapore
"As it shifts from service-orientation to knowledge development, Singapore needs to develop academic health centers."
After years of focusing on clinical care, Singapore is making sweeping strides into the global realm of academic medicine, according to Ms. Ying-I Yong. She described the city-state's current health care system and health-related accomplishments, as well as new challenges and goals for the future. Consuming only 3.8% of Singapore's GDP, Singapore's health care system is a composite of the public sector, private sector, and charities. The public sector provides the bulk of tertiary care, as every citizen holds national catastrophic insurance, while the private sector provides the bulk of primary care.
Singapore is pursuing integration of care in order to create a holistic patient experience, and full implementation of electronic medical records (EMRs) is underway. The country runs national programs for health management, including some that are targeted at specific population groups.
Dramatically shifting from its historical clinical-orientation, medicine in Singapore is now emphasizing knowledge development. Ms. Yong described Singapore's foray into academic medicine through multiple avenues. Biopolis, a biomedical research hub shared by public and industrial researchers, opened in October 2006 anchored by a core group of scientists, including many recruited from the U.S.
"Singapore is keen to be part of global research networks."
Even as it recruits researchers from abroad, Singapore is building its own human capital pipeline. The STAR investigators award, a manpower development initiative modeled on the Howard Hughes investigator relationship structure, supports translational research. Singapore also restructured its grant-giving entity and is looking to the American model as it builds academic health centers. A joint medical school with Duke University will enroll its first students in August 2007.
Establishing and promoting a biomedical research enterprise poses major challenges, and Ms. Yong turned to academic health center leaders to provide advice on the many issues facing Singapore, such as: developing an organizational infrastructure for clinical translational research, determining the governance of academic health centers, addressing the inevitable rise in costs, ensuring an adequate supply of clinicians for Singaporean patients, and developing the health workforce.
While addressing these challenges, Singapore is meeting international standards in biomedical regulations, biomedical ethics, animal protection, and human subjects protection. As research becomes global, Singapore is keen to be part of global research networks.